Monday, August 10, 2009

How to recognize heat-related illness

Heat illnesses are easily preventable by taking precautions in hot weather.

According to the National Institutes of Health, children, elderly, and obese people have a higher risk of developing heat illness. People taking certain medications or drinking alcohol also have a higher risk. However, even a top athlete in superb condition can succumb to heat illness if he or she ignores the warning signs.

If the problem isn't addressed, heat cramps (caused by loss of salt from heavy sweating) can lead to heat exhaustion (caused by dehydration), which can progress to heatstroke. Heatstroke, the most serious of the three, can cause shock, brain damage, organ failure, and even death.

The following are common causes of heat emergencies:
Alcohol use
Heart disease
High temperatures or humidity
Certain medications
Prolonged or excessive exercise
Sweat gland problems
Too much clothing

You most at risk doing work or activities in a hot environment-usually during the first few days of an activity you're not used to. You are also at risk if you sweat a great deal during exercise and don't drink enough or drink large amounts of fluids that lack salt.

This is by no means a substitute for medical advice. As with all other medical problems, a doctor should be called if you are not sure what is wrong, if you do not know what to do for the problem, or if the person is not responding to what you are doing for them. Please seek the advice of a physician or emergency room should you feel you have placed yourself at risk for heat-related illness.

Heat cramps:
are muscle pains or spasms - usually in the abdomen, shoulders, arms, or legs - that may occur in association with strenuous activity in a hot environment. Cramping may also be delayed and occur a few hours later

If you have heart problems or are on a low sodium diet, get medical attention for heat cramps.

What to Do:

• Stop all activity, and sit quietly in a cool place.
• Drink clear juice or a sports beverage.
• Do not return to strenuous activity for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke.
• Seek medical attention for heat cramps if they do not subside in 1 hour.

Call your doctor if these conditions develop:

• If you are unable to drink sufficient fluids because you have nausea or are vomiting, you may need IV rehydration with normal saline.
• If you have more severe symptoms of heat illness, including dizziness, fatigue, vomiting, headache, malaise, shortness of breath, and high temperatures (greater than 104°F), seek medical care.
• If you have more severe forms of heat illness or think you require IV fluids to rehydrate, seek care at a hospital's emergency department.

Heat exhaustion:
This condition often occurs when people exercise (work or play) in a hot, humid place and body fluids are lost through sweating, causing the body to overheat. The person's temperature may be elevated, but not above 104°F.
Heat exhaustion is typically caused when people who are not well adjusted to heat exercise in a hot, humid environment.
At high temperatures, the body cools itself largely through evaporation of sweat.
When it is very humid, this mechanism does not work properly.
The body loses a combination of fluids and salts (electrolytes).
When this is accompanied by an inadequate replacement of fluids, disturbances in the circulation may result that are similar to a mild form of shock.

Heat exhaustion symptoms:

Often pale with cool, moist skin
Sweating profusely
Muscle cramps or pains
Feels faint or dizzy
May complain of headache, weakness, thirst, and nausea

The physicians writing for the website WebMD continue to advise that for heat exhaustion, a person should go to the hospital if any of the following are present:
Loss of consciousness, confusion, or delirium
Chest or abdominal pain
Inability to drink fluids
Continuous vomiting
Temperature more than 104°F which may be combined with an increasing pulse
Temperature that is rising despite attempts to cool the person
Any person with other serious ongoing medical problems

Heat stroke: This medical condition is life-threatening.
The person's cooling system, which is controlled by the brain, stops working and the internal body temperature rises to the point where brain damage or damage to other internal organs may result (temperature may reach 105+°F).
Heat stroke may often develop rapidly.
Medical conditions or medications that impair the body's ability to sweat may predispose people to this problem.
According to the website, heat stroke happens in the following two ways:
The classic form occurs in people whose cooling mechanisms are impaired.
The form caused by exertion occurs in previously healthy people who are undergoing strenuous activity in a hot environment.

*Infants and the elderly are more likely to have this problem, as are those who are taking antihistamines and certain types of medication for high blood pressure or depression.

Call a doctor for heat exhaustion if the person is unable to keep fluids down or if their mental status begins to deteriorate. Symptoms of shortness of breath, chest pain, or abdominal pain may indicate that the heat exhaustion is accompanied by more serious medical problems.

According to WebMD: A person with suspected heat stroke should always go to the hospital (or call for an ambulance) at once.

Heat stroke symptoms:
Unconscious or has a markedly abnormal mental status (dizziness, confusion, hallucinations, or coma)
Flushed, hot, and dry skin (although it may be moist initially from previous sweating or from attempts to cool the person with water)
May have slightly elevated blood pressure at first that falls later
May be hyperventilating
May be experiencing convulsions
Rectal (core) temperature of 105°F or more

Suspected heat stroke is a true, life-threatening medical emergency. Call for an ambulance and request information as to what to do until the ambulance arrives.

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