The Dangers of Heat Cramps, Heat Exhaustion & Heatstroke

Scientists say summers are getting hotter every year, so medical students should become familiar with the season’s two major health hazards besides sunburn: heat exhaustion and heatstroke. Knowing the difference between the two—and how to prevent and treat each—is crucial for learning proper first aid and professional medical attention for patients.

Heat Cramps

The mildest heat-related illness is heat cramps, according to the Boston Children’s Hospital’s website. Symptoms include painful cramps, especially in the legs; flushed, moist skin; and a mild fever (usually less than 102.5 F).

Boston Children’s Hospital suggests the following first-aid treatment for heat cramps:

• Move to a cool place and rest.
• Remove excess clothing and place cool cloths on skin; fan skin
• Give cool sports drinks containing salt and sugar such as Gatorade
• Stretch cramped muscles slowly and gently
  

Heat Exhaustion

Heat exhaustion occurs when the body is unable to cool itself by sweating. The Mayo Clinic says that signs and symptoms of heat exhaustion can begin suddenly after exercise, heavy perspiration and inadequate fluid and salt intake. The Mayo Clinic’s website says the signs and symptoms of heat exhaustion could resemble shock and include:

• Feeling faint or dizzy
• Nausea
• Heavy sweating
• Rapid, weak heartbeat
• Low blood pressure
• Cool, moist, pale skin
• Low-grade fever
• Heat cramps
• Headache
• Fatigue
• Dark-colored urine

The Mayo Clinic suggests the following if heat exhaustion is suspected:

• Get the person out of the sun and into a shady or air-conditioned location.
• Lay the person down and elevate the legs and feet slightly.
• Loosen or remove the person's clothing.
• Have the person drink cool water or other nonalcoholic beverage without caffeine.
• Cool the person by spraying or sponging with cool water and fanning.
• Monitor the person carefully. Heat exhaustion can quickly become heatstroke.

They advise you to “call 911 or emergency medical help if the person's condition deteriorates, especially if fainting, confusion or seizures occur, or if fever of 104 F (40 C) or greater occurs with other symptoms.”

Heatstroke

Heatstroke (hyperthermia, the opposite of hypothermia) is the most serious and life-threatening heat-related illness. The Mayo Clinic says heatstroke is caused by “prolonged exposure to hot temperatures of by doing physical activity in hot weather.” A person has heatstroke when the body temperature reaches 104 F (40 C) or higher. Such factors as high humidity, certain health problems and medications can increase one’s chances of getting heatstroke. Children and the elderly are particularly susceptible to heatstroke.

While waiting for paramedics to arrive, help the person move to a shaded location and remove excess clothing. Place ice packs or cold, wet towels on the person's head, neck, armpits and groin. Mist the person with water while a fan is blowing on him or her.

The Mayo Clinic says heatstroke has the following symptoms:

• A lack of sweating. In heatstroke brought on by hot weather, your skin will feel hot and dry to the touch. However, in heatstroke brought on by strenuous exercise, your skin may feel moist.
• Nausea and vomiting. You may feel sick to your stomach or vomit.
• Flushed skin. Your skin may turn red as your body temperature increases.
• Rapid breathing. Your breathing may become rapid and shallow.
• Racing heart rate. Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.
• Headache. You may experience a throbbing headache.
• Confusion. You may have seizures, hallucinate, or have difficulty speaking or understanding what others are saying.
• Unconsciousness. You may pass out or fall into a state of deep unconsciousness (coma).
• Muscle cramps or weakness. Your muscles may feel tender or cramped in the early stages of heatstroke, but may later go rigid or limp.

Professional Treatment for Heatstroke

After paramedics arrive, professional treatments for heatstroke include administering cool intravenous (IV) fluids and continuing first-aid treatments such as fanning the patient, according to a website about how paramedics and doctors treat the condition.

Once the heatstroke patient is in the hospital, many doctors will immerse the patient in cold water, continue wetting him/her down and use evaporation to cool the body, use cold packs or use cooled IV fluids. The goal is to get the patient’s core body temperature under 102 degrees and to rehydrate him/her. Heatstroke patients are often kept overnight for further observation and to ensure that he/she is properly hydrated and stable before being released.

Avoiding heat-related illnesses

Heat exhaustion and heatstroke are easily preventable if simple precautions are made when the mercury rises.

MedicineNet.com outlines the following steps to take for anyone who spends too much time in the summer sun:

Increase fluid intake: Regardless of your activity level. During heavy exercise in a hot environment, drink 2-4 glasses (16-32 ounces) of cool fluids each hour. Note that if your doctor has prescribed a fluid-restricted diet or diuretics for you, ask your doctor how much you should drink. During hot weather, drink more liquid than your thirst indicates. This is especially true for people 65 years of age and older who often have a decreased ability to respond to external temperature changes. Avoid extremely cold beverages or alcohol.

Mineral replacements: Heavy sweating removes salt and minerals from the body. These are necessary for your body and must be replaced. The easiest and safest way to replace salt and minerals is through your diet. Drink fruit juice or a sports beverage during exercise or any work in the heat. Do not take salt tablets unless directed by your doctor. If you are on a low-salt diet, ask your doctor before changing what you eat or drink-especially before drinking a sports beverage.

Wear appropriate clothing and sunscreen: Wear as little clothing as possible when you are at home. Choose lightweight, light-colored, loose-fitting clothing. In the hot sun, a wide-brimmed hat will provide shade and keep the head cool. Sunburn affects your body's ability to cool itself and causes a loss of body fluids. It causes pain and damages the skin. Use sunscreen with a high SPF.

Pace yourself: If you are unaccustomed 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 in the shade, and rest, especially if you become lightheaded, confused, weak, or faint.

Stay cool indoors: The most efficient way to beat the heat is to stay in an air-conditioned area. If you do not have an air conditioner or evaporative cooling unit, consider a visit to a shopping mall or public library for a few hours. Contact your local health department to see if there are any heat-relief shelters in your area. Electric fans may be useful to increase comfort and to draw cool air into your home at night, but do not rely on a fan as your primary cooling device during a heat wave. When the temperature is in the high 90s F or higher, a fan will not prevent heat-related illness. A cool shower or bath is more effective way to cool off. Limit use of your stove and oven to maintain a cooler temperature in your home.

Schedule outdoor activities carefully: If you must be out in the heat, try to plan your activities so that you are outdoors either before noon or in the evening. While outdoors, rest frequently in a shady area. Resting periodically will give your body's thermostat a chance to recover.

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. People age 65 years of age or older should have a friend or relative call to check on them twice a day during a heat wave.

(Top photo) Photo: Pexels.com

About UMHS:

Built in the tradition of the best US universities, the University of Medicine and Health Sciences focuses on individual student attention, maintaining small class sizes and recruiting high-quality faculty. We call this unique approach, “personalized medical education,” and it’s what has led to our unprecedented 96% student retention rate, and outstanding residency placements across the US and Canada. UMHS is challenging everything you thought you knew about Caribbean medical schools.