Heat Illnesses are a common and treatable summer hazard. A heat related illness should never be ignored; if it is then the victim’s condition will worsen and could lead to death.  Heat illnesses can happen to anyone, but babies under a year old, the elderly, the sick, the physically active, and people exposed to hot weather conditions are at the greatest risk.

Dehydration is easier to prevent than treat.  Your body, under normal conditions, has a certain balance of fluids and electrolytes.  When this balance is disturbed other systems are affected and illnesses occur.  Dehydration is a drop in fluid levels and can usually be treated easily with no lasting effects.  Prevent dehydration by keeping your body hydrated.  If you are doing something active outside such as hiking or a sport, you’ll sweat and breathe a lot harder, losing more fluid than normal.  Some medications also cause fluid loss.  In situations like these, it’s important to drink water or sports drinks (which replace electrolytes as well) whether you feel thirsty or not.  If you feel thirsty, you’re already showing signs of dehydration. It’s good to know the symptoms of dehydration in case you are ever in a situation where you may be at risk.  Below are some of the more common symptoms:

 Early or mild dehydration:

• Extreme thirst
• Flushed face
• Dry, warm skin
• Weakness
• Headache
• Dry mouth with thick saliva
• Decreased coordination
• Fatigue
• Smaller appetite
• Impaired judgment
• Dizziness that worsens as you stand and move
• Small amounts of dark yellow urine
• Arm and leg cramps
• Very few tears (when crying)

Moderate to severe dehydration:

• Fainting
• Convulsions
• Low blood pressure
• Less sweating (internal cooling mechanism becomes ineffective)
• Severe arm, leg, stomach, and back cramps
• Bloated stomach
• Sunken ‘dry’ eyes
• Lack of skin elasticity (a bit of lifted skin takes longer to ‘spring’ back into place)

Dehydration can be treated by:

• Giving the victim more liquids than usual, but in small doses, too much at once could cause vomiting which would lead to even greater fluid loss.  Water, sports drinks, and oral rehydration solutions (ORS) are best.  Sports drinks and ORS replace both fluids and electrolytes.  ORS’s can be bought or made.  The drinks should be sipped slowly, in small amounts for about an hour.  Even if you vomit while doing this, your body is retaining some of the fluids.  Chilling the liquids can help, as it can prevent internal body temps from becoming to high and progressing to heat stroke.
• Nonprescription medicines that will help replenish fluid and electrolyte levels are available.  Salt tabs however should be avoided, as they will lead to further dehydration.
• The person affected should be resting in the shade and should not resume activities until urination becomes normal (pale yellow and clear), and the other symptoms of dehydration disappear.
• Those suffering from dehydration have less of an appetite.  If you fear you are becoming dehydrated (or want to avoid it altogether), make sure you eat and drink small amounts of food 5-7 times a day.
• In cases of severe dehydration, get the person to an emergency room, as untreated dehydration can lead to death.
• If a person who is severely dehydrated can drink, they should still be given the ORS and water.

Heat Exhaustion

Heat exhaustion is similar to, and often follows, dehydration.  It’s what happens when you’re losing more fluid and electrolytes than your body can handle. And although both fluids and electrolytes are being lost, exhaustion is a greater loss of electrolytes whereas dehydration is a greater loss in fluids.  Heat exhaustion is a form of volume shock, in other words, the lack of fluid causes the blood vessels, especially in your arms and legs, to constrict.  Luckily, this is a non-life threatening illness.

Symptoms:

• Sweating
• Increased pulse and respiration
• Pale and clammy skin
• Fatigue
• Nausea and vomiting
• Slightly lowered or elevated temperature
• Exhaustion
• Lightheadedness and dizziness
• Possible heat cramps
• Feeling thirsty
• Decreased urine output

Treatment:

• With enough fluids and rest this illness is self correcting
• A Sports drink or oral rehydration solution (ORS) should be given to replenish decreased electrolytes. Drink fluid slowly, as the body will absorb it better.
• Take a good long rest before continuing with your activities; if symptoms seem severe, you may want to see a medical professional.
• If the person is suffering from heat cramps a slightly salty drink (sports drink or ORS) and stretching the muscle should ease them.  If they return, you should probably discontinue the activity you are doing for the rest of the day.
• If heat exhaustion is not properly treated, it may become Heat Stroke, which is deadly.  If the person’s temperature goes above 103° then treat them for heat stroke!

Prevention:

Keeping up with your body, is more important than keeping a fast pace with your friends.  If you feel the symptoms of exhaustion coming on take a break, slow down, drink and eat a little before going on again.  It will also be helpful to rest during the noontime hours, which are the hottest of the day.  Wearing breathable clothing and a hat will also help to keep you cooler when taking part in physical activities on hot and humid days.

Heat Stroke

Heat stroke is a life-threatening emergency, and victims can die in just 30 minutes so help must be given quickly.  Heat stroke is caused by an increase in the body temperature to about 104° (41°C).  Temperatures over 105° can lead to death.  This increase in temperature causes the brain to overheat.  There are two types of heat stroke: fluid depleted (slow onset) and fluid intact (fast onset).

Fluid depleted (slow)- The person has heat exhaustion, but continues to function in a situation.  Eventually the lack of fluid will minimize the body’s active heat loss capabilities to such an extent that the internal temperature will begin to rise.

Fluid intact (fast)- The person is under extreme heat in a challenging situation, this overwhelms the body’s active heat mechanisms even though fluid levels are sufficient.

Symptoms:

• Hot and Red skin.  Some victims will have hot dry skin (common in the elderly) and others will have hot wet skin (if, for example, they were previously suffering heat exhaustion) in all cases, however the skin should look red
• Pale skin
• Pulse and respiratory rates increase
• Decreased urine output
• Argumentative
• Disoriented
• Increased temperature
• Combative
• Hallucinations
• Dilated and unresponsive pupils
• Seizures, which may lead to the person becoming comatose

Treatment MUST begin immediately

• The most important thing to do is begin to lower the body temperature.  Gently move the person to a shady or cooler spot and remove all non-cotton or un-breathable clothing.  If possible, try moving the person to somewhere where medical assistance will be available.  (Drive to the hospital, or a spot where an emergency team will be able to locate you and take over.)
• Pour cool (NOT cold) water over the person’s extremities.  If water is limited cool off the head and neck area first. Also, try fanning the person to increase air circulation and speed up sweat evaporation.  If available place ice packs at the neck, armpits, and groin In That Order!
• While cooling the person off you should massage the extremities, which helps propel the cooled blood back into the persons core which will in turn lower their temperature.
• After their temperature has dropped to 102° then stop trying to cool them down, as hypothermia may begin and cause the person to shiver, which would generate more heat.  Monitor them closely to make sure their temperature does not begin to rise again.
• If the person is able, begin to replace the fluids they have lost by giving them small sips of water or ORS. Sometimes, because they are temporarily mentally impaired it is impossible to get them to ingest fluids.  In cases like that, continue the cooling process and try to get them to an emergency room.
• In more severe cases, CPR will need to be performed.
• Get the person to an emergency room as soon possible!!  Your quick actions can save their life.

Heat stroke, like all other heat related illnesses is preventable by drinking an ample amount of fluids (not just water, as electrolytes will need to be replaced as well) when you are exposed to heat, or are being physically active. Remember, it is nearly impossible to drink too much water on hot days when you’re active, and that your body absorbs it better when taken in in small amounts.  It is also important not to rely solely on your body to tell you when you’re thirsty as sometimes you become overwhelmed to quickly.  So to stay safe drink often, not because you’re thirsty but because you know you should.

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