Summer 2010

Keep cool during hot weather

“As the thermometer rises this summer, remember to keep cool and use common sense,” states Heidi Kirschbaum, RN, Emergency Room Clinical Coordinator at Prairie du Chien Memorial Hospital. “Here’s a few important tips from the Centers for Disease Control and Prevention.”

• Drink plenty of fluids to increase your fluid intake, regardless of your activity level. Don’t wait until you’re thirsty to drink. During heavy exercise in a hot environment, drink two to four glasses (16-32 oz.) of cool fluids each hour. Warning: If your doctor generally limits the amount of fluid you drink or has you on water pills, ask your doctor how much you should drink while the weather is hot. Don’t drink liquids that contain alcohol or large amounts of sugar-these actually cause you to lose more body fluid. Also avoid very cold drinks, because they can cause stomach cramps.
• Replace salt and minerals. Heavy sweating removes salt and minerals from the body. These are necessary for your body and must be replaced. If you must exercise, drink two to four glasses of cool, non-alcoholic fluids each hour. Sports beverages can replace the salt and minerals you lose in sweat. However, if you are on a low-salt diet, talk with your physician before drinking a sports beverage or taking salt tablets.
• Wear appropriate clothing and sunscreen. Wear as little clothing as possible when you are at home. Choose lightweight, light-colored, loose-fitting clothing. Sunburn affects your body’s ability to cool itself and causes a loss of body fluids. It also causes pain and damages the skin. If you must go outdoors, protect yourself from the sun by wearing a wide-brimmed hat along with sunglasses, and by putting on sunscreen of SPF 15 or higher (the most effective products say “broad spectrum” or UVA/UVB protection” on their labels) 30 minutes prior to going out. Continue to reapply it according to the package directions.
• Schedule outdoor activities carefully. If you must be outdoors, try to limit your outdoor activity to morning and evening hours. Try to rest often in shady areas so that your body’s thermostat will have a chance to recover.
• Pace yourself. If you are not accustomed to working or exercising in a hot environment, start slowly and pick up the pace gradually. If exertion in the heat makes your heart pound and leaves you gasping for breath, STOP all activity. Get into a cool area or at least into the shade, and rest, especially if you become lightheaded, confused, weak, or faint.
• Stay indoors and if at all possible, stay in an air-conditioned place. If your home does not have air conditioning, go to the shopping mall or public library, even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat. Electric fans may provide comfort, but when the temperature is in the high 90’s, fans will not prevent heat-related illness. Taking a cool shower or bath or moving to an air-conditioned place is a much better way to cool off. Use your stove and oven less to maintain a cooler temperature in your home.
• Use a buddy system. When working in the heat, monitor the condition of your co-workers and have someone do the same for you. Heat-induced illness can cause a person to become confused or lose consciousness. If you are 65 years of age or older, have a friend or relative call to check on you twice a day during a heat wave. If you know someone in this age group, check on them at least twice a day.
• Monitor those at high risk. Although anyone at any time can suffer from heat-related illness, some people are at greater risk than others. Infants and young children are sensitive to the effect of high temperatures and rely on others to regulate their environment and provide adequate liquids.
• People 65 years of age or older may not compensate for heat stress efficiently and are less likely to sense and respond to change in temperature.
• People who are overweight may be prone to heat sickness because of their tendency to retain more body heat.
• People who overexert during work or exercise may become dehydrated and susceptible to heat sickness.
• People who are physically ill, especially with heart disease or high blood pressure, or who take certain medications, such as for depression, insomnia, or poor circulation, may be affected by extreme heat.
• Visit adults at risk at least twice a day and closely watch them for signs of heat exhaustion or heat stroke. Infants and young children, of course, need much more frequent watching.
• Adjust to the environment. Be aware that any sudden change in temperature, such as an early summer heat wave, will be stressful to your body. You will have a greater tolerance for heat if you limit your physical activity until you become accustomed to the heat. If you travel to a hotter climate, allow several days to become acclimated before attempting any vigorous exercise, and work up to it gradually.

Hot weather health emergencies

According to the Centers for Disease Control and Prevention, even short periods of high temperatures can cause serious health problems. During the weather health emergencies, keep informed by listening to local weather and news channels or contact local health departments for health and safety updates. Doing too much on a hot day, spending too much time in the sun, or staying too long in an overheated place can cause heat-related illnesses. Know the symptoms of heat disorders and overexposure to the sun, and be ready to give first aid treatment.

Heat Stroke

Heat stroke occurs when the body is unable to regulate its temperature. The body’s temperature rises rapidly, the body loses its ability to sweat, and the body is unable to cool down. Body temperature may rise to 106 oF or higher within 10-15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not provided. Warning signs vary but may include the following:

• An extremely high body temperature, above 103 oF orally
• Red, hot, and dry skin, no sweating
• Rapid, strong pulse
• Throbbing headache
• Dizziness
• Nausea
• Confusion
• Unconsciousness

If you see any of these signs, you may be dealing with a life-threatening emergency. Have someone call for immediate medical assistance while you begin cooling the victim. Do the following:

• Get the victim to a shady area.
• Cool the victim rapidly using whatever methods you can. For example, immerse the victim in a tub of cool water; place the person in a cool shower; spray the victim with cool water from a garden hose, sponge the person with cool water, or if the humidity is low, wrap the victim in a cool, wet sheet and fan him or her vigorously.
• Monitor body temperature, and continue cooling efforts until the body temperature drops to 101-102 degrees F.
• If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
• Do not give the victim fluids to drink.
• Get medical assistance as soon as possible.

Sometimes a victim’s muscles will begin to twitch uncontrollably as a result of heat stroke. If this happens, keep the victim from injuring himself, but do not place any object in the mouth and do not give fluids. If there is vomiting, make sure the airway remains open by turning the victim on his or her side.

Heat Exhaustion

Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids. It is the body’s response to an excessive loss of the water and salt contained in sweat.

Those most prone to heat exhaustion are elderly people, people with high blood pressure, and people working or exercising in a hot environment. Warning signs include heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea or vomiting, and fainting. The skin may be cool and moist. The victim’s pulse will be fast and weak, and breathing will be fast and shallow. If heat exhaustion is untreated, it may progress to heat stroke. Seek medical attention immediately if symptoms are severe or if the victim has heart problems or high blood pressure. Otherwise, help the victim to cool off, and seek medical attention if symptoms worsen or last longer than one hour.

Cooling measures that may be effective include giving the victim cool, nonalcoholic beverages; rest; a cool shower, bath, or sponge bath; an air-conditioned environment; and lightweight clothing.

Recognizing and treating Heat Cramps

Heat cramps usually affect people who sweat a lot during strenuous activity. This sweating depletes the body’s salt and moisture. The low salt level in the muscles may be the cause of the heat cramps. Heat cramps may also be a symptom of heat exhaustion.

Heat cramps are muscle pains or spasms, usually in the abdomen, arms or legs that may occur in association with strenuous activity. If you have heart problems or are on a low-sodium diet, get medical attention. If medical attention is not necessary, stop all activity and sit quietly in a cool place, drink clear juice or a sports beverage, and 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 one hour.

Sunburn

Sunburn should be avoided because it damages the skin. Although the discomfort is usually minor and healing often occurs in about a week, a more severe sunburn may require medical attention. Symptoms of sunburn are well known, the skin becomes red, painful, and abnormally warm after sun exposure. Consult a doctor if the sunburn affects an infant younger than one year of age, or if the victim experiences a fever, fluid-filled blisters, or severe pain. Also, remember when treating sunburn avoid repeated sun exposure; apply cold compresses or immerse the sunburned area in cool water; apply moisturizing lotion to affected area; do not use salve, butter, or ointment; and do not break blisters.