Heat Exhaustion: Identify, Treat and Prevent! An Annapolis Urgent Care Spotlight

Heath exhaustion and other heat-related illnesses are rising as temperatures in the Annapolis area continue to soar. Extreme heat causes more deaths than hurricanes, lightning, tornadoes, earthquakes and floods combined! What are the symptoms of heat stroke? What can you do to help yourself, young children and seniors? Evolve Medical presents an Annapolis Urgent Care Spotlight to make sure you know what to look for, what to do and how to avoid heat stroke and heat exhaustion. 

Heat-Related Illnesses

There are several types of heat-related illnesses but heat stroke and heat exhaustion are the most serious. Below is a brief description and what to look for in more serious cases. 

Heat stroke is the most serious form of heat-related illness and happens when the body becomes unable to regulate its temperature. Sweating stops and the body can no longer rid itself of excess heat. Heat stroke is a medical emergency that may result in death! Call 911 immediately.

What to look for:

• Confusion, agitation, slurred speech, irritability, delirium, seizures and loss of consciousness
• Seizures
• Body temperature of 104 F (40 C) or higher is the main sign of heatstroke
• Alteration in sweating.
  • If brought on by hot weather, skin feels hot and dry to the touch
  • If brought on by strenuous exercise, skin may feel moist
• Nausea and vomiting
• Flushed skin
• Rapid, shallow breathing
• Racing heart rate
• Headache

Heat exhaustion is the body’s response to loss of water and salt from heavy sweating.

What to look for:

• Heavy sweating
• Fatigue and weakness
• Throbbing headache
• Pale, clammy skin
• Rapid heartbeat
• Dizziness
• Fainting
• Nausea or vomiting
• Muscle or abdominal cramps
• Temperature elevation under 104 degrees Fahrenheit 

 

Heat syncope (fainting) usually does not last long and improves when you lie down to a flat position. 

Heat edema is swelling, often of the legs.  If you must stand for a long time in a hot environment, flex your leg muscles often so that blood does not pool in your lower legs, which can lead to heat edema and fainting.

Heat cramps are caused by the loss of body salts and fluid during sweating. Low salt levels in muscles cause painful cramps. Tired muscles—those used for performing the work—are usually the ones most affected by cramps. Cramps may occur during or after working hours.

 

Heat rash (Prickly Heat or Miliaria) is skin irritation caused by sweat that does not evaporate from the skin. 

Emergency and Urgent Treatments for Heat Related Illnesses

All emergency and urgent treatment begins with getting the person out of direct sunlight and lying down in a cooler place (preferably air conditioning but shade with fanning will work in a pinch). Unnecessary clothing should be removed. Below are more specific first aid instructions for each of these conditions. See also CDC.gov, WebMD, MayoClinic.org, for more details. 

Heat Stroke

1. 

   Heat Stroke First Aid

   FIRST, call 911. 

2. Move the person into a cool place, out of direct sunlight.
3. Remove the person’s unnecessary clothing and place the person on his or her side to expose as much skin surface to the air as possible.
4. Cool the person’s entire body by sponging or spraying cool (not cold) water, and fan the person to lower the person’s body temperature. Watch for signs of rapidly progressing heatstroke, such as seizure, unconsciousness for longer than a few seconds, and moderate to severe difficulty breathing.
5. Apply ice packs on the groin, neck, and armpits, where large blood vessels lie close to the skin surface. Do not immerse the person in an ice bath.
6. You CAN use a cool tub of water but you CAN NOT use an ice bath!
7. If a person has stopped breathing, begin CPR.
8. Do not give any medicine to reduce a high body temperature that can occur with heatstroke. Medicines may cause problems because of the body’s response to heatstroke.
9. If the person is awake and alert enough to swallow, give the person fluids [32 fl oz (1 L) to 64 fl oz (2 L) over 1 to 2 hours] for hydration. Most people with heatstroke have an altered level of consciousness and cannot safely be given fluids to drink. You may have to help. Make sure the person is sitting up enough so that he or she does not choke.

Heat Exhaustion

Most heat-related illnesses, such as mild heat exhaustion, can be treated at home.

1. Stop, rest and lie down with legs elevated.
2. Place ice packs under your arms and in your groin area and cool compresses over face, neck and head. 
3. Drink 2 liters of cool fluids such as sports-drinks, juices, or water over 2 to 4 hours. Total rehydration with oral fluids usually takes about 36 hours, but most people will begin to feel better within a few hours. You’ll know you been drinking enough when your urine is light yellow to clear. The darker your urine, the more dehydrated you are!
4. Rest for 24 hours, and continue fluid replacement with a rehydration drink. Avoid strenuous activity for 1 to 3 days.

Heat Cramps

1. Get into a cooler area.
2. Eat a little more salt, such as a few nuts or pretzels but avoid salt tablets.
3. Massage and stretch your cramped muscles.

Heat Rash (Prickly Heat)

1. Gets better and goes away without treatment.
2. Antihistamines may help if you are having problems with itching.
3. Keep areas clean and dry to help prevent a skin infection.
4. Do not use baby powder while a rash is present. The powder can build up in the skin creases and hold moisture, allowing the growth of bacteria that may cause infection.
5. Dress in as few clothes as possible during hot weather.
6. Keep your home, especially sleeping areas, cool.

How To Prevent Heat-Related Illnesses

Evolve Medical provides these recommendations to avoid heat-related illness based on information obtained from the CDC, Mayo Clinic and University of Maryland. Perhaps most important, though, is know what the temperature is AND the heat-related index!

• Wear loose-fitting, lightweight clothing. 
• Protect against sunburn. Sunburn affects your body’s ability to cool itself.
  • Use a wide-brimmed hat and sunglasses and use a broad-spectrum sunscreen with an SPF of at least 15.
  • Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or sweating.
• Drink plenty of fluids. Staying hydrated will help your body sweat and maintain a normal body
  

  Drink more water than usual Don’t wait until you’re thirsty to drink more fluids Drink from 2-4 cups of water every hour while working or exercising outside. Avoid alcohol or liquids containing high amounts of sugar Remind others to drink enough water

  temperature.

  • Take extra precautions with certain medications such as diuretics. Be on the lookout for heat-related problems if you take medications that can affect your body’s ability to stay hydrated and dissipate heat.
• Never leave anyone in a parked car. This is a common cause of heat-related deaths in children.
  • When parked in the sun, the temperature in your car can rise 20 degrees F (more than 6.7 C) in 10 minutes. It’s not safe to leave a person in a parked car in warm or hot weather, even if the windows are cracked or the car is in shade. Don’t forget pets too!
• Take it easy during the hottest parts of the day.
  • If you can’t avoid strenuous activity in hot weather, drink fluids and rest frequently in a cool spot. Try to schedule exercise or physical labor for cooler parts of the day, such as early morning or evening.
• Get acclimated. 
  • People who are not used to hot weather are especially susceptible to heat-related illness. It can take several weeks for your body to adjust to hot weather.
• Know if you are “At Risk”:
  • Age (kids under 5 years age and elderly)
  • Illness or chronic disability
  • Obesity
  • Cardiovascular disease or hypertension
  • Asthma, COPD or chronic respiratory problems
  • Drinking alcohol
  • Taking certain medications
    • Antihistamines (like Benadryl, Claritin, Allegra or Zyrtec)
    • Beta-blockers (like Toprol/metoprol, Coreg, Zybeta, Propanolol)
    • Antipsychotics
    • Tranquilizers
    • Tricyclic anti-depressants  

Natural and Holistic Remedies (from University of Maryland):

Nutrition and Supplements

Health care providers may recommend drinking fluids that contain electrolytes. Endurance athletes may want to take mineral supplements, including:

• Calcium
• Magnesium
• Potassium

Foods high in these nutrients include dark leafy greens, nuts, seeds, whole grains, sea vegetables, blackstrap molasses, and bananas. Please note: Taking any of these minerals in large amounts may cause unwanted symptoms and/or mineral imbalances. Consult your doctor to determine the correct amount of mineral supplementation to meet your needs.

Herbs

The most important treatment for heat exhaustion is replacing lost fluids by drinking water or a sports drink, and getting into a cooler environment. Some herbs may help, but if you have symptoms of heat exhaustion you should talk to your health care provider before taking anything. Although few studies have examined using herbs to treat heat exhaustion specifically, the following herbs may reduce fever or lower body temperature:

• Yarrow (Achillea millefolium) — used to treat fever. Do not take Yarrow if you are pregnant or nursing. Yarrow can have blood-thinning effects and should not be taken with other blood-thinning medications, such as warfarin (Coumadin), and should be discontinued at least 2 weeks before any surgery. Yarrow can interact with lithium and other sedative medications.

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of fevers based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person’s constitutional type — your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• Belladonna — often used for fever, particularly if flushed with bright red skin and dulled mental activity. This treatment is appropriate for people who are not thirsty even though their mouths and skin are dry.
• Glonoinum — used for fever if the person is flushed and sweaty. It’s appropriate for people who complain of a hot face but cold extremities, as well as irritability, headache, and confusion. Homeopaths often recommend this treatment for ailments brought on by overexposure to the sun.

 

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