Summer fun usually involves the summer sun. Do you know how to spot heat related illness? Knowing symptoms of heat stroke, heat exhaustion symptoms and what to do in case of an emergency will insure that you have a fun safe summer!
As a paramedic in Southeast Texas heat related illnesses and emergencies are common sights occurring year round. Coming up on the busy summer travel season a big part of safety is knowing and recognizing the signs and symptoms of heat related illness. Humidity (often found in coastal areas) can significantly increase how hot a day “feels”. It also severely hampers the human body’s normal coping mechanisms and ability to thermos-regulate. Heat related emergencies can come on fast, are extremely dangerous, and can certainly be fatal if left untreated. Luckily, with a little preparation and knowledge these types of emergencies can often be avoided all together or recognized early when there is enough time to treat them. We are going to review heat cramps, heat exhaustion symptoms and symptoms of heat stroke.
Heat Related Illness Risk Factors
Heat related illnesses can happen to anyone but there are definitely some risk factors that can up your chances. Risk factors to be aware of are:
Travel to a new climate.
If you are from the north and decide to take a trip south during the summer, you may be in for a big surprise. Growing up in Rhode Island I used to think that 85 degree summers were miserable because of a relatively high humidity. Well, let me just say that one doesn’t truly understand “hot and sticky” until it is 100 + degrees and foggy even well after the sun has gone down. The moral of this story? Do a little research ahead of time and know what you are getting yourself into.
For some reason every picturesque summer vision involves fun in the sun with a frosty adult beverage but really these two things go together like road flares and gasoline. Don’t get me wrong, you can have a hell of a good time with these things in combination BUT you need to be really careful.
The basics are this:
The sun will make you hot, which will make you sweat. Sweating makes you significantly more likely to become dehydrated. Alcohol, especially with copious consumption, will definitely make you dehydrated. Put these two things together? Now we have the perfect recipe for significant or even severe dehydration. What does severe dehydration do? Severe dehydration knocks out the body’s ability to cool itself. Dominos people. Drink responsibly and hydrate (with water) often.
Did you know that medication you are taking can make heat related emergencies more likely? Medications can interfere with the body’s ability to thermo-regulate. Some of these types of medications include (but are certainly not limited to) trycyclic anti-depressants, phenothiazines, anticholinergic medications (such as dyphenhydramine or Benadryl), pain medications, and benzodiazapines. If you are unsure about a medication you or a loved one takes contact your doctor or pharmacist and ask.
Age- The Young and the Old.
Keep in mind that age plays a big factor in heat emergencies. Both the very young and the very old (relatively of course) are most likely to be effected by temperature extremes. The very young’s ability to thermo-regulate isn’t fully developed, and older bodies no longer function like they used to. Make sure your little ones drink plenty of fluids and stay in the shade as much as possible and be mindful of Grandma wearing her best polyester suit on a 100 degree day.
Heat Related Illnesses Include Heat Cramps, Heat Exhaustion and Heat Stroke
Relatively benign in and of themselves heat cramps are certainly a warning sign that something more severe could be coming. Heat cramps are caused by relatively mild to moderate dehydration and are most likely to occur in the stomach, arms and/or legs. Heat cramps, though painful, don’t usually indicate a state of hyperthermia as the body is most likely still able to cool itself. Vital signs should be relatively normal.
What to do: If you suspect that you or someone else is experiencing heat cramps get out of the sun and into a cool place. Push fluids. This is where electrolyte drinks such as Gatorade and Powerade really shine. Contrary to popular belief, it is actually extremely difficult to “over hydrate” unless you have some type of renal failure or heart condition so drink LOTS of fluids. Avoid caffeinated and alcoholic beverages as they will only make cramps and dehydration worse.
Heat Exhaustion Symptoms
More serious than a heat cramp is heat exhaustion. Immediate and decisive action is required. Sudden weakness, fatigue, dizziness, confusion, nausea, vomiting, profuse sweating, flushed skin, tachycardia (rapid heart rate) or even syncope (passing out or fainting) can all be heat exhaustion symptoms. These heat exhaustion symptoms show that the body is becoming hyperthermic and losing the battle of thermo-regulation. Vital signs start to go a little wonky. Core body temperature will usually be up 1-2 degrees at this point, heart rate will be elevated, and blood pressure will start to drop. This is an emergency and should be treated as such.
What to do:
- Immediately move the person to a more temperate place (such as inside a building with air conditioning).
- Remove excess clothing.
- Attempt to cool the person down by fanning them, use cold compresses, and possibly even ice packs.
- It would be a good idea to call 911 at this point. Those afflicted with heat exhaustion are likely to be severely dehydrated.
Those afflicted with heat exhaustion are likely to be severely dehydrated. The tricky part and the reason that you may want to call 911 is that they may have trouble swallowing. There is a good chance that they will require IV fluids. If you decide to give fluids by mouth be extremely careful. Again avoid drinks with caffeine or alcohol. They will only make the problem worse.
Symptoms of Heat Stroke
Heat Stroke is a no crap, bona fide, emergency and needs to be treated as such. You are officially behind the proverbial “8 ball” at this point. The body is on the brink of total collapse since it has lost its ability to cool itself. Core body temperature will be 104+ degrees. Additionally, this person is likely to be extremely dehydrated.
Symptoms of heat stroke include:
- Changes in mental status (such as confusion and or disorientation)
- Syncope (passing out or fainting)
- Rapid breathing
- Lack of sweating. Lack of sweating in a hot environment is a serious warning sign and of grave concern.
- Cardiac Arrest is certainly possible- particularly if the heart rate is abnormally slow.
- Vital signs will look “shocky,” with a rapid heart rate, rapid breathing, and low blood pressure.
What to Do if You Suspect Heat Stroke:
- Move the person out of the warm environment and into a cool place immediately (such as inside a building with air conditioning).
- Remove clothing and begin active cooling by any appropriate measure such as cold compress, ice pack, and active fanning.
- Call 911 IMMEDIATELY. This person will require immediate medical intervention and IV fluids. Fluids by mouth (assuming that the person is conscious and able to swallow) will not likely be able to fix the problem at this point.
- If the person is unconscious, be prepared to protect his/or her airway and lay them in the “recovery position.” Be prepared to perform CPR. You did remember to take a CPR class right?
Heat Illness Things to Remember
NEVER give anyone who is confused, disoriented, or unconscious ANYTHING by mouth. This is likely to cause an airway obstruction and an immediate threat to their life.
If someone has passed out from what you believe to be a heat emergency, DO NOT pour water down their throat.
Actively cooling someone down who has overheated is tricky because it is very easy to cool them down to much so don’t overdo it and cause a cold exposure emergency in the middle of July. Unsure of what to do? Call 911. We can help. That is what we do.
I’d like to close out with a public service announcement. The VAST MAJORITY of heat related emergencies that I encounter professionally involve both “fun in the sun” and “alcohol” in some combination. Summer is the time for celebratory BBQ’s, weekend getaways, and lake vacations. Make good decisions. Don’t drink and drive anything- this includes cars, boats, bicycles, riding lawnmowers, scooters. Again drink plenty of water and dress appropriately for the weather. Have a fun and safe summer!