Heat Related Illnesses

Updated 3/2017-- photos and all links removed as many are no longer active and it was easier than checking each one.

Here in Arkansas, we are just now getting to the hottest part of our year. The first few weeks of August are typically the hottest for us. This is when we have to worry the most about heat related health issues. I don't typically see heat related injuries in my practice, but do in my relatives (heat cramps and heat exhaustion) who don't always follow common sense regarding the summer heat. My husband likes to mow the yard during the hottest part of the day. I will occasionally see it affect postoperative patients who “think” they are back to normal and find they are more sensitive to the heat than they expected.

The very young and the elderly are especially vulnerable to the heat. People with chronic health issues are also at greater risk and need to take special care to stay healthy in the heat.

Key Precautions for Prevention of Heat-Related Illness

• If possible try to acclimate to the weather. Those who work in the heat are usually more "used" to it. Humidity can make it "seem" warmer than the actual temperature (heat index).
• Dress for the heat. Wear lightweight, light-colored clothing and use a hat or umbrella. If your post-surgery garments (girdles for tummy tucks or liposuction) or casts are unavoidable, then consider staying indoors or carrying a hand-held battery operated fan with mist
• Don't just carry water or juice with you. Drink it, even if you don't feel thirsty. Avoid alcohol and caffeine, which can dehydrate the body. If you are recently post-surgery, you may need even more fluids than normal. Drink enough that your urine is light in color.
  
• Avoid using salt tablets unless directed by a physician.
  
• Avoid strenuous activity. If you must do something physically demanding (work or football/band practice), try to do it during the coolest part of the day (between 4 am and 7 am). If you must do it later in the day, remember fluids. If you are sweating, you are losing fluids and salts. Consider drinking one 8-oz Gatorade for every 1-3 8-oz water.
  
• Stay indoors as much as possible. Use a fan or air conditioning. Really important if you are newly post-surgery, very young or elderly, have a heavy cast on.
  
• Take regular breaks when engaging in physical activity on warm/hot days. Take time out to find a cool place (shade tree, indoors, lake).

Common Heat-Related Disorders
Heat Cramps
Symptoms include painful spasms, usually in the legs and abdominal muscles.
Treatment–
• Stop the activity and rest in a cool place.
• Lightly stretch or gently massage the muscle to relieve the spasms. Sip or slowly drink cool water.
Heat Exhaustion
Symptoms include heavy sweating. Skin may be cool, pale, and clammy (even with the sweating). Pulse will be fast and may be weak. Breathing is often fast and shallow. The person may feel faint and/or dizzy. They may complain of headache, weakness, and thirst. The person may have nausea and vomiting. Core (rectal) temperature is elevated, usually around 100 F or more.
Treatment–
• Get to a cool place.
• Lie down and loosen up your (their) clothing.
• Apply cool, moist cloths. If water hose or mist available, use it to cool the skin.
• Give sips of cool water or ice chips. Gatorade or other sports drinks will help replace the salt that has been lost. Salty snacks are appropriate, as tolerated. If unable to keep this down, then needs to be seen in the emergency room for IV fluids.
Heat Stroke
Symptoms include a temperature of 103 F or more (105 F or more). No sweating, a rapid pulse, fast and shallow breathing. The skin will be flushed (red), hot, and dry. The person will have nausea, dizziness, a headache, and confusion or delirium. The person may be unconscious.
Treatment–
• This is a severe medical emergency. Summon emergency assistance or get the person to the hospital without delay. Delay can be fatal.
• Move the person to a cooler environment while waiting for the EMT’s.
• Use whatever method available (cool baths, water hose, misting) to begin reducing the body temperature while waiting.
Don't forget to Protect your Pets. Animals, like we humans, can easily overheat during the hot summer months. Many of us include our animals in our outdoor activities (walking, picnics, etc) so please protect them as well as yourselves.
• Limit exercise to the coolest part of the day, typically early morning. Watch for warning signs–glassy eyes, frantic panting.
• Make sure your dog has constant access to shade and an endless supply of cool, clean water.
• Never leave a dog in a car, even for a few minutes.
• Remember that older, obese, and short-nosed dogs are less tolerant of the heat.
Heat stroke in animals, as in humans, can be deadly and requires emergency medical attention. While seeking medical help, cool the animal down with wet towel, spray him/her with cool water, provide ice chips if conscious.
Symptoms of heat stroke in animals can include:
• Sluggish and non-responsive demeanor
• Bright red and/or dry tongue and gums• Vomiting or diarrhea
• Unusual breathing pattern, heavy panting, or high heart rate
References:
Heat Exhaustion and Heat Stroke--eMedicineHealth
When the Sun Goes Up, Don’t Let Your Guard Down
By Julie Irby , Special to Redcross.org
Tips for Preventing Heat-Related Illness--CDC
Heat exhaustion: First aid--MayoClinic.com