HEAT EXHAUSTION DURING MASS PILGRIMAGE - IS THERE A DIAGNOSTIC ROLE FOR PULSE OXIMETRY

Every year over 2 million pilgrims (Hajjis) gather from different coun tries to perform the sacred ritual, the fifth pillar of Islam, Hajj. S everal nationalities from different climates come to Saudi Arabia whic h is located in a subtropical area with a hot and humid climate during the long summer season. This undertaking is characterised by several days of continuous physical, spiritual, and emotional exertion followi ng their departure from their homeland. Several factors predispose the m to heat exhaustion, such as the hot climate, excessive physical exer cise, lack of acclimatisation, overcrowding, illiteracy, old age, dise ases, and over zealous performance of Hajj during the peak sunshine ho urs. Several thousands of pilgrims suffer from heat exhaustion which i s a minor form of heat illness that can easily be detected and treated . Patients are usually discharged having fully recovered, but if heat exhaustion is not treated immediately, it may result in heat stroke wi th serious sequelae. Cases that need further observation and managemen t are admitted to hospital, particularly those who have associated med ical disorders. This study was designed to investigate the role of pul se oximetry in detecting hypoxaemia in patients suffering from heat ex haustion. One hundred fifty-five patients from 26 different countries were enrolled in this study. Their ages ranged from 18 to 83 years. Th ere were 51 (33%), 48 (31%), and 56 (36%) from Asia, the Middle East a nd Africa, respectively. One hundred thirty-four patients (86.5%) show ed a form of hypoxia which necessitated O-2 administration. Mild hypox ia (91-94% O-2 saturation) was detected in 81 patients (52.3%) and mod erate to severe hypoxia (<90% O-2 saturation) was detected in 53 (34.2 %) patients.