Beat the Heat

In plain language, under normal conditions the body sweats and then evaporates from the skin.  When engaged in an activity, in a hot environment, excessive sweating can overwhelm the bodies ability to cool itself and or/water is not able to be replaced at the appropriate rate.  Lack of body water impairs further sweating, evaporation and cooling.  If the humidity is too high, sweat on the skin cannot evaporate into the surrounding air and body temperature cooling fails.

• Symptoms of heat exhaustion include profuse sweating, weakness,nausea, vomiting, headache, lightheadedness, and muscle cramps.
• Heat exhaustion can progress to heat stroke when the body's temperature regulation fails. This causes confusion, lethargy and possible seizure, the skin stops sweating and the body temperature may exceed 106 F (41 C ).  This is a life-threatening condition and emergency medical attention is needed immediately.
• Treatment for heat exhaustion includes recognizing the symptoms, stopping the activity, and moving to a cooler environment.  Rehydration with water or a sports drink is essential to treatment for heat exhaustion.  If nausea or vomiting prevents the affected individual from drinking enough water, intravenous fluids may be required.

Other risk factors:

Heat exhaustion usually affects people who are working or exercising in a hot environment. But these circumstances can increase the risk:

• Certain medications such as antidepressants, antipsychotics, and tranquilizers may impair the ability of the body to sweat.
• Alcohol consumption
• The overweight or obese
• Travel from a cooler environment to a hot environment, without proper acclimation

Seeking medical care:

Maintain proper hydration with water, electrolyte replacement solutions or sport drinks.  If nausea and vomiting prevent rehydration, the individual should seek medical attention.
Seek medical care if you experience muscles cramps that cannot relieved through stretching and cramps are recurrent.
Recognize the onset of a life-threatening condition if the person stops sweating, becomes confused, or has a seizure, heat stroke. Call 911 and move the affected individual to a cooler place, remove their clothing, and try to cool the body with cold compresses, ice, and oscillating fans.

Treatment:

• The affected individual should stop their activity and then move to a cooler environment. Clothes may be removed to help with air circulation across the body. Misting the skin with cool water also helps by stimulating evaporation and cooling the body.
• Rehydration is the next important step in treating heat exhaustion. This may be a challenge if the person begins to suffer from nausea and vomiting. Small sips of water, a mouthful at a time, might be tolerated even if some vomiting persists. Water, sports drink and other electrolyte replacement drinks are reasonable options.
• If oral rehydration fails or if symptoms persist, intravenous fluids may be required to replace the water loss because of the excessive sweating. Hydration continues until the patient begins to urinate, a signal that the kidneys have sensed that there is enough fluid in the body, and it no longer retains fluid.
• Muscles cramps and pain may be treated with over-the-counter medications like ibuprofen and acetaminophen.

Complications:

Some affected individuals do not recognize their symptoms and if they are not removed from the hot environment, cooled and rehydrated, the heat-related illness can progress to heat stroke, a life-threatening condition.  Individuals who have suffered from heat exhaustion are more prone to experience another episode and should be cautious when working or exercising in hot conditions.

Prevention:

Understanding one's environment is perhaps the most important step in preventing heat-related illness. If possible, strenuous activities should not be performed in excessively hot or humid environments. However, people often have to work in the heat of the day, or indoors in hot situations and need to make the effort to protect their bodies. These can include frequent breaks taken in a cooler areas, adequate fluid intake, and slowing the pace of work to decrease heat generation within the body.
A person at risk for heat exhaustion should watch their urine output to monitor their hydration status.  If the body is dehydrated, the kidneys will hold onto water, and make concentrated, strong smelling urine. If enough water is present, the urine will turn clear.
Acclimating to conditions allows the body to perform in situations that would otherwise be difficult. The body will make physiologic changes allowing it to cool more efficiently, if it has gradual exposure to hot conditions. Moving from a cool to very hot environment quickly increases the risk of developing heat related-illness symptoms.
Most individuals recover well from heat exhaustion. The key to recovery is recognizing symptoms before they progress to heat stroke. The earlier the activity is stopped, the affected individuals is cooled and hydration begins, the greater the likelihood that complications will not occur.