Straight, No Chaser: Beat the Heat (and Not Just in Miami)

When a loved one dies, families often ask “Is there something I could have done?” Usually I give you information. Today I want to give you information and power to act if needed. There are several varieties of heat related illness, and you would do well to be aware of them, because you can make a difference if someone’s suffering in the heat.

For starters, I really want you to become mindful of Heat Stress, which is the earliest complex of problems arising from excessive heat exposure. Heat stress is that strain and discomfort you get (usually during outdoor exertional activity) that reminds you that you’d be better off inside. You may notice such symptoms as cramping, a prickly-type rash, swelling and a sensation that you want to lose consciousness. If you must remain outdoors due to work, or choose to (playing sports or enjoying the sun), hydration means everything. It really is true that in some instances if you’re not actively urinating, you’re not drinking enough fluid.

Ok, so you’ve ignored both me and your body, and you’re still outdoors, not rehydrating enough. Heat exhaustion may occur next, and it’s defined by ongoing body salt and fluid losses. Now you’re feeling faint, thirsty, anxious, weak, dizzy, you want to vomit and may have a headache, and your body temperature starts to climb. I see a lot of these patients, usually because once you get wobbly, your employers or co-workers are getting concerned, which is good, because at this point, you are actually in danger.

Or maybe you didn’t come to see me when you had the chance, and you’ve collapsed outdoors, to be found and brought in. This is Heat Stroke, and is defined by changes in your mental status, increases in your temperature and disruption of your bodily functions, including a loss of ability to sweat and a loss of your kidney and liver’s abilities to detoxify your body the way they normally do.

Well, in case you’re feeling good about yourself because you’re too smart to exert yourself outdoors, all I’ve been describing is ‘Exertional’ Heat Stroke. The more deadly form of heat related illness is ‘Classic’ Heat Stroke. This is the type that captures the headlines every year in places like Chicago, New Orleans, Miami and Houston. Classic Heat Stroke is seen in those with underlying disease, bad habits or the elderly. I’m talking about the obese, alcoholics, meth and/or cocaine users, folks with thyroid or heart disease or on certain medications like diuretics or beta-blockers. These folks can get the same symptoms simply by not being able to escape the heat. They may actually just be sitting around in a less than optimally air-conditioned home.

So that’s what you’re up against. And yes, many people die from this. By the way, you’re not protected from the heat related illness just because you’re in shape. Let’s end with some 2 tips (one for prevention and the other for assessment and treatment) to help you Beat the Heat.

1) Take caution during the following conditions

  1. 95 degrees is high risk, regardless of the humidity
  2. 85 degrees and 60% or above humidity
  3. 75 degrees and 90% or above humidity

Here, you want to remove yourself from that environment. You need to keep plenty of fluids around. You need to visit an environment where there’s adequate air conditioning. Dress very lightly.

2) If symptoms of heat related illness short of mental status changes occur, think “Check, Call, Care, Cool”

  1. Check – look for those signs and symptoms I mentioned earlier
  2. Call – call 911 immediately. Better to have it and not need it than need it and not have it.
  3. Care – Lie in a cool place, elevate the legs, place cool, wet towels on the body (especially in the armpits and groin), and drink cool fluids. If mental status changes occur, or if the heart or lungs appear to give out, cool by any means necessary while waiting for the ambulance. This could include ice bath, ice packs, fans or cold water, but don’t drown someone trying to put them in a tub of water if you can’t handle them. Don’t forget to remove those layers of clothing.

Please be mindful that it is hotter in July, and unfortunately lives are lost every year to the heat. If you can’t avoid the exposure, at least have a plan for managing the heat and acting on any mishaps. The life you save may be your own.

5 Comments

Filed under Environmental, Health Prevention, Medical Treatment, Neurology

5 responses to “Straight, No Chaser: Beat the Heat (and Not Just in Miami)

  1. Annette

    This is so right-on. (Do they still say that any more?) We (my husband and I) just took a call from a friend a couple of days ago, whose wife was exhibiting all of the symptoms of heat exhaustion. We did a quick Internet search on her symptoms (as described in your blog), which seemed to confirm this observation. Our friend took steps to cool his wife down in the shower and gave her plenty of water to drink. This seemed to restore her to the point that she felt well enough to go to work the next day, but she left early because she was still not feeling that great. So, my question is this: Is the cool-down treatment sufficient, be it for you or someone else? What is the follow-up? Meaning, what symptoms might occur–or persist–to indicate that further medical treatment is needed? Should we be concerned about getting “Jane” to the hospital, no matter what?

    • Hi, Annette, and thanks for the question. From what you’re describing, I’d have advised that patient be seen in the Emergency Department, if for no other reason than to have tests done to check liver and kidney functions. Once you’ve displayed that level of symptoms (certainly any mental status changes, vomiting, cramping, weakness, etc.), you don’t know where the slippery slope ends. The last thing I’d recommend is for you to engage in activity at home and develop a sense of false security. You can be made to feel better pretty easily but still have significant internal damage occurring. That said, I do encourage you to engage in the activities described WHILE you’ve waiting for the ambulance or en route to the ER. There are a lot of times where people come to the ER unnecessarily. This isn’t one of them.

  2. Annette

    Thank you. I shared these thoughts.with my friend and, upon consulting with their doctor, I think he was already planning to take his wife in to the hospital today for evaluation, but he will do so now, for sure (this is, like, 36 hours later).

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