Signs of Heat Stroke

Posted Posted in Continuing Education, Homestudy, Seminars, Webinars

thermometer-501608_640Blizzards, floods, earthquakes, hurricanes, and tornadoes make headlines. They result in many tragic deaths each year. However, all of these natural disasters together do not kill as many people as heat stroke.

Heat-related illness often progresses from heat cramps, to heat exhaustion to fulminant heat stroke. Heat cramps are exertion-induced muscle contractions that develop during or after exercise in high temperatures.

Heat exhaustion is a clinical syndrome of fatigue, weakness, nausea, dizziness and malaise. Syncope or fainting may occur, but mental status usually remains normal. Heat Stroke is life-threatening hyperthermia which provokes a severe systemic inflammatory response with multiple organ dysfunction or failure. Simply put, heat stroke is deadly.

The clinical presentation of heat stroke typically falls into two categories: (1) classic and (2) exertional.

  • Classic heat stroke often evolves over 2 to 3 days of exposure to extreme temperatures during a heat wave. Infants and older, sedentary, frail people without access to air- conditioning and adequate fluids are at greatest risk. Classic heat stroke was responsible for hundreds of deaths in Europe during the severe heat waves in 2003. A similar situation has recently occurred in India.
  • Exertional, heat stroke develops more abruptly in healthy, active people like athletes, people working outdoors or military recruits. High level exertion in extreme heat overwhelms the ability of the body to regulate internal temperature. Muscle tissue breaks down, renal failure develops, brain functions are severely compromised, and clotting disorders develop.

People with heat stroke are often confused and agitated. They can injure themselves & others before they collapse into seizures and comma.

One of the most important early clues to the recognition of heat stroke is the cessation of sweating despite exertion in extreme heat and humidity. The skin becomes hot & flushed but dry.

This is a very worrisome sign since perspiring is a crucial part of regulating internal body temperature. At this point, the pulse and respiratory rate are usually elevated.

Initial treatment of heat stroke in the field involves evaporative cooling by constantly wetting the skin with water (ice water is not necessary). Cold packs can be applied to the groin and axillary area.

Seizures, vomiting, and aspiration can develop during cooling, so the airway must be protected. Curiously, typical fever-reducing medications such as aspirin, acetaminophen, or ibuprofen are ineffective in lowering body temperature in heat stroke. Transport to the nearest hospital and ICU (Intensive Care Unit) are essential.

Preventing heat stroke is obviously much easier than treating it. Common sense measures such as avoiding exertion in high heat and humidity, staying well- hydrated and remaining in an air- conditioned environment are key. Special attention should always be paid to infants, children, the elderly and chronically ill. If ever there were a condition where an ounce of prevention was worth a pound of cure, it would surely be heat stroke.

Learn more about heat stroke and other heat related illnesses in our homestudy courses.


Knee Pain

Posted Posted in Continuing Education, Homestudy, Pain

Knee PainBy Rajinder Hullon, MD, JD

Knee pain is one of the most common complaints seen in outpatient medical-treatment centers. This disorder affects 20 percent of our population and is the fifth most common health complaint, accounting for millions of doctor visits each year.

Physicians treat knee pain more frequently these days for a number of reasons. Better health care options and availability have resulted in people living longer. Because the knee joint is one of the key weight-bearing joints in the body, it is subject to more wear and tear with age. Older people are more likely to suffer from some degree of knee pain.

The nationwide problem with obesity has also contributed to the increasing frequency of knee complaints. More stress is placed upon the knee joint the heavier a person is. At some point, the knee joint will be unable to support this stress, and surgical intervention may be required.

Preventing Knee Injuries

As everyone knows, an ounce of prevention is worth a pound of cure. In the case of the knee joint, the American Academy of Orthopedic Surgeons and the American Orthopedic Society for Sports Medicine offer these suggestions to avoid pain or injury:

  • Stay in shape. Good general conditioning helps control or prevent knee pain, particularly patello-femoral pain. Overweight individuals may need to lose weight to prevent excessive stress on the knees. Doctors recommend a 5-minute warm-up before running or beginning any other exercise.
  • Stretch. Stretching is a good warm-up technique before and after any exercise. When performed in the prone (face down) position, it helps maintain the flexibility of the ligaments, muscles, and tendons within the knee joint.
  • Increase training gradually. Work up gradually and avoid sudden changes in the intensity of exercise.
  • Use proper running gear. Running shoes should have good shock absorption and quality construction. Be sure shoes fit properly and are in good condition. If you have flat feet, you may need shoe inserts. Running shoes should be replaced every 3-4 months if used consistently.
  • Use proper running form. Lean forward and keep the knees bent. Also, try to run on a clear, smooth, and reasonably soft surface. Never run straight down a steep hill. Walk down it, or run in a zig-zag pattern.

Since there can be many different causes for such pain, the clinician must take great care to make an accurate diagnosis in order to ensure proper medical and/or surgical treatment.

Many knee pain cases also involve overuse or injury from sporting activities. In these situations, individuals should be aware of the importance of warm-up exercises and, and if pain arises, the need to seek early treatment to avoid permanent or disabling knee injury.

Of course, if you experience knee pain, the best thing you can do is see a doctor, and remember that if you’ve been diligent about exercise for a long time, a week off for rest and recovery might be the best thing you can do, whether you’ve come down with an injury or not.

INR (Institute for Natural Resources) offers continuing educations courses that cover many medical conditions including knee pain.