ơ chế tan bị tổn hại, chẳng hạn như trẻ sơ sinh và người già, béo phì, nghiện rượu, những người dùng một số loại thuốc (tức là, các phenothiazin, anticholinergics, thuốc kháng histamin, giao cảm) và trong một số hoạt động gắng sức nặng | 28 Vital Signs and Resuscitation 2 dissipating mechanisms are compromised such as infants and the elderly the obese alcoholics those taking certain drugs . phenothiazines anticholinergics antihistamines sympathomimetics and in some engaged in heavy exertion . marathon runners . Anticholinergics diuretics phenothiazines and antihistamines suppress the sweating process Fig. . Fig. . Risk Factors for Hyperthermia. When the temperature approaches 106 F 41 C tachycardia and weakness occur. Neurological changes appear ranging from disorientation and bizarre behavior to seizures and unconsciousness. Although sweating may occur initially the sweating process eventually fails and the skin is hot and dry. Cells are damaged proteins are denatured mitochondria and cell membranes are destroyed and hemorrhages occur. Complications include shock brain damage acidosis muscle cell disruption kidney and liver failure and intravascular coagulation. Vital Sign 1 Temperature 29 The severity of the outcome is a function of the age and health of the patient medicines taken and degree of acclimatization. Early death is from cerebral edema brain cell damage and circulatory failure. Later problems involve the heart central nervous system and kidneys from rhabdomyolysis and acute tubular necrosis. Treatment in the field immediate cooling is mandatory. The person is moved to a cool environment the clothing is removed and he is splashed or sprayed with normal-temperature water. The ABCs are followed see Fig. . In the emergency department normal saline is administered at 1 liter per hour. Fanning is begun and ice-packs are applied to the groin and axillae. Treatment is discontinued when the core temperature is F 38 C . 2 Heat Exhaustion Heat exhaustion is volume depletion which may lead to shock. The person loses salt and water in various combinations without adequate replacement. It occurs in a hot environment over a longer period of time than heatstroke in the .
