Enjoying Your Summer Without Suffering Heat Stroke   Frank Barnhill M.D.
 

It’s true that most heat strokes occur during the hottest part of our year, but it’s a myth that heat stroke only occurs when a person gets too hot or is in an extremely hot environment!

 Any longstanding disease such as diabetes, heart, and lung disease can lower your “resistance” to heat related illnesses.

 It is likewise true that heat strokes tend to occur more in the very young and the much older person.

Heat stroke is just one of four heat related illnesses caused by failure of our bodies to get rid of heat faster than we make it or absorb it. The human body normally effectively gets rid of excess heat by shunting extra blood flow to our skin so that sweating and evaporation (convection) and to a lesser extent, rapid breathing, will carry that heat off in the surrounding air. Sweating is the body’s most efficient way to decrease and control central body temperature. When we take a quick dip in the pool to get cooled off after working in the yard, heat is directly transferred to water (conduction), bypassing the evaporation process. So, obviously, a rapid way to lower body temperature is by wetting a person with cool (not cold) water.

Let’s now take a look at the different types of heat related illnesses.

Heat cramps are the mildest of the four disorders and result from mild dehydration and loss of body sodium. These very painful muscle spasms usually occur in the arms, legs, or lower abdomen. Older persons on diuretics or fluid pills are particularly prone to this condition.

Replacing lots of water and using sodium containing drinks and letting the affected person rest in cooler surroundings will usually lead to a rapid recovery. You can help your children avoid getting heat cramps by letting them drink high sodium (salt) containing sports drinks before playing in hot conditions.

Heat syncope (passing out, loss of consciousness or feelings of faintness with dizziness) is the second most serious heat related illness and occurs as heat cramps go undetected or ignored and untreated. In really hot situations or with very strenuous exercise or work, the affected person may actually progress from muscle cramps to syncope before they are able to seek treatment.

Heat syncope patients typically complain of profound weakness, of being very tired and then become dizzy or faint after heat exposure. This often occurs in persons standing for a long time, become dehydrated and proceed to exercise in hot conditions, or jump up from a sitting position and try to restart exercise without adequate cool-down or slow warm-up (acclimation) periods.

This condition is best treated by letting the person lie down, not sit, and giving cool oral re-hydration in a cool environment. However, if this person is still unconscious or can’t take fluids by mouth, you should seek medical attention immediately!

Heat exhaustion occurs when your body loses large amounts of water and salt through perspiration and is the third most serious of the heat-associated disorders.

Heat exhaustion is associated with all of the above-mentioned symptoms plus profuse hot sweating, headache, blurry vision, loss of appetite, nausea, vomiting, chills, muscle weakness, skin flushing, extreme thirst, irritability, agitation, and sometimes loss of consciousness and rarely seizures.

Though rarely life threatening, heat exhaustion requires immediate first aid type attention as it may progress to heat stroke. The very same treatment used in heat syncope will often work, but if the affected person becomes confused, passes out, has difficulty breathing, starts vomiting, or has a seizure, you must seek emergency medical attention immediately! It may help to remove about half of the person’s clothing to assist in evaporation of sweat.

Persons suffering from heat stroke have very high body temperatures, often in the 104 to 109 degree range, but when touched, will have a hot, dry skin. This paradox occurs as your body’s blood pressure starts to drop as a result of dehydration and must shunt blood back to the brain and vital organs to preserve life. You must call 911 immediately to save this person’s life.

While waiting for an ambulance, remove all clothing, spray the person with cool water, place ice packs on the neck, wrists, ankles and groin, armpits, and if conscious and not vomiting or delirious, give cool liquids to drink.

The sickest heat stroke victim I ever treated was simply cutting the grass on a 90 degree August day after drinking a quart of water and taking a salt tablet. His symptoms occurred so rapidly, his wife found in lying in the yard ten minutes after he came in to drink the water and cool off for ten minutes.

So, what can you do to keep from developing heat related illnesses?
Drink lots of water on hot days.
Listen to the weatherman and avoid being outside or in direct sun at the hottest times of the day.
If you don’t have air conditioning, use fans to cool and move air to help with perspiration evaporation or go to an air-conditioned store or mall during the hottest parts of the day.
Avoid caffeine and alcohol. Both alter the way your body provides blood flow to the skin allowing sweating and evaporation of heat.
Wear light colored, lightweight clothing such as cotton when exposed to excessively hot temperatures or when you plan to be outdoors for more than 30 minutes.
Talk to your doctor about your medications and what you should do about water, salt containing sports drinks and exercise or exertion in heat.
When standing in hot conditions for long periods, such as watching sports events or a parade, avoid sudden exertion, drink water as you watch, wear a hat and if you get too hot, spray your skin with water, loosen clothing or go inside to cooler temperatures.
Wet clothing does not provide as much heat loss as wet skin from which water may evaporate!
Know your work-play heat related limits. Plan for rest and cool off times when working in the yard or during exercise and recreation.
Go slowly at whatever you plan to do in hot environments. Acclimation occurs as a person slowly gets used to being in the heat.
Hopefully these tips and items of knowledge will help you protect yourself and family from the disasters known as heat related illnesses.

Hope you and your family have a great summer!

Dr. Frank

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