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heat stroke coma?
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heat stroke coma?

My 14 yr old daughter collapsed about a month ago from heat.  The hospital didnt take an accurate temp until I started asking much later.  After 3 hrs of being in gown in cool ER, at least 1 liter of fluid and being iced down her axillary temp was 99.6.  I do believe she had a heat stroke although with lack of proper temp she was not diagnosed with it.  She ended up being completed unresponsive for more than 6 hrs.  Yet when she came around she was aware of everything that happened, she just could not physically respond.  Was she truly in a coma?  Also, now she has no tolerance for heat at all.  If it is above 75 degrees she is sick after an hr or two and has to go inside.  This is very disheartening because of her age and she wanted to do sports in school but now that is just out of the question.  I really never got any good answers and would like to know if it would be classified that she was in a coma and if she will likely always have trouble with the heat.   I believe the doctors thought she was faking, because they had her talk to a social worker and gave her narcan to start.  With the new extreme intolerance I do not believe this is true.  
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Avatar_dr_m_tn
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I cannot tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

A heat stroke occurs when the body fails to dissipate heat sufficiently, and results in thermoregulatory failure.  It can cause an alteration in a person’s level of consciousness, and is a life threatening emergency.  Body temperature must be at least 104ºF, and its common causes include physical exertion in a hot environment, and lack of adequate fluid intake.  It can also occur from hyperactivity due to mind-altering drugs such as LSD and cocaine, withdrawal from alcohol, and from use of medications that inhibit our mechanisms for heat loss such as anticholinergics or beta-blockers.  The main actions taken to treat a patient suffering from a heat stroke would be to maintain support of airway, breathing, and circulation, provide cooling measures as needed, and replace fluids.

A related, but less serious condition is known as heat exhaustion.  In this condition body temperatures are typically no higher than 102ºF, and is generally self-limiting and not life threatening.  It can cause weakness, fatigue, profuse sweating, clammy skin, nausea/vomiting, and headache.

It is reassuring that your daughter’s temperature was recorded at 99.6 within a relatively short timeframe.  This would suggest that your daughter may have suffered from heat exhaustion.  It is, of course, concerning that your daughter persists to have heat intolerance.  I would recommend that she see a primary care physician for a full evaluation as soon as possible.  Heat tolerance can sometimes indicate a hormonal imbalance, such as hyperthyroidism.  They may send basic labs, and thyroid function testing for an initial evaluation.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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