Heat Stress Disorders
Basic Information
Even short spans of time spent in hot temperatures can put a person at risk of getting a heat stress disorder. Not only are heat stress disorders serious health problems, but they are all the more dangerous because they are caused by such simple factors: exposure to heat and dehydration. The threat of heat stress disorders increases dramatically during the summer season. In fact, during the hotter months of the year, the various heat stress disorders are common occurrences.
As the body generates energy, it produces heat. Thus, as you move, your body heats up. The body keeps cool on hot days by sending blood close to the skin and by sweating. When the temperature is above 90 degrees, when it is extremely humid, or when you are directly exposed to the sun, it can be difficult for the body to regulate its temperature and remain cool. When the body cannot keep cool on a hot day, it has been impaired by a heat stress disorder. Heat stress disorders include possibly severe health conditions such as heat stroke and heat exhaustion, as well as more mild problems like heat cramps.
Although heat stroke and heat exhaustion are similar problems, they are not exactly the same. Heat exhaustion is what happens when the body loses excessive amounts of water and salt, the major components of sweat. It involves a drop in blood pressure and an increased heart rate. This kind of dehydration most often occurs when people overheat their bodies by exercising in extreme heat. However, elderly people, people with high blood pressure, and people working in a hot environment (such as an office without air conditioning) are also at risk. It is a mistake to think that only vigorous outdoor activity can bring about heat exhaustion. A person can sometimes get heat exhaustion simply from walking around on a hot summer day.
Heat stroke is a more serious condition. It can cause brain damage or even death. Heat stroke happens when the body loses it ability to regulate its temperature. When the body is functioning normally, it uses its sweating mechanism to control its temperature. During exposure to intense heat, the body sweats more profusely in order to cool itself down. When a person gets heat stroke, the sweating mechanism fails to respond to a rapid increase in body temperature, which means that the body is unable to cool down. Dehydration is a large factor in causing heat stroke. When a person is dehydrated they won't sweat as much, which makes it harder to get rid of excess heat and keep cool. Body temperature can reach as high as 106 degrees or sometimes even higher within 10-15 minutes. In these extreme cases, heat stroke can prove fatal or can cause permanent damage if emergency treatment is not provided. Heat stroke often happens when a person is exercising in extreme heat and becomes dehydrated. However, if temperatures are high enough, it can happen to people even if they are not working out. If you get heat stroke once, it increases the chances that you will get it again. It is a medical emergency that requires immediate attention.
Heat cramps are the most mild of all the health conditions considered heat stress disorders. They are muscle contractions, usually occurring in the legs, thighs, and abdomen. Although heat cramps are not dangerous, they can be extremely painful. Although some doctors think that cramps are caused by salt depletion during sweating, others suggest that they are caused by heat, dehydration, and lack of proper conditioning.
Symptoms
The symptoms for both heat stroke and heat exhaustion are very similar. Some of the signs they share include:
- Thirst
- Headache
- Pallor; clammy skin
- Dizziness; possible nausea or vomiting
- Muscle cramps
- Tiredness, weakness; possible fainting
One of the symptoms that distinguishes heat stroke from heat exhaustion is that a person with the latter will experience heavy sweating. In serious cases, a person suffering from heat exhaustion will feel disoriented. The skin may be cool and moist. The heart rate will be fast and weak, while the breathing will be fast and shallow. Another warning sign indicating heat exhaustion is a slightly increased temperature, which is not a fever, but caused by the heat.
At first, because they share so many of the same symptoms, heat stroke may be difficult to distinguish from heat exhaustion. However, cessation of sweating, difficulty walking, disorientation, and fainting or unconsciousness all point to heatstroke. Most people with heat stroke will be extremely confused and unable to help themselves. The person will have an excessively high body temperature (above 103 degrees), and due to the inability to sweat will have skin that is hot, flushed, and very dry. They may also have a strong, fast pulse. In some cases, a person can have seizures or their muscles will twitch uncontrollably.
Diagnosis/Treatment
A commonality among heat stress disorders is that mere recognition of symptoms should serve as all the diagnosis necessary to motivate immediate action and treatment. In all cases, the most essential factor in treatment is the immediacy of the response to the symptoms.
If a person has heat exhaustion, they should stop running (or whatever outdoor activity they may be engaged in) and be moved to a cool area--preferably to an air-conditioned space. The person should slowly drink plenty of water, or a cool sports beverage with a high mineral content if available. After a cool shower or bath, they should put on light weight clothing (clothes that allow the body to breath) and then they should rest in bed. If heat exhaustion is not treated, it can rapidly evolve into heat stroke. If symptoms are severe or if the person has a pre-existing heart condition or has high blood pressure, the person will need immediate medical attention. In severe cases, a person may need IV fluids, particularly if vomiting prevents them from drinking enough fluids. Otherwise, the person should try to cool off, and only seek medical attention if the symptoms worsen or last for longer than an hour.
With heat stroke, the most important thing to do is to cool the person off. In most cases, they will not be able to take care of themselves and will rely heavily on other people for help and treatment. Heat stroke is a life-threatening emergency that usually requires hospitalization, so someone should be sent to get professional medical attention. Meanwhile, the victim should be moved to a cool, shaded area. A person who can still function mentally is not in extreme danger. If the person is conscious or still has normal mental capacities, they will need to drink cool fluids (1 to 2 quarts). Although water is adequate, a sports beverage that can replenish the lost minerals and nutrients is ideal. In most cases the person will require IV fluids for dehydration. It is then essential to cool the person off using whatever means available. You can immerse the person in a tub of cool water; place them in a cool shower; pack ice around the victim's neck, armpits, and groin; spray cool water on them from a garden hose; sponge them with cool water; of if the humidity is low, wrap the victim in a cool, wet sheet and fan the victim vigorously. Under no circumstances should the person be given alcoholic beverages to drink. If the person is experiencing involuntary seizures or muscles spasms, it is good to make sure the person does not injure themselves, but do not place an object in the mouth and do not provide fluids. If they are not experiencing muscles spasms of any nature, then the victim should be kept lying down and their legs should be elevated. Sometimes it can be helpful if their clothes are removed.
In the case of heat cramps, treatment involves getting to a cool area and drinking water or other fluids.
There are many ways to prevent heat stress disorders. All runners or people working in the sun should wear light, light-colored clothes that do not absorb the sun's heat, and they should wear synthetics rather than cotton. Not only should everyone use sunscreen and sunglasses when exposed to direct sunlight, but they should also schedule strenuous activities during the cooler parts of the day. One important thing to consider is that thirst is not an reliable guide to your body's need for hydration. Even when you don't feel thirsty, your body is losing fluids that need to be replaced. It is essential that you drink lots of fluids regularly whenever you are exposed to heat. Proper hydration is probably the most important factor in regard to preventing heat stress disorders. Because alcohol makes it harder for your body to keep cool, you should never drink it if you are going to be exposed to heat (particularly if you are going to be doing strenuous work in warm weather). It is also important not to exert oneself too much in hot weather. This explains why there is a large tendency for athletes to get heat stress disorders.
In regard to children, they should be allowed to play inside on extremely hot days. They should wear clothing that is light and loose. They should never be left alone inside a hot car, and it is a good idea to air out a hot car before putting a child inside.