Wendy Wilson was taking a \"Boot Camp\" aerobics class at a local spa/fitness ce

Question

Wendy Wilson was taking a "Boot Camp" aerobics class at a local spa/fitness center. She had taken this class on several occasions, and loved being outdoors will all the interesting gadgets (giant tires, big ropes, obstacle course) that made the workout fun. Plus Bob, the instructor, was an outstanding motivator and reminded her of her own son, who was off at State University on the pre-Veterinarian track. Bob made sure that everyone was constantly on the move, and gave them three one-minute water breaks at 15 minutes, 30 minutes, and 45 minutes. After the one hour Boot Camp, Mrs. Wilson was winding down, and thought that a soak in the hot tub would help soothe her (soon-to-be!) aching muscles Heather House walked by the hot tub about 10 minutes later, and realized that Wendy was not coherent, very confused, and lethargic. Wendy had slid low down into the water- almost under and not knowing what to do, Heather grabbed Wendy by the hair and dragged her out of the hot tub. She called for help, and one of the gals in the locker room was an off-duty EMT. The EMT grabbed the lemon-ice water pitcher, soaked towels in freezing water, and stuffed them under Wendy's armpits, and wrapper her arms and legs. She then ordered more ice-water to re- soak the towels on the extremities. She also directed a bystander to call 9-1-1, and within seconds the on-duty EMT team arrived. Mrs. Wilson's initial vitals were Parameter |Supine Sitting u BP HR 90/60 75/45 105 bpm 135 bpm Mrs. Wilson was starting to revive with the ice water wraps. She was now coherent, and extremely embarrassed that she had caused all of this commotion. The paramedics debated starting a saline I.V. since she was feeling much better and her vitals had improved, and erring on the side of caution, they hung one bag of fluid. Approximately 30 minutes after Ms. House had pulled Mrs. Wilson from the hot tub, Mrs Wilson's vitals were Parameter |SupineSitting u BP1 116/74115/78 70 bpm72 bpm HR At this point, Mrs. Wilson felt fine, and refused further treatment. She was advised to continue to drink water in moderation, eat something, and to take it easy for the rest of the day. Her husband was called, and he came to pick her up and bring her home. She had no further cardiovascular issues

Explanation / Answer

There can be two physiological reasons for Mrs. Wilson's Shock.

1. The one-hour boot camp might have drained the water content of her body (dehydration), due to which she might have fainted and drowned. She was said to be underwater for about 10-minutes during which the supply of oxygenated blood would have decreased leading to a cardiac shock.

2. During the boot camp due to heavier workouts, the body temperature would have increased rapidly. After she finishes the boot camp the body temperature is lowered by heat dissipation. While she entered the hot tub the Systemic cutaneous vasodilation should have taken place. Due to this the arterial blood pressure had fallen below the normal value and thus, resulting in a cardiac shock

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