Heat Exhaustion and Heatstroke: Do something before it’s too late

Oct 13, 2019 Dr Zulfikar Bux, Features / Columnists

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By Dr Zulfikar Bux
Assistant professor of Emergency Medicine

As we are in the dry season, I am beginning to see more patients who are sick because of excess exposure to the heat. I suspect that this will become a more common phenomenon as global temperatures continue to increase. Heat exhaustion and heatstroke are the two most common complications that occur from overexposing to heat. Today we will discuss these two conditions as they are often ignored and can lead to serious life threatening consequences.

WHAT HAPPENS WHEN YOU GET HEAT EXHAUSTION AND HEATSTROKE?
Whenever you are exposed to too much heat, your body works hard to keep your temperature constant. This can lead to you feeling generally unwell, lacking in energy and feeling dizzy or sick and are early signs that your body is beginning to overheat. In this phase, you are showing early signs of heat exhaustion. If you do not take preventative measures, you will progress to getting heatstroke. Heatstroke happens when your body’s normal mechanisms for regulating your temperature break down, and your temperature rises to more than 40°C. It is a medical emergency and can kill you if you do not receive treatment.
WHO IS AT RISK OF HEAT EXHAUSTION AND HEATSTROKE?
Anyone can experience the physical effects of excess heat, but people at highest risk include:
• Babies and toddlers.
• Elderly people.
• People who are physically active.
• People who are exposed to sun for prolonged periods
• People with chronic health conditions like diabetes or heart, lung or kidney disease.
• People taking ‘water tablets’ (diuretics – usually used for high blood pressure or heart failure), antipsychotic medication or recreational drugs like ecstasy
• People with tummy troubles like gastroenteritis or inflammatory bowel conditions like Crohn’s disease or ulcerative colitis that can cause diarrhea.
WHAT ARE SYMPTOMS OF HEAT EXHAUSTION?
Key signs and symptoms of heat exhaustion include:
• Passing less urine -which is often dark.
• Dizziness and feeling faint.
• Tiredness.
• Headache.
• Feeling sick, lack of appetite, and cramping stomach pain.
• Muscle cramps in legs and arms.
• Rapid pulse.
• Clammy, pale skin and profuse sweating.
HOW IS HEAT EXHAUSTION TREATED?
Fluid and a cool environment are key to treating heat exhaustion. If you think you’re showing signs, immediately:
• Move to a cool room.
• Take off as much clothing as possible, particularly tight clothes.
• Take a cool bath or shower.
• If there are no bathing facilities, sponge down with cool water.
• Put on a fan if possible.
• Lie down if possible.
• Drink as much non-alcoholic fluid as you can.
• Seek medical help if you’re not feeling better within about half an hour.
WHAT ARE THE SYMPTOMS OF HEATSTROKE?
In heatstroke, your body can no longer cope. This is a progression from heat exhaustion and is a life threatening emergency. The normal mechanisms to keep your body cool give up, and your temperature soars to over 40°C. Other symptoms include:
• Severe, throbbing headache.
• Feeling very sick and being sick (vomiting).
• Fast pulse (heart rate)
• Shallow, rapid breathing.
• Very hot, flushed skin.
• Weak or cramping muscles.
• No sweating despite being very hot.
• Dizziness, feeling faint or fainting.
• Confusion and agitation.
• Seizures.
• Sometimes collapse and loss of consciousness.
If left untreated, heatstroke can lead to swelling of your vital organs, including your brain.
HOW IS HEATSTROKE TREATED?
Heatstroke is a medical emergency and can cause serious damage to kidneys and other vital organs if not treated promptly. Someone experiencing heatstroke will most likely be unable to administer self-treatment. If you think someone has heatstroke, immediately:
• Make arrangements to get them to the nearest emergency room
• Move them to a cool place and lay them down.
• Stay with them at all times.
• Remove as much of their clothing as possible.
• Wet their skin with cool water; then fan them.
• If possible, put them in a cool bath or shower.
• For a young, healthy person who has developed heatstroke from vigorous exercise in hot weather, consider applying ice packs to their armpits, neck and back.
• Put them in the recovery position if they lose consciousness.
HOW CAN HEAT EXHAUSTION AND HEATSTROKE BE PREVENTED?
Heat exhaustion often occurs as a result of direct sun exposure. However, it is important to remember that it is possible to develop heat exhaustion even when you are not in direct sunlight. To avoid damage from heat as well as sun:
• Keep your fluid intake up.
• Do not drink alcohol or too much caffeine. These dehydrate you and reduces your awareness of the warning symptoms.
• Avoid strenuous exercise in hot weather.
• Wear loose clothes made from natural fibers such as cotton or linen, which allow your body to evaporate heat readily by sweating.
• Keep your home cool by pulling curtains in daytime. If the weather outside is hotter than inside, keep windows closed and use a fan. When the weather outside cools down, particularly at night, keep windows open.
• Take regular cool showers or baths.
• If you are feeling hot, put a damp cloth on the back of your neck and keep changing it. As the water evaporates from your skin, it will cool you down.
• Remember that south-facing rooms with windows in direct sunlight are hotter than north-facing ones.
• Keep indoor plants which help cool the air as they evaporate water.
The cooler and calmer you are, the better your chances of avoiding heatstroke or heat exhaustion.

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