Heat Illnesses: How to Stay Safe in the Heat

Do you know what the warning signs are if you've stayed out too long in the sun? Here is a quick guide of what to look for and what you can do to keep cool.

Heat Illness Overview

When your body becomes heated to a point that your body cannot cool itself down properly, it begins to show various warning signs. Heat illnesses fall under several categories:

  • heat rash
  • heat cramps
  • heat swelling
  • heat syncope
  • heat exhaustion
  • heat stroke

Heat Rash

While most heat rashes (also called prickly heat) are mild and disappear in a few days, severe cases can interfere with the body's ability to cool itself and can lead to fever or heat exhaustion. The condition most often occurs in humid environments, and is more likely to affect infants and active people.

Symptoms

  • itchy skin
  • prickly, stinging sensation
  • tiny bumps surrounded by red skin (usually on clothed parts of the body)

Prevention

Limit outdoor activities that cause excessive sweating, especially in high humidity areas. Stay cool with air conditioning, fans and cool showers. Keep skin dry and wear lightweight, loose-fitting clothing.

Treatment

Keep the infected area cool and dry. After the skin has cooled down from its initial exposure to heat, apply calamine lotion or a 1% hydrocortisone cream for the itching. However, stay away from any oil-based ointments and lotions, which will continue to trap sweat on your skin. You may also want to consult your doctor about using an antihistamine, such as Benadryl. If the rash does not clear up in a few days, or if it develops an infection, consult your doctor.

Heat Cramps

Heat cramps often occur after strenuous exercise in heat, and tend to occur in the legs or abdomen.

Symptoms

  • cool, moist skin
  • muscle spasms, twitching
  • hard and lumpy muscles
  • tender muscles
  • nausea, possibly with vomiting
  • fatigue
  • rapid heartbeat

Prevention

Heat cramps occur as your body loses water and electrolytes (minerals in your body) through excessive sweating, so be sure to drink plenty of fluids anytime you are outdoors. Water is great at preventing dehydration, but also consider drinking sports drinks, such as Gatorade, or juice in order to replace lost electrolytes. Be sure to check with your doctor before drinking sports drinks if you are on a low sodium diet.

Treatment

Because salt is one of the things your body has lost through sweat, consider eating salted foods for a few days, if you are not on a sodium-restricted diet. However, stay away from salt tablets, which may upset your stomach. Also be sure to avoid intense activity for a few days to allow your muscles to rest. Massaging and stretching the sore muscles should also help. If symptoms do not ease after one hour, consult your physician.

Heat Swelling

Heat swelling, also called edema, usually occurs in the hands, legs, ankles and feet. It happens after standing or sitting for a long time in heat.

Symptoms

  • swelling, especially in lower legs and feet

Prevention

If you are standing outside for a long time, be sure to periodically flex your leg muscles. This will help with circulation and help to prevent blood from pooling in your legs (which can also lead to fainting).

Treatment

Rest and elevate the legs.

Heat Syncope

Heat syncope, which is a form of fainting, occurs after a sudden loss of blood pressure as the blood pools in the legs after a long period of standing or exercise.

Symptoms

* faintness
* lightheadedness (especially when changing positions, such as sitting or standing)
* weak pulse
* cool, moist skin

Prevention

Be sure to keep as hydrated and cool as possible. If standing for long periods of time outdoors, try sitting down as much as possible or at least periodically bending the legs to keep the blood circulating.

Treatment

This condition is usually short-lasting and greatly improves after lying down in a cool environment. However, if the fainting lasted for more than a minute, or is accompanied by changes in mental state, consult your doctor immediately.

Heat Exhaustion

If exposure to heat continues, your body will experience heat exhaustion, also known as heat prostration and heat collapse. While not usually life threatening, it does require immediate medical attention, and should be taken very seriously as it can lead to heat stroke.

Symptoms

* dizziness, fainting
* nausea, possibly with vomiting
* headache
* rapid heartbeat and breathing
* change in mental state (irritability or decreased alertness)
* blurred vision
* fatigue and weakness
* heavy sweating
* pale, clammy skin
* heat cramps

Prevention

This condition usually occurs from a combination of heat and loss of fluids. Always make sure to keep as cool as possible when outdoors (find shade, fan yourself, wear lightweight clothing) and drink plenty of fluids.

Treatment

Most very mild cases of heat exhaustion can be treated by simply rehydrating the body and cooling its temperature. However, with more severe symptoms (such as changes in mental state, vomiting, blurred vision, fainting, etc.) or symptoms lasting for more than one hour, consult your doctor immediately. Heat exhaustion itself is not usually a life-threatening condition, but it can easily escalate into heat stroke, which can be fatal. If ever in doubt of the seriousness of your condition, do not hesitate to consult your physician or seek emergency treatment.

Heat Stroke

The most dangerous heat illness, however, is heat stroke. This is when the body can no longer cool itself down and the results often lead to death.

Symptoms

* hot skin, either extremely wet or dry
* temperature of 105°F or higher
* vomiting and diarrhea
* unconsciousness
* delirious mental state, including dementia, disorientation or hallucination
* mental state changes, including anxiety, restlessness or confusion
* seizures
* rapid heartbeat
* rapid, shallow breathing
* breathing difficulty

Prevention

As with other heat illness, try to keep as cool and hydrated as possible. At the earliest signs of heat stroke, seek medical help immediately. If you are unsure whether symptoms are leading to a heat stroke or not, err on the side of caution and consult a physician or seek emergency care.

Treatment

Calling for emergency help or going immediately to the emergency room is your first priority. While waiting for help or in route to the hospital, focus on cooling the victim's body with the following methods:

* drink water if physically able (do not force if unconscious or in decreased mental state from the stroke)
* move to shaded or air conditioned area
* remove noncotton clothing
* soak body with water (especially head and neck)
* fan the body
* use ice packs on neck, armpits and groin areas
* lie down with feet raised
* massage extremities for circulation
* do NOT give aspirin or acetaminophen -- extreme body heat from heat stroke is not treated the same as a normal fever; taking these medications may cause further problems
* you may need to perform rescue breathing if the victim stops breathing

Dehydration

Dehydration is another heat-related condition that you need to watch for because it will put you at risk for other heat illnesses. Always drink plenty of fluids to keep properly hydrated. Once you've become thirsty, your body is telling you that you're already dehydrated. So don't wait until you're thirsty to drink water -- start treating fluid intake as a preventative measure.

Symptoms

*
* increased or extreme thirst
* dry mouth
* decreased urination
* dark urine
* lightheadedness

Severe dehydration requires immediate emergency care and is life-threatening. Symptoms include:

* lightheadedness or faintness not relieved by lying down
* weak, rapid pulse
* either cold, clammy skin or hot, dry skin
* little or no urination
* unconsciousness
* change in behavior (severe anxiety, confusion, drowsiness)

Who's Most at Risk for Heat Illnesses?

* elderly adults
* children, especially under five years old
* mentally impaired people
* alcohol and illegal drug users (which interfere with heat regulation)
* obese people
* people without access to air conditioners
* people living alone or in poverty
* people who work or exercise outside for long periods of time
* people with illnesses such as high blood pressure, heart disease, diabetes, peripheral vascular disease, cystic fibrosis, mental illnesses, Parkinson's (many of these conditions are treated with medications that interfere with heat regulation)
* people who are dehydrated

General Heat Illness Prevention

* get plenty of water -- approximately 8 oz of water per 20 minutes of activity (note: if you are on limited fluid intake or on water pills, please consult your physician as to the amount of water you should take)
* stay away from alcoholic, caffeinated and carbonated beverages
* take frequent showers to cool down
* wear lightweight, light-colored and loose-fitting clothing
* wear a wide-brimmed hat
* avoid strenuous outside activity during the hottest parts of the day
* stay in the shade when outdoors and use air conditioning indoors and in the car
* NEVER leave any person or animal in a closed, parked vehicle
* check regularly on people who are at risk for heat illness
* use a buddy system -- heat exhaustion and stroke can occur suddenly and may affect mental alertness

General Heat Illness Treatment

* stop physical activity and take time to rest – preferably in an air-conditioned or shaded area
* elevate feet
* remove unnecessary clothing
* use an ice pack, fans or cool water to cool down, especially under armpits, on neck and on groin areas
* drink plenty of fluids, including water, juices and sports drinks – stay away from beverages containing alcohol, caffeine or carbonation (note: consult your physician if you are on a low-sodium diet before drinking sports beverages; also consult your physician as to the recommended amount of water intake if you are on a fluid-restricted diet or on water pills)
* be sure to get plenty of rest for the next few days to allow your body to recuperate
* do not take acetaminophen or aspirin to reduce your body's heat -- your body will not react in the same way as it does to a regular fever

In summary -- play it safe in the heat. Drink plenty of fluids and limit your amount of time in the heat. When it comes to heat illnesses, never take a chance with your health. Do not hesitate to seek medical help -- heat strokes can occur suddenly and can be fatal, so keeping your body in check before this happens is key.

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