Nervous felt dry which is another major sign of

Nervous System Case Study

            In this
case study, a 16-year-old male named Martin was mowing lawns when the boy
started to experience light-headedness and nausea. At the last mowing job that
day, the patient passed out after showing very uncharacteristic behavior. Martin
was taken to the emergency room and the patient’s skin was dry, even though the
patient had been sweating profusely previously.

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            The most
likely diagnosis for Martin at this point is heat illness, more specifically
heat stroke. Heat stroke occurs when your core body temperature gets to 104oF
or higher and can cause damage to the brain, heart, kidneys, and muscles in the
body (CDC, 2017). Martin’s core body temperature when taken at the hospital was
105oF, which could lead to a heat stroke if untreated. Being that the
patient was on the sixth lawn of the day, Martin was more than likely
dehydrated. Martin initially suffered from heat exhaustion, based on his
profuse sweating before fainting and being admitted to the ER. However, upon
arrival to the ER it was reported that his skin felt dry which is another major
sign of heat stroke. It isn’t uncommon for dehydration and heat exhaustion to
lead to heat stroke. Heat exhaustion is typically a precursor to heat stroke. Martin
reported feeling fatigued, light-headed, and nauseated which are all signs of
heat exhaustion. Since Martin did not rest and cool down his body temperature
throughout the day, his body was not able to regulate his body temperature well
enough which caused it to rise above 104oF and heat stroke set in
(Mayo Clinic, 2017).

The best thing Martin could have
done to prevent heat stroke is to rest and hydrate as the patient was working.
Martin and his mowing partner, should have begun to recognize his symptoms at
the previous client’s lawn. Cooling him down earlier could have prevented mild
heat illness from becoming heat stroke. 
After heat stroke had set in, the doctors would have tried several
cooling techniques. Some cooling techniques would include ice baths and cooling
blankets (Mayo Clinic, 2017).

Nonsteroidal anti-inflammatory drugs
(NSAIDs) have also been helpful in treatment of fevers. NSAIDs has been able to
do this because they work at a molecular level to inhibit COX enzymes. This is
important because COX enzymes have been found to make prostaglandins, which are
chemicals that promote fever, inflammation, and pain (Simons et at., 2000).

Thermoregulation is the process the human body uses to
maintain a stable core temperature. A healthy core temperature ranges between
98 and 100 degrees Fahrenheit. The body has flexibility when it comes to core
temperature, but if temperatures reach extremes the body’s function can be
compromised.  To maintain equilibrium,
the body uses sweating, vasodilation, vasoconstriction, thermogenesis, and
hormonal thermogenesis (Holland, 2016). 

When the autonomic nervous system senses a change in body
temperature, a signal is sent throughout the body to begin perspiration. Once
the body beings to perspire the skin becomes moist. The sweat evaporates and
causes the core temperature to begin to cool down (Roth, 2016). The circulation
system works along with perspiration to cool the human body. As the core
temperature of the body rises, the active cutaneous vasodilation is activated
by the sympathetic nervous system. The human body is capable of sending up to
60% of cardiac output to the skin (Charkoudian, 2010). The enormous amount of
blood supply to the skin is needed so that heat can be quickly transferred from
the core to skin’s surface. As blood is transferred to the surface of the skin,
sweat evaporates and the thermal gradient allows heat to transfer from the
blood to the skin and then in to the environment. The blood that has cooled
down then is transferred back to the core to help lower the core temperature
(Charkoudian, 2010).

Vasoconstriction is activated by two branches of the
sympathetic nervous system when the body’s core temperature drops. Blood flow
to the skin is decreased to prevent heat exchange with the skin and environment
(Charkoudian, 2010). Thermogenesis is more commonly known as shivering. When
the body gets too cold the muscles contract and expand in quick bursts. The
expanding and contracting produces heat which raises body temperature (Bryner,
2013). Hormonal thermogenesis causes the thyroid gland to secrete hormones that
increase metabolism. The increase in metabolism creates an increase in energy
and heat (Holland, 2016).

 

            Martin
suffered from dehydration coupled with heat illness. The dehydration limited
Martin’s ability to sweat, severely reducing his ability to dissipate heat
through the skin. The reduced heat loss through the skin quickly caused a rise
in body temperature, leading to heat stroke. Hydration and common cooling
techniques, such as cool towels and relocation to cooler areas, could have
prevented this heat illness. Awareness of heat illness symptoms when working in
high temperature conditions is important for all working in high heat
environments.

 

 

 

Literature
Cited

Bryner,
M. 2013. Why Do We Shiver When Cold? Live Science. https://www.livescience.com/32475-why-do-we-shiver-when-cold.html  Accessed January
25, 2018.

CDC. 2017. Warning Signs and Symptoms of Heat-Related
Illness. Retrieved January 25, 2018, from https://www.cdc.gov/disaster/extrememheat/warning.html

Charkoudian,
N. 2010. Mechanisms and modifiers of reflex cutaneous vasodilation and
vasoconstriction in humans. Journal of Applied Physiology. 109(4): 1121-1228.

Holland,
K. 2016. Thermoregulation. Health Line. https://www.healthline.com/health/thermoregulation Accessed January 25, 2018.

Mayo Clinic. 2017. Heatstroke. Retrieved January 25, 2018,
from https://www.mayoclinic.org/diseases-conditions/heat-stroke/symptoms-causes/syc-20353581

Roth, E.
2016. Sweating (Normal Amounts): Causes, Adjustments, and Complications. Health
Line. https://www.healthline.com/health/sweating Accessed January 25, 2018.

Simons,
D., Wagner, D., Westover, K. 2000. Nonsteroidal Anti-Inflammatory Drugs,
Acetaminophen, Cyclooxygenase 2, and Fever. Clinical
Infectious Diseases. 31(5):211–218.