Sizzling Summer Survival

Understanding and recognizing the dangers of overheating help to prevent medical emergencies.

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The hot, humid months of summer may be perfect for sitting poolside, but extended time in the heat can be dangerous.

Heat-related deaths and illnesses are preventable, but the Centers for Disease Control and Prevention reports that 658 Americans, on average, die each year from extreme heat.

“Heat exhaustion or heat stroke refers to an elevation of core body temperature to a level that is unsafe for our body and can lead to a variety of complications and, in some cases, can be life threatening,” says Layne Keathly, a family medicine physician with INTEGRIS in Oklahoma City. “In addition to an elevated core body temperature, headaches, nausea, persistent muscle cramps, weakness, confusion, rapid heart rate or breathing, among other non-specific signs or symptoms, may develop.

“Heat stroke is a more severe form of heat exhaustion. Heat stroke refers to an elevated core body temperature above 104 degrees Fahrenheit along with central nervous dysfunction and additional organ and tissue damage. Central nervous system dysfunction includes anything from confusion [and] disorientation to seizures, coma or death. Fortunately, heat exhaustion does not always lead to heat stroke.”

Heat-related illness is among the leading causes of death in young athletes each year, Keathly says. Also at risk are firefighters, construction workers, military personnel and others who may wear extra clothing, equipment or protective gear in extreme temperatures.

Dana Davis, an internal medicine and pediatric physician with Warren Clinic in Tulsa, says children and seniors are particularly vulnerable to heat.

“Children will be playing outside and not realize that they’ve quit sweating and don’t feel well,” she says. “Symptoms in children are very similar to those in adults, but the problem is that children aren’t aware of what the symptoms mean. They may be thirsty, complain of weakness and/or muscle cramps, be sweating profusely, or feel dizzy or nauseated. These are going to be some of the main symptoms for heat exhaustion. But then, if things escalate and the body isn’t able to cool itself, they may become confused, disoriented, and/or agitated and then it becomes a medical emergency.”

Davis also notes the deaths of children left in hot cars: “Even in moderate heat, a child or an elderly person in a car is at high risk for heat exhaustion or heat stroke.”

She adds that children under 12 months old cannot fully regulate their body temperatures and communicate their specific needs.

“Babies cannot verbalize if they are thirsty, nauseated or feel dizzy,” she says. “As parents, we have to take extra precautions for this age group and not let them get close to experiencing heat exhaustion.”

Davis emphasizes preventive measures. If you know you’re going to be outside, hydrate beforehand and continually drink fluids.

“When you are sweating, you are excreting salt,” she says. “Water is great, but you also need to intermittently drink an electrolyte fluid.”

Keathly advises immediate medical attention if you believe someone has heat exhaustion or heat stroke. Otherwise, he says the first step is to cool down as soon as possible.

“Get in the shade and away from the sun as quickly as possible,” he says. “Ideally, get indoors and in front of a fan or into a cool shower or bath – the cooler the better. Ice water immersion is preferred. Ice pack application is recommended; removing excess clothing and ensuring proper hydration is achieved [are] also important. Have the person lay on his or her back with legs elevated above the level of the head. Avoid sudden or prolonged standing until fully recovered. If you have any lingering concerns following this, I’d recommend seeking medical care. Prognosis is worse when cooling is delayed and core body temperature is allowed to remain above the critical threshold for a longer period of time.”

Overheating Guidelines

Moderation: Limit the amount of time spent in the heat and schedule sporting events or other outdoor activities early or late in the day to avoid extreme temperatures.

Hydration: Have fluids readily available. For athletes, regular, scheduled breaks ensure proper hydration.

Attire: Loose fitting, lightweight clothing without excess layers reduces the trapping of heat.

Acclimatization: Don’t overdo it in time and intensity in the heat. Slowly expose yourself to longer, more intense activities or exercise over a number of days to allow time for your body to adjust.

Alcohol and medications: These substances can increase the risk of heat-related illnesses, and may include (but are not limited to) antihistamines, diuretics, decongestants and anticholinergics.

Combat too much heat with these gadgets (Web-Exclusive)

The evaporative bandana, vest and personal miniature fans are the best cooling gadgets to ensure you do not overheat this summer. Put the bandana in cool water for one minute before use. The vest takes five minutes in cool water to activate but is perfect for farmers and road workers and can remain cool for up to four hours. The fan is your most simplistic choice and keeps the air moving when you need it.

Leaving your children in the car is illegal in Oklahoma and considered child endangerment, no matter the temperature outside. During the spring and summer you are also putting your child at risk for a vehicular heatstroke. According to noheatstoke.org, 754 children have died after being left in a hot car since 1998. A child’s body overheats five times faster than an adult. The majority of the temperature increase occurs within the first half hour. “There are cases of children dying on days as cool as 70 degrees,” said Catherine McLaren, MD, clinical instructor in emergency medicine. To help prevent vehicular heat strokes, create a habit of looking in the backseat before you lock the car and walk away. If you see a child unattended in a hot car, call 911.

As the summer progresses, the Emergency Medical Services Authority (EMSA) in Oklahoma City and Tulsa will issue a medical heat alert when they respond to five or more heat related illnesses within 24 hours of each other. Watch your local media for those alerts.

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