Oxybutynin-Induced Heatstroke in an Elderly Patient

OBJECTIVE: To report an elderly patient with oxybutynin-induced heatstroke and to remind clinicians of the possibility of drugs as an etiology of hyperthermia. CASE SUMMARY: An elderly man was admitted to the emergency department in a confused state. The day of admission was the hottest of the summer months in the San Francisco area. Because his rectal temperature was 40 °C and his skin was hot and dry, he was immediately packed in ice, given intravenous NaCl 0.9%, and a cooling fan was used to aid in external cooling. The patient was taking oxybutynin chloride, a drug with anticholinergic properties. The previous summer he had been admitted with a rectal temperature of 41.1 °C. No infectious etiology could be found. He was discharged in an improved state after a 48-hour observation period. The drug was discontinued. DISCUSSION: It is important to recognize heatstroke and institute prompt management because of the high mortality associated with this thermoregulatory disorder. Prompt treatment should consist of rapid cooling and vigorous cardiopulmonary support. CONCLUSIONS: The possibility of drug-induced heatstroke should be investigated in all patients admitted during the summer months with unexplained hyperthermia, especially the elderly. To our knowledge this is the first reported case of heatstroke associated with the use of oxybutynin.

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Stratum Corneum Barrier Function in the Elderly-An Evaluation of Irritant Response to Sodium Lauryl Sulfate by Visual Scoring and Transepidermal Water Loss Measurements. Anastasia B. Cua, Klaus-P. Wilhelm, and Howard I. Maibach, Department of Dermatology, University of California, San Francisco, CA.

Dermatitis ◽

10.1097/01206501-199009000-00020 ◽

1990 ◽

Vol 1 (3) ◽

pp. 202

Author(s):

&NA;

Keyword(s):

Stratum Corneum ◽

San Francisco ◽

Water Loss ◽

Barrier Function ◽

Sodium Lauryl Sulfate ◽

The Elderly ◽

Transepidermal Water Loss ◽

University Of California ◽

Lauryl Sulfate ◽

Visual Scoring

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Creating a Safer Patient Room Environment: The Contribution of Patient Bed Height

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857921101163 ◽

2021 ◽

Vol 10 (1) ◽

pp. 180-184

Author(s):

Dorothy Taylor ◽

Janice Morse ◽

Andrew Merryweather

Keyword(s):

Elderly Patient ◽

Fall Risk ◽

The Elderly ◽

Lower Leg ◽

Patient Specific ◽

Leg Length ◽

Patient Room ◽

Patient Falls ◽

Sit To Stand ◽

Bed Height

Elderly patient falls are expensive and may cause serious harm. Studies have identified the sit-to-stand-and-walk (STSW) task as the task where the greatest number of elderly patient falls occur. There is a great need to identify the particular movement and environmental conditions that lead to these elderly patient falls. This study begins to address this gap by evaluating the elderly patient during self-selected hospital bed egress. Using an observed fall risk episode (FRE) as a fall proxy, statistically significant parameters were identified which include bed height, pausing prior to initiating gait, level of fall risk, and Stand phase. Low bed height was identified as the least safe bed height. Patient-specific bed height (PSBH) using the patient’s lower leg length (LLL) is recommended. In addition, suggested guidelines are presented for clinical application in setting PSBH without measuring the patient’s LLL.

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