It has been very hot all over the world this summer. Here in Oklahoma we had over a dozen days in July alone with temperatures over 100 degrees.
The risk of suffering from a heat-related illness such as heat exhaustion and heat stroke increases during extreme heat. According to the CDC, between 2004 and 2018, an average of 702 people died each year from heat-related causes, and thousands more ended up in hospital. Young children and adults over 65 are most susceptible to heat-related illnesses. However, it can strike anyone who works or exercises vigorously in the heat. In fact, heat stroke is one of the three most common killers of soldiers and athletes in training.
Below, we explain how to recognize heat exhaustion and heat stroke and what to do to treat both conditions.
How to Recognize and Treat Heat Exhaustion
Heat Exhaustion Symptoms
Heat exhaustion occurs when your body can no longer cool itself through sweating due to a loss of water and electrolytes. Heat exhaustion should be treated as soon as you recognize it in yourself or others. Without treatment, it can turn into its most serious sibling: heat stroke.
Symptoms of heat exhaustion include:
- Profuse sweating
- Cold, pale and clammy skin
- Rapid and weak pulse
- Nausea or vomiting
- Muscle cramps
- Tiredness or weakness
- Brief fainting (fainting)
How to Treat Heat Exhaustion
The goal of treatment for heat exhaustion is to cool the victim and restore fluids.
- Move to a cool room. If you don’t have access to an air-conditioned room, at least move to a shady spot.
- Take a cold shower or bath. If this is not possible, drape (do not wrap tightly – this will trap heat) cool, damp towels/rags over the body. Turn on a fan over those towels if you can.
- Remove extra clothing.
- Sip cool liquids, like water and Gatorade.
If symptoms of heat exhaustion persist for an hour despite your treatment, see a doctor.
How to Recognize and Treat Heat Exhaustion
Heat Stroke Symptoms
Heatstroke is the most serious heat-related illness. With heatstroke, the body has lost its ability to cool itself, resulting in a dangerously high internal body temperature (above 104 degrees Fahrenheit). Elevated internal body temperature is life-threatening as it can cause seizures, organ failure, and rhabdomyolysis. Even if you are recovering from heatstroke, you can still suffer long-term damage to your heart, brain (creating cognitive impairments), kidneys (requiring lifelong dialysis or transplant) and liver (requiring also a transplant). Victims of heatstroke often die months after they have “recovered”.
To guide me through the intricacies of identifying and treating heatstroke, I spoke to Dr. Sean Langan, research assistant at the Korey Stringer Institute at the University of Connecticut. The Korey Stringer Institute specializes in research on preventing heat stroke deaths in athletes.
Symptoms of heat stroke include:
- Central nervous system (CNS) dysfunction:
- Aggressiveness/restlessness (Dr. Langan says you frequently see heatstroke victims biting and punching)
- Very high body temperature (104 degrees F or higher)
- Red, hot and dry skin (no sweating). Sean notes that you rarely see dry skin in sufferers to the effort heat stroke (caused by exercise or working in the heat). Those who exercise in the heat may still sweat, and you should be on the lookout for other symptoms, especially CNS dysfunction.
- Throbbing headaches
- Nausea Vomiting
- rapid breathing
- fast pulse
According to Dr. Langan, the critical symptom of heatstroke to watch out for is CNS dysfunction:
You can have really fit people who have an internal body temperature of 104 degrees Fahrenheit at the end of a marathon and are doing well. Their body is adapted to have such a high internal temperature so that they have no CNS dysfunction and cool down quickly after finishing their run.
You may also have someone who has an internal body temperature of 103, but is suffering from CNS dysfunction. This person has heat stroke and needs to be treated.
If you see someone who has been in heat and is showing signs of CNS dysfunction, your best bet is to start treating that person for heat stroke. To confirm, take her temperature with a rectal thermometer (it will give you the most accurate reading) to see if it falls around that 104 degree mark.
How to Treat Heat Stroke
If you think you or someone else has heatstroke, call 911 immediately. This is a life-threatening emergency.
After calling 911 and waiting for help, your goal is to calm the victim as quickly as possible. Research shows that recovery from heatstroke is nearly 100% as long as the body is cooled within 30 minutes of onset. After that, serious, long-lasting and life-threatening complications will occur. Time is really running out.
- Move to a cool place.
- Remove excess clothing.
- Put the victim in an ice bath. It is the best treatment to follow. If this is not possible, douse the victim with cold water and place cold, damp cloths/towels all over their body.
- Pay particular attention to cooling certain areas of the body. Although you have to cool the whole body, the search for Stanford scientist Craig Heller suggests not neglecting the palms of the hands and the soles of the feet. When we overheat, blood flow increases to these areas of the body, which Heller calls “natural mammalian radiators.” You can take advantage of this increased blood flow by placing cold cloths on the palms of the victim’s hands and the soles of their feet. The cold cloth will cool the blood, and the blood will return directly to the heart through the veins, which will help to lower the body temperature. Cold compresses in the groin and armpits will do the same.
- Once you have cooled the person down, give them fluids. Dr. Langan told me that giving a heatstroke victim fluids is not a top priority because it does little to help cool the person down, which is your main job. Once the casualty is cool, offer fluids to rehydrate.
- Continue to monitor the internal temperature until it drops to 102. According to Dr. Langan, this is the safe zone.
Prevent heat exhaustion and heat stroke
An ounce of prevention is better than cure, and there are several things you can do to prevent heat exhaustion and heatstroke.:
Drink plenty of water (and electrolytes). Duh! Your body cools down by sweating. If you don’t have enough fluids in your body, you can’t sweat. If you know you’ll be outside in hot weather, hydrate beforehand. While you’re outdoors, drink at least 8 ounces of water every 15 to 20 minutes.
Don’t skimp on electrolytes, either. Aim to ingest 500 to 700 milligrams of sodium for every hour of exercise. You can get this sodium from sports drinks or electrolyte pills. I like to use a liquid electrolytic productwhich allows me to add more or less to my water, depending on my exercise/sweat level.
Avoid being outdoors during the hottest hours of the day and when it is humid. 3:00 p.m. to 5:00 p.m. is usually the hottest part of the day. If you can, stay indoors during this window.
Also keep in mind that it is more difficult for the body to cool itself the more humid it is.
Be fit. Fit people are not immune to heatstroke, but fitter people are generally better able to handle the heat. Start exercising. It’s the cure for almost everything.
Gradually acclimatize to the heat. If you can’t avoid being outside in the heat due to a scheduled job or sport, you can help your body adapt to it to reduce your risk of developing illness from the heat.
Dr. Langan pointed out several adaptations your body makes as it acclimates to heat. For example, you sweat more and begin to sweat at a lower body temperature, your plasma volume increases, and your core body temperature stays lower longer at a given workload.
Due to the death of American football players from heatstroke in late summer and early fall, several states have implemented a mandatory preseason. heat acclimatization protocols for high school athletes. These states have seen a 55% reduction in heat illnesses since the protocols began.
The essence of the heat acclimatization protocol is to gradually increase the duration and intensity of activity performed in the heat. Regular sauna use can also help speed up the acclimatization process.
Dr. Langan told me that you can start seeing heat adaptation in as little as 3-5 days, but if you really want to make sure you’re ready for hard work in high temperatures, two weeks is the ideal acclimatization time.
Be smart, plan ahead, adapt, and you’ll be ready for the heat.