How to address dehydration in patients with heatstroke

Aug 02, 2025 Source: Cainiu Health

Dr. Sun Lianqing

Introduction

For patients with severe dehydration who are unable to take fluids orally, intravenous infusion of electrolyte solutions containing sodium, potassium, and other components can rapidly replenish fluids and electrolytes, correct the dehydrated state, and maintain internal balance. For conscious patients with normal swallowing function, oral rehydration salts should be prepared according to the recommended ratio and consumed in small amounts multiple times. This method not only replenishes water but also replaces lost electrolytes, avoiding disturbances caused by water supplementation alone.

To address dehydration in patients with heat stroke, intravenous infusion of electrolyte solutions, oral rehydration salts, nasal feeding for hydration, local mucosal moisturization, and combined cooling and hydration measures are generally used. A detailed explanation is as follows:

1. Intravenous Infusion of Electrolyte Solutions: For patients with severe dehydration who are unable to take fluids orally, intravenous infusion of electrolyte solutions containing sodium, potassium, and other components can rapidly replenish water and electrolytes, correct dehydration, and maintain internal balance.

2. Oral Rehydration Salts: Patients who are conscious and have normal swallowing function should drink oral rehydration salts in small amounts multiple times according to the recommended dilution ratio. This can replenish both water and lost electrolytes, avoiding imbalances that may result from water intake alone.

3. Nasal Feeding for Hydration: For patients with impaired consciousness who still require hydration, medical staff may administer appropriate amounts of warm water or nutritional liquid through a nasogastric tube. This approach hydrates the patient while reducing the risk of coughing and aspiration.

4. Local Mucosal Moisturization: Use moist cotton swabs to wipe areas such as the patient's mouth and lips to keep mucous membranes moist, alleviate dryness and discomfort, and indirectly help relieve localized discomfort caused by dehydration.

5. Combined Cooling and Hydration: During physical cooling, simultaneously replenish fluids intravenously to reduce bodily fluid consumption through cooling while replacing lost body fluids, thereby synergistically addressing dehydration.

When addressing dehydration in heat stroke patients, an appropriate method should be selected based on the patient's condition, with priority given to following medical advice and avoiding giving water without authorization. The patient's condition should be closely monitored during the process; if symptoms such as vomiting or changes in consciousness occur, promptly inform medical staff to adjust the treatment plan, ensuring safe and effective hydration.

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What is the relationship between heatstroke and drinking禁忌?

Heatstroke patients lose large amounts of electrolytes through excessive sweating. Blindly drinking large quantities of pure water would worsen this imbalance, thus creating a contraindication for simple rehydration alone, necessitating concurrent electrolyte replacement. Fluid intake must also be controlled due to cardiac load; hyperthermia affects heart function, and excessive water consumption increases blood volume and thereby加重心脏负担, forming a contraindication for unrestricted drinking, to avoid inducing cardiac dysfunction.

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Why is drinking water prohibited for heatstroke?

Heatstroke patients often experience impaired consciousness and weakened or lost swallowing function. In such cases, drinking water easily causes liquid to enter the trachea, triggering severe coughing, and in serious cases, leading to airway obstruction and a risk of suffocation; therefore, water intake should be prohibited. During high fever, the heart is already in a state of excessive workload. Drinking water rapidly increases blood volume, further burdening the heart and potentially inducing arrhythmia or heart failure.

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What are the reasons for not drinking water in heatstroke?

Heatstroke patients often experience confusion and delayed swallowing reflexes. Drinking water can easily irritate the gastrointestinal tract and cause vomiting, which may lead to aspiration and airway obstruction; avoiding water intake reduces this risk. Hyperthermia impairs cardiac function, and water consumption increases blood volume, further burdening the heart and potentially causing arrhythmias. Avoiding water intake prevents additional stress on the heart.

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How should patients with heatstroke replenish electrolytes?

Heatstroke patients can replenish electrolytes generally through intravenous administration of balanced fluids, oral rehydration salts, consuming electrolyte-containing beverages, drinking lightly salted water, and ingesting electrolyte-rich foods. The method of electrolyte supplementation for heatstroke patients should be selected according to the severity of the condition. For patients with altered consciousness or severe dehydration, intravenous supplementation is preferred. Patients who are conscious may be given oral supplementation.