What happens when you get heat stroke? - Douglas J. Casa

Summary

The video script narrates the story of Douglas Casa, who survived exertional heat stroke during a race in 1985 and has since saved 167 others. It explains the dangers of this condition, which is a leading cause of death among athletes and soldiers. The script outlines the process of diagnosing heat stroke through core body temperature and physical symptoms, emphasizing the critical 'cool first, transport second' treatment approach, including rapid cooling methods and the importance of immediate action to prevent severe outcomes.

Takeaways

• 🏃‍♂️ Douglas Casa, at 16, suffered an exertional heat stroke during a championship race, highlighting the risk even for young athletes.
• ⚔️ Exertional heat stroke has been a concern from ancient times to present, affecting athletes and soldiers due to intense exercise in the heat.
• 🌡️ Unlike classical heat stroke, exertional heat stroke is caused by physical exertion under heat and humidity, not just high ambient temperatures.
• 🔥 During exercise, nearly 80% of energy is converted to heat, which under normal conditions, the body can dissipate through sweating.
• 💦 Uncompensable heat stress occurs when the body cannot lose heat fast enough, leading to a dangerous rise in core temperature.
• 🧬 High core temperatures can cause proteins and cell membranes to denature, impairing cell function and leading to cell leakage.
• 🚑 Exertional heat stroke is diagnosed by a core body temperature over 40°C along with physical and CNS symptoms like confusion or unconsciousness.
• 🌡️ Rectal thermometers are the most accurate method to measure core body temperature in cases of suspected heat stroke.
• 🧊 The primary treatment is rapid cooling on site before transportation, as the body can endure high temperatures for a short time without permanent damage.
• 🛁 Placing the victim in an ice water tub or dousing with ice water and applying wet towels can help lower body temperature quickly.
• 🆘 Always call emergency services first, then begin cooling measures and keep the victim calm until help arrives.
• 🌡️ On-site medical staff should continue cooling until the core temperature drops to 38.9°C, ensuring the best chance of survival.

Q & A

What incident occurred to Douglas Casa in 1985 during the Empire State Games?

Douglas Casa, a 16-year-old athlete, suffered an exertional heat stroke during the championship 10,000 meter track race, collapsing twice before the finish line.

How many people has Douglas Casa helped save since his own heat stroke incident?

Douglas Casa has helped save 167 people in similar circumstances to his own heat stroke incident.

What is the difference between exertional heat stroke and classical heat stroke?

Exertional heat stroke is caused by intense exercise in the heat and primarily affects athletes and soldiers in training, while classical heat stroke affects vulnerable individuals like infants and the elderly during heat waves.

Why is exertional heat stroke considered a serious concern?

Exertional heat stroke is a serious concern because it is one of the top three killers of athletes and soldiers in training.

What percentage of energy used during exercise is transformed into heat?

Nearly 80% of the energy used during exercise is transformed into heat.

What is compensable heat stress and how does the body handle it?

Compensable heat stress is a condition where the body can dissipate heat as quickly as it's generated through cooling methods like the evaporation of sweat.

What causes uncompensable heat stress?

Uncompensable heat stress occurs when the body is unable to lose enough heat due to overexertion or high temperatures and humidity, leading to an increase in core temperature beyond normal levels.

What are the potential consequences of a core temperature increase due to exertional heat stroke?

Potential consequences include protein and cell membrane denaturation, cell dysfunction, liver damage, blood clot formation in the kidneys, damage to the gastrointestinal tract, and even vital organ failure.

What is the main criterion for diagnosing an exertional heat stroke?

The main criterion for diagnosing an exertional heat stroke is a core body temperature greater than 40 degrees Celsius, along with physical symptoms or signs of central nervous system dysfunction.

Why is it important to initiate rapid cooling on site for an exertional heat stroke victim?

It is important to initiate rapid cooling on site because the human body can withstand a core temperature above 40 degrees Celsius for about 30 minutes before cell damage sets in.

What is the recommended initial treatment for an exertional heat stroke victim?

The recommended initial treatment is to cool the victim first using methods like an ice water tub or wet towels, while monitoring vitals and waiting for emergency personnel to arrive.

What should be done to continue cooling an exertional heat stroke victim until medical help arrives?

If medical staff are available on site, cooling should continue until the victim's core temperature reaches 38.9 degrees Celsius.

Outlines

00:00

🏃‍♂️ Surviving Exertional Heat Stroke: A Personal Story

This paragraph tells the story of Douglas Casa, a 16-year-old athlete who suffered an exertional heat stroke during a championship race in 1985. Despite collapsing twice with a dangerously high body temperature, he survived thanks to immediate and proper treatment. The paragraph introduces exertional heat stroke as a serious and often fatal condition affecting athletes and soldiers due to intense exercise in hot conditions. It explains the difference between compensable and uncompensable heat stress, the physiological effects on the body, and the importance of rapid cooling as a primary treatment method.

Keywords

💡Exertional Heat Stroke

Exertional heat stroke, also known as exertional heat illness, is a serious medical condition that occurs when the body's temperature rises to dangerous levels due to intense physical activity in hot conditions. It is a leading cause of death among athletes and soldiers in training, as highlighted in the script with the story of Douglas Casa. The condition is characterized by a core body temperature greater than 40 degrees Celsius, accompanied by symptoms such as increased heart rate and confusion, which can lead to organ damage if not treated promptly.

💡Compensable Heat Stress

Compensable heat stress refers to a physiological state where the body can effectively dissipate the heat generated during physical activity. In the script, it is mentioned that under normal circumstances, nearly 80% of the energy used during exercise is converted into heat, which the body can manage through cooling methods like sweat evaporation. This concept is crucial for understanding the contrast with uncompensable heat stress, which leads to exertional heat stroke.

💡Uncompensable Heat Stress

Uncompensable heat stress is a condition where the body cannot adequately lose heat due to factors like overexertion or high environmental temperatures and humidity. As explained in the script, this can cause the core body temperature to rise beyond normal levels, leading to cellular damage and potentially severe health consequences, such as exertional heat stroke.

💡Core Body Temperature

Core body temperature is the internal temperature of the body, which is a critical indicator of health. In the context of the video, a core body temperature greater than 40 degrees Celsius is a primary diagnostic criterion for exertional heat stroke. The script emphasizes the importance of accurately measuring this temperature, typically with a rectal thermometer, to determine the severity of the condition and the urgency of treatment.

💡Sweat Evaporation

Sweat evaporation is a natural cooling mechanism of the body, where sweat on the skin's surface evaporates, helping to dissipate heat. The script mentions this process as a primary method by which the body normally deals with heat stress during exercise. However, in cases of uncompensable heat stress, this mechanism may be insufficient, contributing to the risk of exertional heat stroke.

💡Denaturation

Denaturation refers to the alteration of a protein's structure, causing it to lose its normal function. In the script, it is mentioned that high body temperatures during exertional heat stroke can cause proteins and cell membranes to denature, leading to cellular dysfunction and leakage of cell contents, which can have devastating effects on the body.

💡Rapid Cooling

Rapid cooling is an emergency response technique used to lower the body temperature quickly in cases of exertional heat stroke. The script describes the process of placing the victim in an ice water tub or dousing them in ice water and applying wet towels as methods to achieve rapid cooling. This is crucial because it can prevent cell damage and buy time for further medical treatment.

💡Vital Organs

Vital organs are those whose functions are essential for life, such as the heart, lungs, and kidneys. The script warns that exertional heat stroke can lead to damage or failure of vital organs if not treated promptly, emphasizing the severity of the condition and the importance of immediate and proper treatment.

💡Diagnosis

Diagnosis in the context of the script refers to the process of identifying exertional heat stroke based on a combination of a high core body temperature and physical symptoms. The script explains that recognizing the condition early is critical for initiating treatment and preventing severe outcomes.

💡Treatment

Treatment for exertional heat stroke, as outlined in the script, involves immediate cooling measures followed by medical transport. The emphasis is on 'cool first, transport second' to prevent cell damage and reduce the risk of severe complications or death.

💡Emergency Services

Emergency services are organizations that provide urgent assistance in critical situations, such as medical emergencies. The script advises calling emergency services as part of the initial response to exertional heat stroke, ensuring that professional medical help is on the way while immediate cooling measures are taken.

Highlights

In 1985, 16-year-old Douglas Casa survived a potentially fatal exertional heat stroke during a 10,000 meter race.

Exertional heat stroke is a serious concern for athletes and soldiers, being one of the top three killers in training.

Nearly 80% of the energy used during exercise is transformed into heat, which can lead to compensable or uncompensable heat stress.

Uncompensable heat stress occurs when the body cannot lose heat fast enough, leading to a rise in core temperature and potential cell damage.

Exertional heat stroke can cause severe consequences like liver damage, blood clot formation in the kidneys, and vital organ failure.

A core body temperature greater than 40 degrees Celsius, along with physical symptoms, is the main criterion for diagnosing exertional heat stroke.

Rectal thermometers are the most accurate method for assessing core body temperature in cases of exertional heat stroke.

The treatment priority for exertional heat stroke is rapid cooling on site before transporting the victim to a medical facility.

Placing the victim in an ice water tub and continuously monitoring vitals is an effective method for rapid cooling.

Emergency services should be called immediately when dealing with exertional heat stroke, and cooling should continue until the victim's core temperature reaches 38.9 degrees Celsius.

Keeping the victim calm and cooling as much surface area as possible is crucial while waiting for emergency personnel.

Exertional heat stroke is 100% survivable with proper care, despite being a leading cause of death in sports.

Douglas Casa has helped save 167 people in similar circumstances since his own exertional heat stroke incident.

Exertional heat stroke is distinct from classical heat stroke, affecting primarily those engaged in intense physical activity.

The body's inability to dissipate heat during uncompensable heat stress can lead to protein denaturation and cell membrane damage.

Physical symptoms of exertional heat stroke include increased heart rate, low blood pressure, rapid breathing, and signs of central nervous system disfunction.

Exertional heat stroke can strike down even the strongest individuals, as noted by Dr. JJ Levick in 1859.

Transcripts

In 1985, 16-year-old Douglas Casa,

ran the championship 10,000 meter track race at the Empire State Games.

Suddenly, with just 200 meters to go, he collapsed,

got back up and then collapsed again on the final straightaway,

with his body temperature at dangerous levels.

He had suffered an exertional heat stroke.

Fortunately, with immediate and proper treatment,

he survived the potentially fatal episode

and has since helped save 167 people in similar circumstances.

From ancient soldiers on the battlefield

to modern day warriors on the gridiron,

exertional heat stroke, or sunstroke, has long been a serious concern.

And unlike classical heat stroke, which affects vulnerable people

such as infants and the elderly during heat waves,

exertional heat stroke is caused by intense exercise in the heat,

and is one of the top three killers of athletes and soldiers in training.

When you exercise, nearly 80% of the energy you use

is transformed into heat.

In normal circumstances, this is what's known as

compensable heat stress.

And your body can dissipate the heat as quickly as it's generated

through cooling methods like the evaporation of sweat.

But with uncompensable heat stress,

your body is unable to lose enough heat

due to overexertion or high temperatures in humidity,

which raises your core temperature beyond normal levels.

This causes the proteins and cell membranes to denature,

creating cells that no longer function properly

and begin to leak their contents.

If these leaky cells proliferate through the body,

the results can be devastating.

Including liver damage, blood clot formation in the kidneys,

damage to the gastrointestinal tract and even the failure of vital organs.

So how do you diagnose an exertional heat stroke?

The main criterion is a core body temperature greater than 40 degrees Celsius

observed along with physical symptoms

such as increased heart rate, low blood pressure and rapid breathing

or signs of central nervous system disfunction

such as confused behavior, aggression or loss of consciousness.

The most feasible and accurate way to assess core body temperature

is with a rectal thermometer

as other common temperature-taking methods are not accurate in these circumstances.

As far as treatment goes,

the most important thing to remember is cool first, transport second.

Because the human body can withstand a core temperature above 40 degrees Celsius

for about 30 minutes before cell damage sets in,

it's essential to initiate rapid cooling on site

in order to lower it as quickly as possible.

After any athletic or protective gear has been removed from the victim,

place them in an ice water tub while stirring the water

and monitoring vitals continuously.

If this is not possible,

dousing in ice water and applying wet towels over the entire body can help.

But before you start anything, emergency services should be called.

As you wait, it's important to keep the victim calm

while cooling as much surface area as possible

until emergency personnel arrive.

If medical staff are available on site, cooling should continue

until a core temperature of 38.9 degrees Celsius is reached.

The sun is known for giving life,

but it can also take life away if we're not careful,

even affecting the strongest among us.

As Dr. JJ Levick wrote of exertional heat stroke in 1859,

"It strikes down its victim with his full armor on.

Youth, health and strength oppose no obstacle to its power."

But although this condition is one of the top three leading causes of death in sports,

it has been 100% survivable with proper care.