Heat stroke is a disease characterized by dysfunction of the thermoregulatory center, failure of the sweat glands and excessive loss of water and electrolytes under hot weather, high humidity and windless environmental conditions. According to the different pathogenesis and I clinical manifestations, heat stroke is usually categorized into heat cramps, heat exhaustion and heat (sun) ejection disease. Clinical manifestations include headache, dizziness, thirst, excessive sweating, weakness and soreness of the limbs, lack of concentration, and uncoordinated movements. Heat stroke is a general term for the symptoms of impaired thermoregulation of the body, disorders of water and electrolyte metabolism and impairment of nervous system function under the prolonged action of high temperature and heat radiation. Patients with craniocerebral disorders, the elderly, the weak, and women with poor maternal heat tolerance are particularly susceptible to heat stroke. Heatstroke is a life-threatening emergency illness that can cause convulsions and death, permanent brain damage or kidney failure if not treated quickly and vigorously. A core body temperature of 41°C is a sign of a serious prognosis; a slight increase in temperature is often fatal. Old age, debility and alcoholism can worsen the prognosis. The diagnosis of heatstroke can be made on the basis of elevated body temperature, muscle cramps and/or fainting when working and living in a hot environment, and other diseases should be excluded before diagnosis. Prevention of heatstroke should fundamentally improve labor and living conditions, isolate heat sources, reduce the temperature of the workshop, adjust the work and rest time, and supply cool drinks containing 0.3% salt. Publicize the knowledge of prevention and treatment of heat stroke, especially the early symptoms of heat stroke. To have cardiovascular organic disease, hypertension, central nervous system organic disease, obvious respiratory, digestive or endocrine system diseases and liver, kidney disease patients should be listed as high temperature workshop employment contraindications. Etiology There are many causes of heat stroke, working in a high-temperature workshop, if coupled with poor ventilation, it is highly susceptible to heat stroke; agriculture and open-air work, by the direct exposure to the sun, coupled with the earth by the sun’s exposure to the sun, so that the atmospheric temperature rises again, so that the human meninges are congested, the cerebral cortex ischemia and caused by heat stroke, the enhancement of the humidity in the air is easy to induce heatstroke; in public places, the family, crowding and concentration of crowdedness, heat dissipation is difficult. Heat production is concentrated, and it is difficult to dissipate heat. In addition to high temperature, sun exposure, mental overstress, too dense, too much work intensity, too long, sleep deprivation, excessive fatigue, etc. are common triggers. In the high temperature (generally refers to the room temperature of more than 35 ℃) environment or hot summer sun exposure to engage in a certain period of time of labor, and no adequate measures to prevent heat stroke, often prone to heat stroke. Sometimes the temperature does not reach high temperature, but due to high humidity and poor ventilation, can also occur heat stroke. Elderly, weak, fatigue, obesity, alcohol, hunger, water loss, salt loss, wearing tight, impermeable clothes and pants, as well as fever, hyperthyroidism, diabetes mellitus, cardiovascular disease, extensive skin damage, congenital lack of sweat glands and the application of atropine or other anticholinergic nerve drugs that affect the secretion of sweat glands and other factors that often contribute to the pathogenesis of heat stroke. Normal body temperature is generally constant at about 37 ℃, is through the role of the hypothalamus thermoregulatory center, so that the heat production and heat dissipation of the results of balance. In addition to the body’s heat production mainly from the body’s oxidative metabolic process of basic heat, muscle contraction due to heat is another major source. When the ambient temperature exceeds the skin temperature, the body heat dissipation depends only on sweating and evaporation from the skin and alveolar surface. For every 1g of water evaporated, 2.43KJ (0.58kcal) of heat is lost. Heat from the deep tissues of the body is carried by circulating blood flow to the subcutaneous tissues to be dissipated via dilated cutaneous blood vessels. Therefore, the more dilated the skin blood vessels and the more blood flow through the skin blood vessels, the faster the heat dissipation. If the body produces more heat than it dissipates or if heat dissipation is impeded, there is excessive heat accumulation in the body, causing damage to organ function and tissues. According to the severity of clinical manifestations, heatstroke can be divided into aura heatstroke, mild heatstroke and severe heatstroke, and the relationship between them is progressive. Symptoms of heat stroke Under high temperature environment, headache, dizziness, thirst, excessive sweating, limb weakness and acidity, poor concentration, uncoordinated movements and other symptoms. Body temperature is normal or slightly elevated. If you move to a cool and ventilated place in time and replenish water and salt, you can recover in a short time. Symptoms of mild heatstroke Body temperature is often above 38 degrees. In addition to dizziness and thirst, there are often flushing, profuse sweating and burning of the skin, or cold and clammy extremities, pallor, drop in blood pressure and rapid pulse. If treated promptly, recovery can often be achieved within a few hours. Severe heatstroke symptoms As the name suggests, it is the most serious type of heatstroke, if not treated in time will be life-threatening. This type of heatstroke can be divided into four types: heat cramps, heat exhaustion, sunstroke and pyrexia. Characteristics of heat cramp symptoms: most often occur in a large amount of sweating and thirst, drink a lot of water and salt supplementation is insufficient to cause a rapid and significant decrease in the concentration of sodium chloride in the blood. This type of heat stroke occurs when there are sudden paroxysms of pain in the muscles. Characteristics of heat exhaustion symptoms: this kind of heat stroke often occurs in the elderly and people who fail to adapt to the high temperature for a while. The main symptoms are dizziness, headache, panic, thirst, nausea, vomiting, cold and clammy skin, drop in blood pressure, fainting or confusion. At this time the body temperature is normal or slightly high. Characteristics of sunstroke symptoms: the cause of this type of heatstroke is just as its name suggests, because directly under the scorching sun, strong sunlight penetrates the head skin and skull caused by brain cell damage, resulting in congestion of brain tissue, edema; due to the damage is mainly the head, so the first discomfort is a severe headache, nausea and vomiting, irritability, and then coma and convulsions can occur. Symptoms of pyrexia characteristics: there are also some people in the hot environment to engage in physical labor for a long time, the body produces too much heat, and not enough heat dissipation, resulting in a sharp rise in body temperature. Early onset of a large number of cold sweat, followed by no sweat, shallow and rapid respiration, rapid pulse, restlessness, confusion, blood pressure drop, and gradually to coma accompanied by convulsions of the limbs; severe cases can produce cerebral edema, pulmonary edema, heart failure. Treatment: Infusion and cooling therapy. Heat exhaustion Causes: Water and salt replenishment can not catch up with the large amount of sweating, forming the symptoms of dehydration when it occurs. Symptoms: Various symptoms, such as a rise in rectal temperature to 39°C, cold skin, and marked sweating. Treatment: Fluid infusion and cooling therapy. Cause: Occurs when only water is replenished after profuse sweating and there is a shortage of salts and minerals. Symptoms: Sudden, painful cramps and stiffness develop. Body temperature is higher than usual and sweating is evident. Treatment: Transoral injection of saline. Pyrexia Cause: Occurs when the thermogenic center [of the inferior colliculus] is impaired and thermoregulation is lost. Symptoms: High degree of impaired consciousness, body temperature rises above 40°C, inconspicuous sweating, dry skin. Treatment: Emergency hospitalization and cooling therapy as soon as possible. Treatment and medication Patients with heat cramps and heat exhaustion should be quickly transferred to a cool, ventilated place to rest or lie down. Give cool saline and cool salty drinks by mouth. Patients with peripheral circulatory failure should be given intravenous saline, dextrose solution and potassium chloride. Patients usually recover within 30 minutes to a few hours after treatment. The prognosis of patients with pyrexia is serious, with a mortality rate of 5% to 30%, so the following first aid measures should be taken immediately. Physical cooling In order to reduce the patient’s high temperature quickly, the patient can be immersed in 4 ℃ water, and massage the skin of the limbs, so that the skin vasodilatation and accelerated blood circulation, to promote heat dissipation. In the physical cooling process must be observed and recorded at any time anal temperature, to be anal temperature down to 38.5 ℃, should immediately stop cooling, the patient will be transferred to the room temperature of 25 ℃ below the environment to continue to closely observe. If the body temperature has risen, can be re-immersed in 4 ℃ water or cool water bath, shower, or in the head, armpits, groin placed in the ice packs, and fan blowing, to accelerate the heat dissipation, to prevent the temperature from rising. Elderly, frail and patients with cardiovascular disease often can not tolerate 4 ℃ bath, some patients coma is not deep, immersed in 4 ℃ water may occur muscle shaking, but increase heat production and aggravate the burden on the heart, can apply other physical cooling methods. Drug cooling Chlorpromazine’s pharmacological effects are to regulate the function of the body temperature center, dilate blood vessels, relax muscles and reduce oxygen consumption, is to assist the physical cooling of the commonly used drugs.