The underlying cause must be removed. Mild<unk>  caused by exertion on a hot day may be adequately treated through self-care measures, such as increased water consumption and resting in a cool place.<unk>  that results from drug exposure requires prompt cessation of that drug, and occasionally the use of other drugs as counter measures. Antipyretics (e.g., acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heatstroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heatstroke. In this situation, antipyretics actually may be harmful in patients who develop hepatic, hematologic, and renal complications because they may aggravate bleeding tendencies. When body temperature is significantly elevated, mechanical cooling methods are used to remove heat and to restore the body's ability to regulate its own temperatures. Passive cooling techniques, such as resting in a cool, shady area and removing clothing can be applied immediately. Active cooling methods, such as sponging the head, neck, and trunk with cool water, remove heat from the body and thereby speed the body's return to normal temperatures. Drinking water and turning a fan or dehumidifying air conditioning unit on the affected person may improve the effectiveness of the body's evaporative cooling mechanisms (sweating). Sitting in a bathtub of tepid or cool water (immersion method) can remove a significant amount of heat in a relatively short period of time. It was once thought that immersion in very cold water is counterproductive, as it causes vasoconstriction in the skin and thereby prevents heat from escaping the body core. However, a British analysis of various studies stated: "this has never been proven experimentally. Indeed, a recent study using normal volunteers has shown that cooling rates were fastest when the coldest water was used." The analysis concluded that iced water immersion is the most-effective cooling technique for exertional heat stroke. No superior cooling method has been found for non-exertional heat stroke. Thus, aggressive ice-water immersion remains the gold standard for life-threatening heat stroke. When the body temperature reaches about , or if the affected person is unconscious or showing signs of confusion,<unk>  is considered a medical emergency that requires treatment in a proper medical facility. In a hospital, more aggressive cooling measures are available, including intravenous hydration, gastric lavage with iced saline, and even hemodialysis to cool the blood. Epidemiology==<unk>  affects those who are unable to regulate their body heat, mainly due to environmental conditions. The main risk factor for<unk>  is the lack of ability to sweat. People who are dehydrated or who are older may not produce the sweat they need to regulate their body temperature. High heat conditions can put certain groups at risk for<unk>  including: physically active individuals, soldiers, construction workers, landscapers and factory workers. Some people that do not have access to cooler living conditions, like people with lower socioeconomic status, may have a difficult time fighting the heat. People are at risk for<unk>  during high heat and dry conditions, most commonly seen in the summer. Various cases of different types of<unk>  have been reported. A research study was published in March 2019 that looked into multiple case reports of drug induced<unk> . The study concluded that psychotropic drugs such as anti-psychotics, antidepressants, and anxiolytics were associated with an increased heat-related mortality as opposed to the other drugs researched (anticholinergics, diuretics, cardiovascular agents, etc.). A different study was published in June 2019 that examined the association between<unk>  in older adults and the temperatures in the United States. Hospitalization records of elderly patients in the US between 1991 and 2006 were analyzed and concluded that cases of<unk>  were observed to be highest in regions with arid climates. The study discussed finding a disproportionately high number of cases of<unk>  in early seasonal heat waves indicating that people were not yet practicing proper techniques to stay cool and prevent overheating in the early presence of warm, dry weather. In urban areas people are at an increased susceptibility to<unk> . This is due to a phenomenon called the urban heat island effect. Since the 20th century in the United States, the north-central region (Ohio, Indiana, Illinois, Missouri, Iowa, and Nebraska) was the region with the highest morbidity resulting from<unk> . Northeastern states had the next highest. Regions least affected by heat wave-related<unk>  causing death were Southern and Pacific Coastal states. Northern cities in the United States are at greater risk of<unk>  during heat waves due to the fact that people tend to have a lower minimum mortality temperature at higher latitudes. In contrast, cities residing in lower latitudes within the continental US typically have higher thresholds for ambient temperatures. In India, hundreds die every year from summer heat waves, including more than 2,500 in the year 2015. Later that same summer, the 2015 Pakistani heat wave killed about 2,000 people. An extreme 2003 European heat wave caused tens of thousands of deaths. Causes of<unk>  include dehydration, use of certain medications, using cocaine and amphetamines or excessive alcohol use. Bodily temperatures greater than 37.5–38.3 °C (99.5-101.0 °F) can be diagnosed as a<unk>  case. As body temperatures increase or excessive body temperatures persist, individuals are at a heightened risk of developing progressive conditions. Greater risk complications of<unk>  include heat stroke, organ malfunction, organ failure, and death. There are two forms of heat stroke; classical heatstroke and exertional heatstroke. Classical heatstroke occurs from extreme environmental conditions, such as heat waves. Those who are most commonly affected by classical heatstroke are very young, elderly or chronically ill. Exertional heatstroke appears in individuals after vigorous physical activity. Exertional heatstroke is displayed most commonly in healthy 15-50 year old people. Sweating is often present in exertional heatstroke. The associated mortality rate of heatstroke is 40 to 64%.
Hyperthermia
Fever
Hypothermia
Acidosis
Alkaline tide
Anoxia
Malignant hyperthermia
Hypoxemia