This photo-info visual above was tweeted to me, Gloria Poole,Registered Nurse licensed in Missouri/ artist/author/cartoonist/illustrator/writer/photographer/ personhood promoter/white/Christian/twice-divorced/single-again/woman-mother of 2 grown daughters named Jennifer and leigh, by a meteorologist for one of the TV stations, though why I didn't write down which one I do not know. It is a good visual and since it was for the public's health, I am including it here with more info about heat stroke since that is the condition which causes death. It shows the symptoms of heat exhaustion which is the less dangerous condition that usually progresses to heat stroke if person stays in the heat instead of going indoors or into water to cool off. Heat stroke is a VERY DANGEROUS, life-threatening situation that must be treated immediately! This post is intended to provide health care professionals AND average people the first aid of heat stroke and the what to do next if heat stroke occurs.
Defining heat stroke : "The moment at which the rectal temperature reached 43.5˚C [110.12 degrees Fahrenheit] was considered as the time of onset of heat stroke [abbreviated HS].
What are heat strokes and why is it important to prevent them and treat them?
1. People die from heat stroke when it is not treated immediately!
"Heatwaves are hot weather events, which breach regional or national thresholds, that last for several days. They are likely to occur with increasing frequency in some parts of the world. The potential consequences were illustrated in Europe in August 2003 when there were an estimated 30,000 excess deaths due to a heatwave. Electric fans might be used with the intention of reducing the adverse health effects of a heatwave. Fans do not cool the ambient air but can be used to draw in cooler air from outside when placed at an open window. The aim of the fans would be to increase heat loss by increasing the efficiency of all normal methods of heat loss, but particularly by evaporation and convection methods. However, it should be noted that increased sweating can lead to dehydration and electrolyte imbalances if these fluids and electrolytes are not replaced quickly enough." https://www.ncbi.nlm.nih.gov/pubmed/22786530;
2. Heat stroke is preventable with early warning of weather conditions:
"In New York City, maximum heat index performed similarly to alternative and more complex metrics in estimating mortality risk during hot weather. The linear relationship supports issuing heat alerts in New York City when the heat index is forecast to exceed approximately 95-100 degrees F. Periodic city-specific analyses using recent data are recommended to evaluate public health risks from extreme heat."https://www.ncbi.nlm.nih.gov/pubmed/20056571;
Avoid "oven cities" ;https://www.ncbi.nlm.nih.gov/pubmed/21446212; "extremely hot summers (the average daily temperature in July is 37.2 degrees C and maximum daily temperature often exceeds 40 degrees C)."
"The excess risk of Heat Stroke during the heatwave with 1 to 4 level of intensity increased by 2.54, 2.97, 5.61, and 11.3 times, respectively, as compared with that of non-heatwave. Extreme heat is becoming a huge threat to public health..." https://www.ncbi.nlm.nih.gov/pubmed/28191617;
"Existing evidence suggests a significant impact of heatwave on mortality, but the magnitude of the effect estimates varies under different heatwave definitions. Heatwave-related mortality risks increased by 4% (using "mean temperatures ≥95th percentile for ≥2days" as a heatwave definition), 3% (mean temperatures ≥98th percentile for ≥2days), 7% (mean temperatures ≥99th percentile for ≥2days) and 16% (mean temperatures ≥97th percentile for ≥5days). Heatwave intensity plays a relatively more important role than duration in determining heatwave-related deaths. Heatwaves significantly increase mortality across the globe, but the effect estimates vary with the definition of heatwaves. City- or region-specific heat health early warning systems based on identified local heatwave definitions may be optimal for protecting and preventing people from the adverse impacts of future heatwaves.
Copyright © 2016. Published by Elsevier Ltd.; https://www.ncbi.nlm.nih.gov/pubmed/26878285;
3. Even with treatment heat stroke can damage permanently the organs of the human body: the brain and internal organs:
Effects of heat stroke on body :
"In the HS groups, the serum levels of TNF‑α, IL‑1β and IL‑6, as well as the numbers of apoptotic aortic endothelial cells were increased compared with the normothermic control group. Additionally, the plasma prothrombin time, activated partial thromboplastin time and D‑dimer level were significantly increased in the HS group compared with the normothermic control group following recovery for 6 h. By contrast, the platelet count was decreased in the HS group compared with the normothermic control group. The serum levels of creatinine, blood urea nitrogen, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase were increased and histopathological damage to multiple organs was observed in the HS group following recovery for 6 h.".... "In the STS‑HS [ treatment w/ IV sodium tanshinone IIA sulfonate (STS) ] groups, cytokine levels and apoptotic aortic endothelial cell numbers were reduced compared with the HS group after 6 h recovery. STS (40 mg/kg) treatment additionally improved the serum levels of organ injury indicators and plasma indicators of coagulopathy, and prevented histopathological damage to multiple organs. These findings demonstrated that STS treatment may ameliorate multiple organ damage by attenuating inflammatory responses, aortic endothelial cell apoptosis and DIC [Dessiminated Intravascular coagulation] in CHS. These results suggested that STS may hold potential as an alternative therapeutic strategy for the treatment of patients with HS."
Preventing heat stroke:
1) Avoid "oven cities" in summer.
2) Hydrate yourself when the external temperature is higher than 95 degrees fahrenheit.
3) Stay indoors on those days when temperature is 95 degrees or higher, except for critical tasks and when outdoors, minimize physical exertion.
4) Cool off in water: swimming pools, lakes, oceans, cool water in bathtubs.
5) Replace salt by adding it to food, and calcium [via milk products such as milk, yogurt, butter, ice cream] quickly since those are depleted by sweating.
6) Take 2 adult aspirin before you plan to be in extreme temperatures : Quote: "pretreatment with aspirin can provide preventive effects against heatstroke and reinforce the heat and fatigue endurance, which may be associated with inhibition of systemic IL-1betalevels and local iNOS levels." https://www.ncbi.nlm.nih.gov/pubmed/16094491
7) Avoid high temperature with low humidity exposure to outdoors: "Under high temperature and low humidity, the risk of heat stroke showed the highest."
First Aid for heat stroke:
1} Immerse person in cold water as soon as possible and stay with person, till body temperate drops.
2) Give aspirin if patient older than 16 years, and can swallow of two tablets of 325 mg each but do NOT give children that dose. Call pediatrician or Emergency Dept with the weight of the child to get the dose for a child since it is calculated by weight of child and is given with "baby' aspirin which is much smaller dose than an adult.
3) IF the first aid does not lower the body temperature substantially and the symptoms go away, take the person to the Emergency Department closes to you.
Things that increase the risk of heat stroke:
A) "Taking Indomethacin before heat waves might increase severity of heat stroke : "HI doses of INDO resulted in 45% mortality rate by 24hrs(HI INDO +HS group). The gut showed dramatic increases in gross morphological hemorrhage in HI INDO +HS in both survivors/non-survivors. HI INDO +HS survivors had significantly lower red blood cell counts and hematocrit suggesting significant hemorrhage. In the liver, HS induced cell death at HYPO and increased inflammation at Tc,Max, HYPO, and 24hrs with HS, however there was no additive effect with INDO +HS. Further, the metabolic profile of the liver was disturbed by heat, but there was no additive effect of INDO +HS. This suggests there is an increase in morbidity risk with INDO +HS, likely resulting from significant gut injury."https://www.ncbi.nlm.nih.gov/pubmed/28596269;
B) Lithium : "Permanent Cerebellar Degeneration After Acute Hyperthermia with Non-toxic Lithium Levels: a Case Report and Review of Literature.Copyright © 2017, Journal of Applied Physiology.' https://www.ncbi.nlm.nih.gov/pubmed/28593454;
C) Dehydration as preexisting state.
D) Low salt diets in summer deplete the sodium chloride ions your body has to have to have normal heart beat and brain function.
E) Avoiding all calcium rich foods on certain diets depletes the calcium ion your heart needs to function.
Medical Treatment of heat stroke:
A) " Our results support multiple organizations that deem CWI [cold water immersion] as the only acceptable treatment, when compared to the cooling rates of The Polar Life Pod® and ice sheets."https://www.ncbi.nlm.nih.gov/pubmed/28344741;
B) Give aspirin! "but rats in the aspirin group had significantly longer survival time (P<0.05). ECG showed that the heart rate and QT intervals of both groups were increased, while PR intervals were decreased after heat exposure. Plasma IL-1beta levels in the two groups were significantly elevated at 60 min in comparison with the basal level (P<0.05), which was more obvious in the control group (P<0.05).
Pretreatment with anti-inflammatory dose of aspirin can provide protection against heat stroke in rats, which may be associated with the inhibition of elevation of plasma IL-1beta levels by aspirin." https://www.ncbi.nlm.nih.gov/pubmed/15201075;
C) FROM NIH Abstract:
Dexamethasone (DXM) is known as an immunosuppressive drug used for inflammation control. In the present study, we attempted to examine whether DXM administration could attenuate the hypercoagulable state and the overproduction of pro-inflammatory cytokines, improve arterial hypotension, cerebral ischemia and damage, and vital organ failure in a rat model of heat stroke. The results indicated that all the rats suffering from heat stroke showed high serum levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), accompanied with increased prothrombin time, activated partial thromboplastin time and D-D dimer, and decreased protein C. During the induction period of heat stroke, plasma levels of blood urea nitrogen (BUN), creatinine, glutamic oxaloacetic transaminase (SGOT), glutamic pyruvic transaminase (SGPT), and alkaline phosphatase (ALP), were consistently increased. High striatal levels of glycerol, glutamate, and lactate/pyruvate were simultaneously detected. On the contrary, the mean arterial pressure, plasma levels of interleukin-10 (IL-10), and local cerebral blood flow at the striatum were all decreased. Importantly, intravenous administration of DXM substantially ameliorated the circulatory dysfunction, systematic inflammation, hypercoagulable state, cerebral ischemia and damage during the induction period of heat stroke. These findings demonstrated that DXM may be an alternative therapy that can ameliorate heat stroke victims by attenuating activated coagulation, systemic inflammation, and vital organ ischemia/injury during heat stroke."https://www.ncbi.nlm.nih.gov/pubmed/25411796
D) "In the STS‑HS [ treatment w/ IV sodium tanshinone IIA sulfonate (STS) ] groups, cytokine levels and apoptotic aortic endothelial cell numbers were reduced compared with the HS group after 6 h recovery. STS (40 mg/kg) treatment additionally improved the serum levels of organ injury indicators and plasma indicators of coagulopathy, and prevented histopathological damage to multiple organs. These findings demonstrated that STS treatment may ameliorate multiple organ damage by attenuating inflammatory responses, aortic endothelial cell apoptosis and DIC in CHS. These results suggested that STS may hold potential as an alternative therapeutic strategy for the treatment of patients with HS."
E) From NIH Abstract:
The purpose of the present study was to assess the therapeutic effect of hypothermic retrograde jugular vein flush (HRJVF) on heatstroke. HRJVF was accomplished by infusion of 4 degrees C isotonic sodium chloride solution via the external jugular vein (1.7 mL/100 g of body weight over 5 min). Immediately after the onset of heatstroke,....Immediately after the onset of heatstroke, resuscitation with an i.v. dose of 4 degrees C saline significantly improved survival during heatstroke (208-252 min). All heat-stressed animals displayed systemic inflammation and activated coagulation, evidenced by increased tumor necrosis factor alpha, prothrombin time, activated partial thromboplastin time, and d-dimer, and decreased platelet count and protein C. Biochemical markers evidenced cellular ischemia and injury/dysfunction: plasma levels of blood urea nitrogen, creatinine, glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, and alkaline phosphatase; and striatal levels of glycerol, glutamate, and lactate/pyruvate; dihydroxy benzoic acid, lipid peroxidation, oxidized-form glutathione reduced-form glutathione, dopamine, and serotonin were all elevated during heatstroke. Core and brain temperatures and intracranial pressure were also increased during heatstroke. In contrast, the values of mean arterial pressure, cerebral perfusion pressure, and striatal levels of local blood flow, partial pressure of oxygen, superoxide dismutase, catalase, glutathione peroxidase, and glutathions reductase activities were all significantly lower during heatstroke. The circulatory dysfunction, systemic inflammation, hypercoagulable state, and cerebral oxidative stress, ischemia, and damage during heatstroke were all significantly suppressed by HRJVF. These findings demonstrate that brain cooling caused by HRJVF therapy may resuscitate persons who had a stroke by attenuating cerebral oxidative stress, systemic inflammation, activated coagulation, and tissue ischemia/injury during heatstroke."
Thanks to the readers of the previous post of this blog from US,Switzerland,Germany, Russia and Ukraine. I have readers and twitter followers in 74 countries of world and you can see that list of countries on my https://gloriapoole.blogspot.com
I do not own the copyright to the visual at top of this post [about heat stroke] that was provided by the TV station but since it was tweeted to me, and I am not charging a fee for the use of this blog, it is "fair use doctrine" of copyright. I do however own the copyright to this blog as an entirety especially to the art sketches I have added as illustrations from time to time that are my own creations, so see the previous links to see information about me, Gloria Poole,Registered Nurse/artist/author/illustrator/cartoonist/writer/blogger/prolife advocate/Christian/ twice-divorced white woman. It is necessary to make the point that I am white woman because according to Tallahassee Police there is also a black woman who told police her name was Gloria Poole, but she had no proof of that according to that Police years ago. So, I have to clarify that point to avoid confusion.
You can see my Feb 2017 selfie :
My selfie in Feb 2017:This is a selfie of me [Ms] Gloria Poole,Registered Nurse, and artist in all visual mediums, that I photographed yesterday to add to a blog. It is necessary to do this for several reasons: there was a well-orchestrated effort last week to totally annihilate me from the web and to steal my landline telephone, a cell phone number of mine, and there was a fake obituary that was sent to Google to try to fool the world about me. I am alive and well [except for the permanent damage to my physical body from trauma on 2 occasions]. I am adding this here today to document that I am alive and well, and still very much active on web and in other ways. I photographed this in my bathroom so I could use the mirror to see the push button on other side of camera, and forgot I had a towel over the door! And that white streak is where I wiped mirror first but didn't realize til photo that threads got on mirror. I often look very red in summer because I walkabout a lot in the sunshine. I am a white woman and that is apparent in a better light. photo-by-gloriapoole. Copyright. Gloria Poole. Missouri. 27 Feb 2017. ALL RIGHTS RESERVED.
https://prolife-nurse.blogspot.com/p/about-gloria-poolern.html is a profile page for me.
This is another selfie of me same day in Feb 2017 after I had been crying because of cyber-attack by prodeathers that was intended to destroy me:
photo-by-gloriapoole. This is my selfie --one in a series of photographs of myself I,
, Registered Nurse and artist, photographed yesterday with two different cameras after I had cried so hard about the attempt by evil people to destroy me in March 2017. I am posting the different selfies to different blogs as each is different pose, to prove that the fake obituary that was sent to Google was a treacherous scheme of evil people to steal my content and life. I am alive and well except for much trauma to me on two different occasions that left permanent damage to my brain, leg, chest, but I have survived all of that. Copyrighted photo.
You can follow me on twitter at any of all of these twitter accounts which I accumulated over time of necessity and each is different: @gloriapoole; @gloria_poole; @glorias_writing; @ProlifeNurse; @personhood1;@tweetie0817,@gpoole817, and @tartan_Bliss.
This blog and all content,and this apartment in Missouri, and all telephones and all equipment and all possessions in it and all financial accounts that buy services related to what I create belong exclusively to me Gloria Poole of Missouri. There are NO business financial accounts for this account or any other account of mine. Also, all words, all photos and all art on it, are owned by me and were created and posted by me Gloria Poole , RN, artist of Missouri and Georgia, signed by me, photographed by me and uploaded by me, and I own all rights to it collectively and individually.