Lewis Gale Physicians July 05, 2017

Bob is a 30 year-old office worker who likes to go for a run every day. Mary is a 75 year-old retiree who lives alone and does not have air conditioning in her house. Aiden is a 7 month-old child who spends a lot of time in his car seat and stroller as his busy mom runs errands around town. What do Bob, Mary, and Aiden have in common? All are at risk for suffering from heat exhaustion or heat stroke when temperatures start to rise.

Heat exhaustion occurs when the body overheats after a person is overly active in hot temperatures. Heat stroke is a more severe illness that can be life-threatening. Both heat exhaustion and heat stroke can happen when there is a very hot environment, someone is engaging in heavy activity, or someone has too little fluid and salt intake for their body.


Risk Factors

Young children and older adults are at increased risk for heat exhaustion. In addition, people with a chronic medical condition, outdoor workers, and athletes are most at-risk for heat-related illnesses. Factors that may increase the risk of heat exhaustion and heat stroke include:

  • Participating in a job or activity that involves long periods of outdoor activity in hot weather
  • Taking medication that may intensify the way the body handles hot weather, including, antihistamines, beta-blockers, benzodiazepines (including Valium® and Xanax®), amphetamines, neuroleptics (a.k.a. antipsychotics), some antidepressants, cocaine, and alcohol.

Signs and symptoms of heat exhaustion include:

  • Confusion
  • Fast pulse
  • Muscle cramps and tenderness
  • Nausea or vomiting
  • Moist and sweating skin
  • High temperature (over 100 degrees)
  • Weakness and lightheadedness

Signs and symptoms of heat stroke include:

  • Blurred vision
  • Confusion
  • Fast breathing and heartbeat
  • Seizures
  • Pale and dry skin; no sweating
  • High temperature (over 103 degrees)
  • Unconsciousness
  • Weakness and lightheadedness

Treatment

If heat exhaustion is suspected:

  • Move the person to a cool, shady area.
  • Give fluids—fluids that contain both salt and sugar work best. If the person isn't able to drink, it may be necessary to give fluids by IV.
  • Encourage the person to rest.

If heat stroke is suspected:

  • Call 911 immediately. Heat stroke is a medical emergency.
  • Move the person to a cool, shady area.
  • Actively cool the person—the most effective way is called evaporative cooling. In evaporative cooling, the person is sponged with cool water or sprayed with cool mist, and fans are used to blow air onto the person.
  • Do not give fluids.

Prevention

The easiest way to help prevent heat exhaustion and heat stroke is to:

  • Avoid prolonged exposure to high temperatures and, when possible, schedule activities early in the day.
  • Drink plenty of fluids, preferably sports drinks that contain both salt and sugar, and take frequent breaks in the shade. Avoid alcohol.
  • If you have a risk factor for heat exhaustion or heat stroke, be careful participating in activities in hot weather.
  • Stop activity if you feel faint, weak, or have muscle cramping. These can be early signs of overheating.
  • During heat waves, try to spend time indoors with air conditioning. This is especially important for older adults.
  • Never leave infants or children in a parked car.
  • Check on friends or neighbors who are at-risk for heat exhaustion or heat stroke.

Many cities offer air-conditioned shelter to the homeless or poor during times of extreme heat. Some also have programs that help with cooling bills or give free fans or air conditioners to residents who cannot afford them. Check with your municipality’s department of public health to see if a program exists in your area.

For more information regarding heat stroke, exhaustion, or other illnesses that tend to occur in the warmer months, please contact Henry Burgess, MD, at LewisGale Physicians in Daleville, Virginia. His office phone number is (540) 966-6430.

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