What should be paid attention to in children with heatstroke?

summary

Human is a constant temperature animal. No matter how much the temperature changes, the body temperature can be maintained at about 36-37 ℃ under normal conditions through the regulation of hypothalamic thermoregulatory center. However, the human body has a certain tolerance limit to the rising degree and duration of the ambient temperature. When exposed to high temperature for a long time, the body will lose the function of regulation and compensation. Heatstroke or summer heat is defined as a series of symptoms, such as the disorder of thermoregulation, the disorder of water and electrolyte metabolism, the damage of nervous system function, etc., caused by long time of activity in high temperature, high humidity environment or direct sunlight. Generally speaking, people with acute onset and severe illness are called heatstroke. Patients with mild onset, mild symptoms and long duration are called summer fever. In recent years, the incidence rate of the air conditioner has decreased obviously due to the improvement of living standards and the extensive application of air conditioners.

What should be paid attention to in children with heatstroke?

The internal cause of the disease is physical weakness, and the external cause is summer heat fumigation. After children feel the heat, it accumulates in the lung and stomach, burns the Yin fluid of the lung and stomach. If the Yin fluid is damaged and the internal heat is blazing, they will get high fever and drink more thirsty. Summer heat is easy to hurt Qi, Qi deficiency subsides, Qi does not turn into water, and water tends to bladder and urinate more. The lung dominates the skin and hair, and also regulates the opening and closing of the skin. The lung fluid is injured by the summer heat, and the chemical source is insufficient. The water can not be applied, and the pores of the skin are blocked. Therefore, there is little sweating or sweating. Sweating and urination are the same Yin fluid. If sweating is closed, there will be more urine. If urine is too much, there will be fluid injury. Therefore, drinking water can help oneself. If the patient's condition is prolonged, or the spleen and kidney are deficient, and the internal true Yang is insufficient, it is easy to appear that the heat is abundant in the upper part and the Yang Qi is deficient in the lower part.

Heatstroke should be considered in children who have been exposed to high temperature environment or have a history of exposure to the sun, with elevated body temperature, sweating, dehydration, irritability, drowsiness, muscle twitch or disturbance of consciousness. The higher the body temperature, the longer the duration, the worse the prognosis. Body temperature up to 41 ℃ is a risk index, often coma or convulsion, if the fever continues for several hours, the survivors may leave permanent brain damage; When the body temperature is as high as 42 ℃, it is easy to secondary central respiratory and circulatory failure and lead to death; The loss of a large amount of sodium chloride in the body can also lead to paroxysmal limb muscle spasm and convulsion; Because of high fever, dehydration, acidosis, blood concentration or increased viscosity, DIC can be induced, so that the condition suddenly worsens or even dies.

The children with heatstroke should take effective cooling measures immediately. First of all, remove the child from the high-temperature environment, and transfer him to a cool and ventilated place or an air-conditioned room. After lying on his back, place ice bags on his head, neck, armpit and groin, and use cold water or 35% alcohol to wet the towel and wipe the whole body. When doing physical cooling, due to the stimulation of cold, the skin may have vasoconstriction and muscle tremor, which will affect the heat dissipation and increase the body's heat production. Therefore, it is often combined with drugs to cool down at the same time. Chlorpromazine can dilate peripheral blood vessels, reduce muscle tremor, and achieve the purpose of cooling. Generally, it is 1-1mg / kg every time and injected intravenously into normal saline for 1-2h. However, it is not suitable for patients with pale face, cold and wet extremities, and obvious decrease of blood pressure. Adrenocortical hormone has a rapid antipyretic effect and can reduce the incidence of heatstroke complications.

matters needing attention

Symptomatic treatment: according to the patient's condition, give symptomatic treatment, such as shock arrest, pressor, respiratory and circulatory support. Generally, the prognosis is good. The patients with long duration of hyperthermia after heatstroke may have permanent brain damage or even death. Due to persistent fever, loss of appetite and gradual weight loss, children with summer fever are prone to respiratory tract infection, dyspepsia, dehydration, acidosis, etc. A small number of children had onset in 2-3 summers, but the symptoms were mild and the course of disease was short.