Heat stroke

Case history #1

An 83-year-old bedridden man presents to the emergency department after being found unresponsive in his apartment. His medical history includes hypertension, and schizophrenia treated with antipsychotic medications. At the time of presentation, the city has experienced >7 days of temperature highs >104°F (>40°C). The patient lives on an upper floor of an apartment building, which has no air conditioner, and he lives alone with neighbors and family members looking in on him only intermittently. On evaluation, he is found to have a core temperature of 107.6°F (42°C).

Case history #2

A 23-year-old woman is brought to the medical tent after collapsing during a 10 km road race. The race start was delayed, and the ambient temperature at the time of starting was 105°F (40.5°C), with 90% humidity. The woman had traveled to take part in the race from her home, which was much cooler than the city in which the race took place. At the time of her collapse, she was found to be hypotensive and tachycardic. Rectal temperature was elevated at 105.8°F (41°C). She was initially combative and declined care, insisting that she would walk to her home 620 miles away instead of submitting to care by the race physicians.

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