July 15, 2021 – Hundreds of Americans have died of heat-related illnesses in the latest country-wide heat wave, and this week’s forecast also brings temperatures back into the triple digits for millions. At thermometers rise to historic levels, many are at risk, from young children attending camps to the elderly seeking shelter from the heat.
Heat-related illnesses can mean heat exhaustion or heatstroke, the latter of which is more serious and potentially life-threatening. Heat exhaustion is a milder form of heat illness that can happen after a person is exposed to high temperatures without drinking enough water. Heatstroke occurs when the body’s internal temperature reaches 104 F, or 40 C. Heatstroke can cause seizures or comas, and if left untreated, it can lead to heart attacks and death. (Learn more about heatstroke here.)
How to Take Action
The best ways to help someone with heat exhaustion differ from those recommended for someone having heatstroke. Here are the best tips:
- Drink cool fluids, specifically sports drinks and water. Caffeinated and alcoholic beverages are diuretics and will make you pee more, so avoid those. Keep the fluids cool as opposed to cold, because cold water can cause stomach cramps.
- Rest in a cool place. This could be a building with air conditioning, or at least a shady spot outside. Rest on your back with your legs higher than your heart.
- Try cooling measures, such as taking a cool shower or bath. You could also put towels soaked in cold water on your skin. If you’re outdoors and don’t have access to a faucet, find a cool pond or stream to stand in.
- Loosen your clothing. Remove any clothing you don’t need, and make sure your clothes are lightweight and don’t bind to you.
Unlike heat exhaustion, heatstroke requires medical help right away. When someone has heatstroke, the most important thing to do is call 911 for medical help. While waiting for help to arrive, do the following:
- Get the person to a cool place. Go to nearby air-conditioned buildings, or find a shady spot.
- Perform cooling measures, such as placing the person in a cool shower or bath. Taking a sponge, soaking it in cold water, and moving it along the person’s skin can also help.
- Monitor body temperature. Take the victim’s temperature, and continue cooling measures until their body temperature drops to 101 F.
- Have the victim drink if they are awake and able. Stick to water. Avoid sugary drinks. Caffeinated and alcoholic beverages are diuretics and will increase urination, so avoid those as well. Keep the fluids cool as opposed to cold, because cold water can cause stomach cramps.
These tips will help prevent heat-related illnesses in the first place:
- Drink plenty of liquids. Avoid coffee, tea, and alcohol in excess. Once you’re thirsty, you are at least a half-liter behind. You should drink when you are thirsty. Eat salty snacks with fluids to avoid diluting your salt levels.
- Limit your exercise in hot and humid environments. Take it easy, especially around midday and early afternoon, when the heat is most likely to be at its peak.
- Wear lightweight and breathable clothing.
- Wait to acclimate. If you’re not used to high temperatures, wait to exercise in heat until you’ve become used to them.
Understanding Heat-Related Illnesses
Heatstroke can damage human cells that are key to the central nervous system and other systems, says Grant Lipman, MD, a clinical professor of emergency medicine at Stanford University School of Medicine and founder of GOES.health.
“This internal temperature is a combination of both induced internal temperature, through metabolic functioning and exercise, and passive exposure to external temperature, minus the body's ability to shed heat,” he says.
GOES, which stands for Global Outdoor Emergency Support, is a digital medical guide and emergency support application for outdoor adventurers.
Heatstroke can be a result of physical exertion -- in this case, the body can regulate heat normally, but too much exercise hurts the ability to do so.
For example, you can get heatstroke from a strenuous workout in hot weather without drinking enough water beforehand. Heatstroke can also happen when the body’s temperature regulation system has failed, which is more likely to happen in elderly people who may have chronic health conditions.
Signs and Symptoms of Heat Illness
The signs of heatstroke and heat exhaustion are different in some ways. Heat exhaustion will often cause heavy sweating and pale skin, dizziness or fainting, headache, muscle cramping or weakness, nausea or vomiting, and a rapid pulse. Heatstroke, on the other hand, is marked by a lack of sweat, along with skin that appears red, hot, and dry. People having heatstroke may also be confused, have a headache, get dizzy, faint, have a rapid and strong heartbeat, and have nausea or vomiting.
People prone to heat illnesses include those who exercise in hot and humid environments, which can include children in summer athletic training and camps.
“Rapid and fast exercise is likely to produce more heat than slower-paced exercise, but both can produce substantially elevated internal temperatures,” Lipman says.
Exercise in a hot, humid environment limits the body’s ability to cool itself by sweating, which puts you at higher risk of heatstroke, he says.
The elderly are at increased risk for heat illnesses, as is anyone who takes medications used to treat high blood pressure and heart problems (beta-blockers and diuretics) and allergy symptoms (antihistamines).
Obesity is a risk factor as well, because carrying excess weight can cause the body to retain more heat. Also, people who aren’t used to high heat, such as those living in cold climates year-round, are at higher risk.