Stay Healthy and Cool in the Summer
Lisa Lanning, DO
As you look forward to spending time outdoors this summer, here are some tips on heat-related illnesses such as heat exhaustion and heat stroke.
Both conditions are preventable, yet, according to the Centers for Disease Control and Prevention, more than 600 people die every year of heat-related illness. They occur when the body loses its natural ability to cool itself in extreme heat conditions and happen most often when temperatures are higher than average and people are spending more time outside.
Heat exhaustion is a fairly common condition in summer. It occurs when the body has dehydrated through excessive sweating and loses its ability to cool. Symptoms include sweating heavily, a fast and weak pulse, muscle cramps, extreme fatigue, weakness, headache, nausea or vomiting, dizziness, lightheadedness and cool, clammy skin.
Heat exhaustion might be mild and often can be treated with oral hydration, cooling and rest, but it might need medical evaluation at a doctor’s office. If you experience extreme exhaustion with hot skin temperature, decreased urination or very dark urine, you need to be evaluated in the emergency department. When severe, heat exhaustion can affect vital organs, including the heart, kidneys and brain.
Heat stroke is a less common medical emergency and the most serious form of heat-related illness. It requires urgent evaluation and treatment in the emergency department and occurs when the body loses its ability to sweat and normal self-cooling mechanisms are impaired.
With heat stroke, body temperature reaches 103 degrees Fahrenheit or higher, physical symptoms of heat exhaustion are present and the skin is usually hot, red and dry. Neurologic symptoms are the hallmark of heat stroke and might range from mild confusion to severe delirium and life-threatening seizures.
Severe cases of heat-related illness can cause acute kidney injury, abnormal heart rhythms and, in extreme cases, might lead to cardiac arrest and death – all in a matter of hours if symptoms are unrecognized and inadequately treated. Effective interventions such as IV fluids and electrolyte replacement do the most good in the early hours of severe heat exhaustion and heat stroke, before lasting damage has occurred.
Anyone can be affected by heat illness, but infants and the elderly are most at risk. Those with chronic illnesses, developmental disability, mobility problems and people who are on dialysis, taking medications that reduce the ability to sweat or increase the chance of dehydration, taking diuretics (water pills) and those with chronic lung disease also are at increased risk.
Many common medications also can increase the risk of heat illness, so please discuss with your primary care provider or pharmacist whether excess heat should be avoided.
Others at risk include workers exposed to hot conditions such as road maintenance and factory workers, emergency workers, police officers, construction crews and landscapers.
When possible, avoid heavy exertion during the hottest part of the day. Do yard work and exercise when it’s coolest in the morning or late evening. Stay indoors in air-conditioned spaces when you are able, and drink plenty of water. If you do not have air conditioning at home, spending time in public places such as a library or the mall are sensible ways to pass the hottest hours of the day. Some communities might set up heat-relief stations in schools or churches during heat waves.
When you have to be outside, wear lightweight, light-colored and loose clothing that “breathes” and allows air movement to cool you. Wear a wide-brimmed hat and sunglasses to protect your eyes and an SPF 15 or higher sunscreen (I recommend SPF 30 or 50 for most folks) to protect your skin.
If you start to feel bad or notice someone with heat-related symptoms, move indoors immediately if possible. If not, get to a shaded area. Rest, drink plenty of water and fluids with electrolytes such as Gatorade or Pedialyte, and monitor symptoms closely.
You may use cold packs, cool baths, showers and fans to cool the body quicker. If symptoms worsen, especially a severe headache, nausea and vomiting, irregular pulse, confusion or other mental changes, go directly to the nearest emergency department. This is an appropriate time to call 911 if you are unable to transport yourself or the individual affected.
Heat-related illness is preventable but can have severe and devastating consequences. Think ahead when you are going to be outside for an extended time during hot weather. Have plenty of fluids available, seek shelter when you notice the earliest symptoms of heat fatigue, and, if symptoms are not improving within an hour or two with home treatment, seek medical attention.
Do not leave infants, children, pets or adults in a hot car for any length of time. With a little planning, we can keep most cases of heat illness from becoming a tragic statistic. Early recognition and treatment of heat-related illness is the next-best strategy to reduce serious heat-related injury – but prevention is always best.
For more information, the Centers for Disease Control and Prevention has many great materials at the touch of a button. Check cdc.gov/niosh/topics/heatstress for tips and, yes, there’s even an app for that!
The National Institute for Occupational Safety and Health has many helpful free apps that you can use to assess your own risk for heat illness, including the OSHA-NIOSH Heat Safety Tool App and podcasts. There are many resources for employers and workers to reduce the risk of heat illness and recognize early warning symptoms.