PP 16 HEAT STROKE FATALITY DURING EL-NINO: EXPERIENCE IN HOSPITAL SEGAMAT

Abstract

INTRODUCTION

Heat stroke is a life threatening illness characterized by hyperthermia and altered mental status after exposure to the hot weather. The global heat wave caused by El Nino phenomenon recently affected Malaysia with many suffering health consequences. We report the case of the first victim, a 23-year-old young trainee policeman who died of heatstroke after exposed to the hot environment during his training.

CASE REPORT

A 23 years old Malay man, who just enrolled in police training program, has been brought to Emergency & Trauma Department (ETD) Hospital Segamat after fainted during his training session. He was initially brought to nearby public health clinic. Unfortunately, it took nearly two hours for patient to arrive in ETD Hospital Segamat. His GCS upon arrival was 9/15 with the temperature of 40.2°C. Without delay, patient was intubated to secure the airway. With the working diagnosis of heat stroke at that moment, aggressive cooling therapies were started in the ETD. After three hours of resuscitation in emergency department, he was admitted to ICU for definitive care. His condition was further complicated by disseminated intravascular coagulation (DIVC) and refractory hypotension. He died on day two of admission with the cause of death of heat stroke complicated with DIVC and severe lactic acidosis.

DISCUSSION & CONCLUSION

This unfortunate case demonstrates the fundamental importance of early recognition and prompt treatment of heat stroke. In this case, failure to recognize with the delay of first aid and cooling, lead to poor outcome. With the relatively uncommon El Nino phenomenon, several preventive measures should have be taken, these involve identification of vulnerable individuals like police and military trainees, dissemination of information about dangerous heat waves may help to prevent life-threatening heat stroke.