Heat Stroke??

[SmallShips]

Please help, i'm in a bit over my head here! My best friend is staying with me this week whilst my DH is at sea.

Anyway shes just been sent home from work (hot kitchen), as she nearly passed out. She got here literally stepped through the door and threw up. Gave her water, but shes very sunburnt from a weekend of pimms and sleeping on the beach. She has headache, muscle aches, nausea/vomitting, very hot, but not sweating, she also said she has the runs, (my 1st thought was a bug, but apprentely she gets the runs when shes about to come on, which she is), shes quite confused and feels like shes in a bubble, although she is talking relatively normally.

What do i do here, googling says 999, but shes told me not to be so ridiculous!

That's ok avenalife. I just think people underplay some conditions. If this was a 6 month old with a rash everyone would be screaming ambulance. A dehydrated through heat stroke adult is just as serious a case and warrants the same reaction.

I'm a third yr paeds student nurse and I've spent time in paeds A&E. It's not just the level of the fever that concerns me. It's the vomiting, lack of sweating and all the other symptoms. The OP said she was sitting out in the sun yesterday so she was more than likely dehydrated before hand. I've seen dehydrated kids, they get past a point where they look fine but they are not.

Surelt common sense means that she should be looked at, not diagnosed over the phone by someone who is not there and unable to see her condition for themself.

There are different levels of heat exhaustion, ranging from mild to life threatening. It should be checked in person by a medical professional because it's not worth the risk of getting it wrong.

103 is not a mild fever!!! And with ALL her symptoms taken into account there is more going on, and the fact small ships is concerned enough to ask advice on her/call the docs etc means she also feels it could be more serious. Go with your gut. Don't ignore the concerns cos someone who has not seen your friend thinks it is less serious. If I was you I would take her to a and e. A quick bag of fluids and she'll be right as rain. Its not over reacting its just the most appropriate and swift treatment. A and e won't laugh at you for it.

Just to add my two pence worth -

my Dad had exactly these symptoms three nights ago - he went to bed and woke up to go to the toilet about 1am. He then woke up freezing four hours later in an enormous pool of blood after collapsing and cracking his head open on the radiator in the bathroom.

My mum said it looked like a pig killing.

You really should not take the chance if you don't have to.

of course she should seek medical help if she's worried! But then I don't think that folk imeediately jumping to "she needs an ambulance NOW and needs IV fluids straight away, phone 999" is particularly helpful either? I thought that heat stroke was only generally diagnosed if there was a temp of over 104 - 106?

Those forehead things are not very precise. I wouldn't base any diagnosis on one symptom. Its the whole package that is concerning. Her history (sitting on beach in sun, probable over consumption of alcohol) over the weekend, plus her symptoms now, would concern me enough to go to a and e asap. If the friend is fairly with it then maybe an ambulance is not needed. But treatment most definitely is needed. A bag of fluids is so quick and easy to give, you're not wasting anyones time, why would you deal with a poorly person all night, who might get much worse and have to go to hospital anyway, when you can go to a and e now and be sorted within a few hours at most. The iv drips are miracle workers, they make all the difference in getting a dehydrated person better quickly.

Thanks for all your advice guys, shes had a cool shower and has perked up alot! I phoned NHS who said to keep an eye on her temp and keep up with the water.

No more throwing up and she has decided to eat a cheese sandwich.

"Please help, i'm in a bit over my head here! My best friend is staying with me this week whilst my DH is at sea.

Anyway shes just been sent home from work (hot kitchen), as she nearly passed out. She got here literally stepped through the door and threw up. Gave her water, but shes very sunburnt from a weekend of pimms and sleeping on the beach. She has headache, muscle aches, nausea/vomitting, very hot, but not sweating, she also said she has the runs, (my 1st thought was a bug, but apprentely she gets the runs when shes about to come on, which she is), shes quite confused and feels like shes in a bubble, although she is talking relatively normally.

What do i do here, googling says 999, but shes told me not to be so ridiculous"

Heat stroke: divded into 4 subdivisions, all 4 require IV fluids in a hospital.

1. heat collapse: fatigue, giddiness, temp loss of consciousness. High blood pressure, low heart rate, may be vomiting, muscle cramps. Yet again, treatment is IV fluids. Matches some of OP's thread. Not all.

2. heat exhaustion: increasing weakness, gidiness, dizziness, insomnia, lack of sweating, normal pulse, temp 37.8 -38.3, treatment IV fluids.

3. Heat cramp: temp is slighlty raised but cramps to muscles, sweating, headache, gidiness, anxiety. IV fluids

4. Heat Hyperpyrexia: energy loss and irritability, mental confusion ("she's quite confused"), no sweating (she's not sweating"), can rapidly become comatosed, body temp 41-42Oc. Is fatal unless urgent treatment.

The symptoms described are included in all of these. I told her to call an ambulance because patients can go down hill very quickly. She asked for help so I gave her help. You can't see someone's condition over an internet chatroom, this is why I told her to phone an ambulance. If it was a level 4 and I told her to give her some water what do you think would have happened to op's friend?

ALL medical staff work on the side of caution. I'm not appologising for this.

OFGS - heat exhaustion etc in an adult does NOT require IV fluids in hospital.

working on the side of caution is one thing - immediatley jumping to the conclusion that something is potentially fatal is another. As a paeds nurse I can understand why you would "work on the side of caution" - but scaring the life out of people unnecessarily can be harmful in itself.
If someone is concerned about a potential emergency situation then they should contact the professionals - not depend on over the internet diagnoses.

Glad to hear your friend has perked up small ships.

Scaring me now! Do you think that even though she seems totally normal now, something could be going on inside?!

small ships - if your friend is responsive and seems totally normal - then in all likliehood she is. If she gets worse or you're worried later on then call NHS direct again.

well done

Thanks all!

I would take her to A&E Smallships, just so they can check her over.

why????? Why take her to A&E? Avena - in my opinion you are completely over reacting. Small has followed advice given by a medical professional and her friend has recovered/is recovering. Why would she need to go to A&E????

Because it's always better to check. You can't get an accurate diagnosis over the phone when the person on the other end can't see the patient. They shouldn't be guessing at what's wrong with a patient without a thorough examination. Who's to say she has a tummy bug? Nor should we be diagnosing and guessing over the internet. We can't see her friend, I have seen a few posts on here that have been serious, they have been given advice and have done nothing. That's why I might appear OTT.

Water does not rehydrate. It's not been best practice to treat a dehydrated patient with water for years because it doesn't work. It doesn't replace the electrolytes that are lost and it is not policy where I am. Children and adults are given IV fluids if they are as dehydrated as the op's friend sounds. We have posters all over the place warning staff about the dangers of dehydration, they also state that a heavily dehydrated patient will start to feel better before going down hill.
I may be over reacting but I'd rather over react then sit back and tell the op that there's nothing to worry about. If you read the opening thread and pretend this was a parent bringing a 10 year old child to you would you give the same advice? Just because it's an adult there shouldn't be any difference. I would still take her to A&E and get her checked. If she doesn't need treatment then the op has peace of mind and her friend's been checked over. Her friend's welfare is paramount IMO.

OK, I'm going to muscle in here and you can shoot me down if you like.

Smallships, it sounds as though your friend could do with being seen face-to-face by someone medical this evening to assess her hydration status and the potential need for being in hospital. Call NHS direct and ask if you can she be seen by an out of hours GP or whether she should go to A&E. Noone can assess hydration accurately without seeing the patient or advise accordingly.

There are varying severities of heat stroke/exhaustion, and the majority can be managed with careful fluid replacement and temperature control. I disagree with what has been posted here previously about ALL cases needed IV fluids- that has not been the case in my experience. Mild dehydration can be treated adequately with oral fluids, although some of the sugars and electrolytes also need replacing (try sugary pop/squash if you don't have dioralyte for now). There are some fairly important differences in the physiology between adults and children, which would make the treatement differ if this were a child.

Forehead strips are notoriously inaccurate, however, if it were 103- that would be a reasonably high fever.

Please don't put her in a cold/tepid bath or shower as this can make the temperature higher and problem worse.

All the best and I hope your friend is feeling better soon.

Blimey... any update here...

Hope everything is ok now