Preventing heat-related illness

Now that August is here, we are facing the apex of summer weather and the onset of warmer temperatures.

Without appropriate preventative measures, we are vulnerable to a wide range of heat-related illnesses—from heat swelling and muscle cramping to life-threatening heat stroke. As with cold-related conditions in winter, such as hypothermia and frostbite, prevention is essential.

Heat-related conditions develop because the body cannot dissipate heat, leading to differing degrees of heat reactions. Many people notice swelling of the hands, ankles and feet when first exposed to high temperatures. Athletes running in hot weather can experience muscle cramps. More serious expressions of these conditions can be exercise-associated passing out, heat exhaustion and heat stroke.  

Heat-related symptoms are frequently reported in high school-aged students during the early part of football season; this is the third leading cause of death in these athletes. A similar pattern is reported in the U.S. Armed Services and police academies during training.  

There are many environmental and physiological issues that can lead to impaired body temperature control. At high temperatures, our bodies attempt to lower body temperature by sweating. Heart rate increases in an attempt to meet muscle demands if the person is exercising. Blood circulation is diverted from internal organs and directed to blood vessels close to the skin. If sweating is excessive, a person can become dehydrated. If the amount of heat overcomes the body’s ability to dissipate it, our internal temperature begins to rise, leading to heat exhaustion or heat stroke.

Risk factors include the use of certain prescription medications and excessive alcohol intake. Children less than 15 years old as well as older adults can have impaired heat regulation. Lack of exercise, along with a sedentary lifestyle, excessive clothing, obesity and large muscle mass are additional factors. Certain medical conditions like heart diseases, diabetes, sickle cell trait and extensive skin conditions such as prior burns, psoriasis, eczema and prior radiation can also impair heat regulation. If you have any of these medical conditions or have questions about medication, ask your personal physician if you might be at higher risk for developing heat-related illnesses.

Milder forms of heat-related illnesses

Swelling of soft tissues 

Heat rashes 

Cramps of large muscles

Moderate 

Exercise-associated collapse – lightheadness, dizziness when sitting up, and possible temporary loss of consciousness.

Heat Exhaustion: headache, difficulty walking, rapid heartbeat, vomiting, diarrhea, cold clammy skin and elevated body temperature above 101 to 104 degrees.  The distinction between heat exhaustion and heat stroke is where the person is experiencing any degree of confusion or disorientation.

Severe 

Heat stroke: confusion, seizures, low blood pressure, increased respiratory rate, skin can be clammy or dry, internal temperature above 105 F.  Multisystem organ failure (kidney, heart, central nervous system) will occur if not treated as an emergency. 

What to do if you or someone else is experiencing heat-related illnesses?

For mild-heat related conditions, replace their fluids with salt-containing drinks like Gatorade, if available, or just water. For muscle cramps, try getting the person to stretch and offer a gentle massage. For heat rash, find a cooler environment and remove excess clothing and gear.

If someone around you is experiencing moderate heat conditions, such as exercise-associated collapse, it is important to get the person supine with their legs elevated, encourage fluid intake and find a cooler environment. Because it is often unclear why the person collapsed, the person should see a physician as soon as possible.

If someone is exhibiting serious conditions such as heat exhaustion or heat stroke, there are some immediate measures that should be taken, including getting the person supine, elevating their legs, removing any excessive clothing, moving the person to a cooler environment, using a fan, or misting the person with water. This person requires emergency hydration. Fluids should be offered, but the person may be experiencing vomiting. Contact emergency services immediately. 

There are some common-sense measures that can be taken to avoid these heat-related conditions. 

Before fully exerting yourself in a warm environment, start with gentle exercise and gradually increase intensity. Also do not exercise during the warmest time of the day.

Wear light-colored, loose fitting clothing.

Take frequent water breaks.

Monitor and regulate your fluid intake before, during and after exercising or physical exertion. About two hours before exercising, drink two to three cups of fluid. Drink one cup of fluid five to 10 minutes before exertion and drink one cup of fluid every 15 to 20 minutes while exercising. 

Cold fluids are better absorbed than warm fluids. Studies show that the stomach can empty about one quart per hour. If you drink more volume than that, you will feel bloated.