July-September, 2003

Heat-related illnesses: learn the symptoms and warning signs

Summer provides an excellent opportunity for us to get outside, increase activity, and avoid a year-round sedentary lifestyle. But lots of activity in the summer sun without proper hydration can lead to heat illnesses such as heat cramps, heat exhaustion and heat stroke, especially for athletes and seniors.

Many medications often taken by seniors for high blood pressure and heart disease, for example, are diuretics – they remove salt and fluid volume from the body. Coupled with perspiring from high temperatures, diuretics can lead to dehydration, which, in turn, can lead to discomfort, confusion, damage to major organs and even death.

Most healthy individuals will naturally replenish their body's fluids when they get thirsty. But for many older adults, the thirst mechanism is not as finely tuned as in younger people. And for those seniors who have suffered from a stroke, Alzheimer's or another brain disease, their thirst mechanism is even less likely to direct them to consume enough fluids.

Drinking at least six 8-ounce glasses of fluid each day will help prevent dehydration. Salt tablets are not recommended because they can cause more harm than good, according to St. John’s Midwest Sports Medicine Center.

In addition, seniors' bodies are not as able to regulate temperature. Check in on frail seniors frequently during the summer to make sure they're taking in enough fluids, their homes are properly ventilated and their mental state is normal. Confusion is a sign of heat exhaustion and dehydration. If a senior has a fever or exhibits behavioral changes from the heat, take him or her to their health care provider immediately for treatment of possible heat stroke and dehydration.

If you suspect someone is suffering from heat stroke, have someone call an ambulance immediately while you do everything you can to keep the victim cool. If possible, place him in a cold bath or shower. At the very least, put him in the shade and douse him with water. If you have a thermometer, check his temperature regularly and keep cooling him until it drops below 102. If there is violent twitching of the muscles, don't give the victim any fluids or put any object in his mouth. If he vomits, turn him on his side to keep the airway open.

Call for medical help immediately if the victim has heart disease or high blood pressure, if the symptoms are severe, or if they last for more than an hour. Otherwise, keep her temperature down by moving her to an air-conditioned room, giving her cool drinks, or putting her in a cool shower or bath.

Prevention

St. John’s Midwest Sports Medicine Center suggests athletes not exercise in extreme heat, and coaches should be aware of the symptoms of heat-related illnesses. Athletes also must stay well hydrated.

The American College of Sports Medicine released new guidelines a year ago to help coaches, parents and players tackle the heat safely.

Ease into play: Sports medicine experts agree that it’s smart for fall athletes, such as football players to shape up on their own before practices begin. It takes the body up to two weeks of activity in hot weather to undergo the physiological changes needed to exercise safely.

Avoid sideline supplements: Many performance enhancing pills can deplete the body of water, experts say, especially ephedra.

Educate athletes: Players should be taught about the dangers of heat stroke and encourage them to speak up.

Seniors: The best way for seniors to stay cool during a heat wave is to stay indoors with the air conditioner on high. If you don't have an air conditioner, consider taking a trip to the mall, library, or movies for a couple of hours. A fan can help, but it can't take the place of an air conditioner. If the temperature reaches the 90s, even the best fan may not protect you from heat exhaustion or heat stroke.

General Tips: Avoid dark colors and wear breathable fabrics, such as cotton. Individuals with chronic conditions, such as asthma and diabetes and those taking medications, pregnant women and children are more susceptible to heat stroke.

When you do go outside on a hot day, use common sense. Drink more than you need to quench your thirst, and if you're sweating heavily, choose fruit drinks or sports beverages to replace lost minerals. If you plan to exercise, start out slowly, particularly if your body isn't used to hot weather. At the first sign of lightheadedness or weakness, stop exercising and get yourself to a cool place immediately.

Symptoms & Warning Signs

What is heat stroke?
Heat stroke, which can be fatal, occurs when the body can't control its temperature. The victim's temperature climbs past 103 degrees and may even reach 106 in as little as 10 minutes. In addition to high temperature, symptoms may include the following:

•  Red, hot, skin with no sweating

•  Heavy sweating with cold, clammy skin

•  Rapid pulse

•  Intense headache

•  Confusion

•  Nausea

•  Dizziness

•  Unconsciousness

Heat stroke vs. heat exhaustion:
Heat exhaustion occurs when the body loses large amounts of salts and water through sweating. It is not especially dangerous on its own, but it can quickly progress to heat stroke. Watch for these warning signs:

•  Heavy sweating

•  Pale skin

•  Muscle cramps

•  Fatigue

•  Weakness

•  Headache

•  Nausea or vomiting

•  Fainting