Heat Exhaustion and Prevention

Anybody can develop heat exhaustion or heat stroke during hot weather.

When visiting an area with temperatures you are unaccustomed to, check the weather reports and prepare yourself for the change.

Bring appropriate fluids and drink often.

Do not allow yourself to begin the day dehydrated.

If you have additional problems, such as a chronic medical condition, do not sit for long periods or exert yourself in the heat.

Helpful Tips for Preventing Heat-Related Illnesses or Injuries

• Increase your fluid intake, regardless of your activity level. Thirst is a late response of the body to fluid depletion (dehydration). Drink frequently and in small amounts.
• Limit exercise in a hot environment, and drink 2-4 glasses of water or sports drinks each hour.
• Avoid drinks containing caffeine, alcohol, or large amounts of sugar. Also, avoid very cold beverages because they can cause stomach cramps.
• Stay indoors in an air-conditioned environment.
• Ask your doctor whether medications you take affect your body's response to the heat.
• Plan your outdoor activities so that you are outdoors either before noon or in the evening.
• Use an umbrella or stay in a shady area so your body's thermostat has a chance to recover.
• Wear lightweight, light-colored, and loose-fitting clothing. A wide-brimmed hat will provide shade and keep your head cool.
• Never leave people or pets in a closed, parked vehicle.
• Wear sunscreen.

Remember... any sudden change in temperature, such as an early summer heat wave, will be stressful on your body.  

If traveling to a hotter climate, allow several days to become acclimated before attempting any vigorous exercise, and work up to such exercise gradually.

The following people are most susceptible to heat injuries :

• Athletes
• Workers who labor outdoors or near ovens/furnaces
• Those who are in poor physical condition
• The chronically ill
• Those not used to warmer weather
• Those with weak cardiovascular systems
• Those using certain drugs, such as diuretics or anti-psychotics
• The obese
• Burn patients
• The elderly
• Children

There are three types of heat-related illnesses or injuries:

Heatstroke

Heatstroke is a true life-threatening emergency. 

Heatstroke is simply the failure of the body to cool itself sufficiently. As the body overheats and reaches temperatures between 105 and 110 degrees Fahrenheit, brain cells become damaged, causing permanent disability or death. No sweating occurs in about half of these patients. No cooling takes place, therefore the heat is stored in the body. Of the 4,000 people in the U.S. who die of heatstroke each year, approximately 80% of those people are over the age of fifty.

Rapid, aggressive treatment is necessary to prevent death and permanent damage from heatstroke. 

Treatment depends upon how long the patient has been hypothermic (overheated). The number one priority after ABC's (checking the Airway, Breathing, and Circulation - in that order) is immediate, rapid cooling of the body. Quickly do whatever is necessary to remove the patient from the source of the heat.

Never give the patient stimulants or hot drinks during the heat emergency!

Signs & Symptoms:

• initial deep, rapid breathing that becomes shallow and weak.
• dilated pupils
• rapid, strong pulse
• decreased blood pressure
• increasing dizziness and weakness
• hot, red skin
• dry mouth
• headache
• nausea or vomiting
• loss of appetite
• mental confusion
• anxiety
• hysteria
• combativeness
• coma

Treatment: 

Call 9-1-1.

Cool the patient. Simple ice packs (if used alone) will not effectively lower the patient's temperature. Use a variety of the following methods:

• Remove excess layers of patient's clothing
• Pour cool water over the patient, avoiding the nose and mouth.
• Keep patient shaded from the sun. (Fan briskly.)
• Place cold packs under the patient's arms, on the neck, groin, wrists, and ankles, and behind each knee to cool the large surface blood vessels.
• If the patient starts to shiver, slow down the cooling process, as shivering produces heat.
• If the patient is conscious, the head and shoulders should be elevated slightly during cooling.
• Be prepared for the related complications of heatstroke treatment, such as convulsions, which produce great body heat.
• Convulsions are likely to occur once the body cools to 104 degrees Fahrenheit.
• Vomiting commonly accompanies convulsions. 
• Position the patient on his/her side for drainage.
• Watch the patient closely.

Heat Exhaustion

Heat Exhaustion is the most common heat injury. 

It occurs in healthy, fit persons involved in extreme physical exertion in a hot, humid environment.  It can also occur among the elderly or those who have too little salt or water in their bodies, even without physical activity. Dehydration is the most critical problem and, left untreated, can progress into heat stroke.

Signs and Symptoms:

• rapid heartbeat
• hot, sweaty skin
• dizziness
• fainting and exhaustion
• stiff, board-like abdomen
• nausea and vomiting

Treatment:

• Move the patient to a cool place away from the source of heat.
• Make sure the patient does not become chilled.
• Apply cold, wet compresses to the skin and fan lightly.
• Have the patient lie down and elevate his/her feet about eight to twelve inches. 
• Remove as much clothing as possible, and loosen what cannot be removed.
• If the patient is conscious, give him/her cool water.
• Encourage the patient to drink as much as possible. 
• Do not give sweetened drinks.
• If the patient vomits, stop giving fluids.
• If the patient does not improve or continue to improve, call 9-1-1.

Heat Cramps

Heat Cramps are the least serious heat injury.

Heat cramps are muscular spasms that occur when the body loses too much salt during profuse sweating, and not enough salt is taken in. Heat cramps can be caused by overexertion of muscles or inadequate stretching or warm-up. Hot weather is not necessarily a cause of heat cramps. In order to function properly, muscles need a strict balance of water, calcium, and sodium. Whenever the balance is disrupted, regardless of environmental temperature, heat cramps may result.

Signs and Symptoms:

• painful cramps
• rapid heartbeat
• hot, sweaty skin
• dizziness
• fainting and exhaustion
• stiff, board-like abdomen
• nausea and vomiting.

Treatment:

• If in a hot environment, immediately remove the patient from the heat.
• Loosen tight clothing.
• Give sips of an electrolyte solution (a very diluted mixture of water and Gatorade or sports drinks) at the rate of one-half cup every 15 minutes.
• Apply moist towels over the cramping muscles.  Do not massage cramping muscles; rather, try gently stretching the involved muscle group.
• Cramps are painful; keep the patient calm.
• If there is heavy sweating, the cramps will reoccur.
• The patient should avoid strenuous exercise for at least 24 hours.
• The patient should respond favorably to the fluid/electrolyte replacement.
• If the patient worsens, call 9-1-1.