Sunday, December 4, 2022

Tips for staying safe in the heat

Circa 2001, Heat Illness in its various manifestations came to the forefront on the nation’s collective consciousness. Korey Stringer in 2001 of the Minnesota Vikings died of a severe heat related illness with a core body temperature of 108°F.  Korey had intravenous fluids for hydration before his collapse and death.

Fortunately, sports medicine has rapidly progressed, and aggressive measures are made to prevent a disaster like this from ever happening again. Measures of humidity and on-field temperature with careful monitoring of student athletes’ hydration status and monitoring signs of heat illness prevents tragedies like these from happening. Our local athletic trainers do a tremendous job of maintaining the safety of our student athletes.

Heat Illness is still an important cause of death throughout the U.S.  Somewhere between 175 and 400 U.S. citizens succumb to some form of heat illness each year. In 2003 during a heat wave in Europe 35,000 people died from heat related causes!  Recognizing the signs and symptoms and early treatment are the keys to saving lives.

Heat Illness comes in a continuum of syndromes. Heat cramps occur early as an overabundance of salts are lost in sweat as compared to water. Heat exhaustion is what we see most commonly in the medical setting. Symptoms to watch out for are nausea, dizziness, headache, weakness, stiff limbs, shakiness, and, of course. cramping.  Don’t confuse these symptoms with “a bug” or a bad hot dog you just grilled. Vomiting or confusion are serious indicators that real trouble is about to set in. Heat stroke is the most serious and frequently fatal form of the disease and occurs when the body loses its ability to cool itself off at a certain point. Seek immediate medical care. In the meanwhile, disrobe and use a water mister and fan to lower your body temperature until help arrives. Ice packs in the groin and armpits are also of benefit. Fortunately, this form of heat illness is the least common.

The minute any of these symptoms occur, one should immediately remove themselves from the heat to a significantly cooler place and slowly rehydrate with a balanced decaffeinated rehydration drink or water. Some items such as Gatorade contain sugar and diluting them in half with tap water is perfectly acceptable. If your symptoms do not immediately improve, seek medical attention immediately. If you treat yourself you should generally wait at least 24 hours after all your symptoms have passed, then slowly re-engage in whatever activity in the heat with frequent water breaks in the shade or indoors. Consult with your physician.

Prevention is often overlooked and rather easy. Hydrate well before your activity and take plenty of water breaks in a cooler place. Various sports drink and rehydration products are on the market. For most people either mix one of these with water–half/half–or alternate the drink with water. Flavored salt tablets are also another viable and popular option.  Wide brimmed hats do help reduce the amount of heat you absorb. Alcohol is never a good idea when you are going to be out in the sun for a prolonged period of time. If you do drink, drink responsibly and alternate the alcohol with a non-caffeinated beverage or water. Our body depends on sweating for evaporation to keep ourselves cool. Be very, very wary of taking drugs like Benadryl, Claritin, or Zrytec before being in the heat as they inhibit your ability to sweat. This drastically increases your chances of developing a heat-related illness. If you have small children with you or elderly with you, use extra care.

In Texas many of us sense that we are immune to the heat. (One man’s heat spell is another man’s cold front, right?) It is true that our bodies do acclimate when the temperature increases gradually and our tolerance goes up. There are limits to this, however, and even the most ardent sun lovers and boaters know this to be a fact. Beware of sudden heat shifts!

I recall one summer not too long ago we had had a mild June until the last weekend when the temperature spiked 20° in a matter of one day (such is Texas).  I was working in an ER where we rarely saw any trauma aside from motor vehicle accidents. In a period of 5 hours that evening 4 stabbings (unrelated to one another) and one gunshot wound came in. This nightmare was undoubtedly related to the sudden shift in temperature causing some heat-related illness, with changes in personality and flaring temperatures.

I use this real life experience to illustrate how easily the average citizen can be fooled by a drop in the temperature. July comes around, and it rains for a day. The high temperature reported for the day is 87°, and our weekend warriors decide to take advantage. One fails to take into account the humidity index and viola, they develop a severe heat illness to their surprise. I have seen this countless times.

As important as hydration is with or without salt containing drinks, there is one more important point I would like to relay to the community. No matter how acclimated you may be, no matter how hydrated you are, our bodies can only absorb so much heat before our systems can no longer accommodate it (see 1st paragraph). This is very individual and varies greatly from person to person. The symptoms are easy to ignore, but they do cascade quickly and can lead you into grave trouble. If you develop the warning signs discussed, immediately take yourself out of that environment. If you are still not improving, please seek medical attention!

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