Tom, MALE.

LEARNING ISSUES.
- Effects on the brain and heart in hyperthermia?
- Solution concentrations for exercise (what is needed/optimal? What
do common solutions contain?).
- Normal race preparation.
- Order of organs that are vasoconstricted in hypovolamemia.
- Why large intestine?
- How long until necrotic bowel?
- Fluid resuscitation- What is added?
- Fluid compartments of the body.
- Vomitting centres.
- How hot you get before you die?
Presenting problems:
- Emesis.
- Confusion.
- Disorientated.
- Weakness.
- Fatigue.
- Dehydrated.
- Heatstroke?
- Collapse.
- Tachycardic.
- Tachypnoiec.
- Fever.
- Severe weight loss.
Emesis:
- Acidosis (lactic acid).
- Dehydration?
- Metabolic problem?
- Electrolyte imabalnce.
- Infection.
- Drugs.
- Vestibulocochlear issue (vertigo).
- Cardiac event.
- Hyperthermia.
Muscle weakness.
- Muscle fatigue- insufficient oxygen.
- Neurological deficits (increase/decrease of descending control).
- Hypocalcaemia.
- Lactic acidosis.
- Peripheral nerve damage.
- Hypoglycaemia.
Fatigue.
- Anaemia.
- Infection systemic infection.
- Lack of sleep,
- Drugs/toxins.

Malabsortpion/malnutrition (iron and others, sugar, water,

electrolytes).
- Decreased cardiac output.
- Peripheral vasodilation to get rid of heat.
- Hyperuraemia.
Confusion.
- Decreased cerebral perfusion (hypovolaemia, raised ICP).
- Perioheral vasodilation.
- Head trauma.
- Hypoglycaemia.
- Dehydration.
- Electrolyte imbalance.
- Respiratory failure.
- Hypothermia.
- Drugs.
- Lactic acidosis.
- Respiratory failure (diaphragmatic fatigue).
History and clinical examination.
- BP: LOW (for him, an athelete).
- HR: High.
- RR: High.
- Temperature: High.
Timeline.
- Morning: Banana, mueseli, 500mL H20.
- SWIM.
- BIKING: Drank 6% carb solution with Na+ and K+. ~250mL every
hour. Vomitted and sweating (no fluid from this point). STARTED
FEELING HOT.
- Near 500mL, staggering/stumbling. Eyes feeling glazed.
INVESTIGATIONS.
- Blood pH, blood glucose, electrolytes level,
INVESTIGATION RESULTS.
- Low glucose, normal sodium, normal potassium, normal chloride.
- Haematocrit: High.