Friday, July 4, 2014

Heatstroke: What To Watch for and What To Do for Victims


In the summer of 1949, when I was only 6 years old, two great-uncles from Kansas City, MO, visited my folks' home in Oswego, KS. They planned to spend a few days fishing the Neosho River. As it turned out, though, that vacation ended in tragedy for one of them.

While sitting on the bank of the Neosho, in the hot August sun, without a hat on his head, my Great-Uncle Chris had a heatstroke and died. Had cellphones been around back then, there's a chance my uncle's life might have been spared, but, of course, those devices still were several years away at that point.

Even with all the cellphones today, heatstroke continues to be an emergency that kills hundreds each year and leaves many more disabled. What makes it so severe and potentially life-threatening is the fact the body's normal mechanisms for dealing with heat stress, such as sweating and temperature control, become inadequate. The main sign of heatstroke is a markedly elevated body temperature--usually more than 104 degrees F--with changes in mental status, ranging from personality changes to confusion and coma. The skin may be hot and dry, although if heatstroke is caused by exertion, the skin may be moist.

Other signs and symptoms may include:
     * Rapid heartbeat
     * Rapid and shallow breathing
     * Elevated or lowered blood pressure
     * Cessation of sweating
     * Irritability, confusion or unconsciousness
     * Feeling dizzy or lightheaded
     * Headache
     * Nausea
     * Fainting, which may be the first sign in older adults

What To Do for Heatstroke When You Can Get Help

Call 9-1-1 immediately. Never wait and see if someone with heatstroke is going to get better on their own. Their organs are cooking.

Until the ambulance arrives, cool the person off as best you can. If they can walk, and it's not far, get them into air-conditioning. Otherwise, have them lie down in the shade. Take off all but their underclothes. Spray or bathe them with cool/cold water and fan them. When the victims are unconscious, place them on their side so their tongue won't impede their airway.

What To Do for Heatstroke When You Can't Get Help

Your only hope is to cool the person off as quickly as possible and get some fluids in him/her. In addition to the earlier guidelines, here are some more tips:

     * If you have ice, place a pack on the person's groin and armpits, and under his/her neck.
     * Even if available, there's a debate about whether someone with heatstroke should soak in a tub of ice water. The problem is, if his/her heart stops, it's going to be difficult to do CPR. The majority recommend doing whatever gets a victim the coolest the fastest.
     * Soak a sheet in the coolest water possible, and wrap it around the victim's bare skin.
     * Fan the victim for the cooling effect of evaporation.
     * If the victim is alert enough, have him/her slowly drink as much cool water as possible. Make sure they're sitting upright enough not to choke.
     * If you should have access to intravenous fluids, now would be the time to give them.

Even if you fully hydrate and cool someone with heatstroke, they'll have multiple-organ damage, so get them to a medical facility as soon as possible.

(The previous item and the one that follows are designed as reminders that we're heading into the dog days of summer, when it pays to stay alert to your body and what it's telling you.)

How To Prevent Heatstroke

Wear loose-fitting, lightweight clothing. Wearing excess clothing or clothing that fits tightly won't allow your body to cool properly.

Wear light-colored clothing if you're in the sun. Dark clothing absorbs heat. Light-colored clothing can help keep you cool by reflecting the sun's rays.

Drink plenty of fluids. Staying hydrated will help your body sweat and maintain a normal body temperature.

Take extra precautions with certain medications. Be on the lookout for heat-related problems if you take medications that can affect your body's ability to stay hydrated and dissipate heat.

Never leave children or anyone else in a parked car. This is a common cause of heat-related deaths in children. When parked in the sun, the temperature in your car can rise 20 degrees F in just 10 minutes. It's not safe to leave a person inside a parked car in hot weather for any period of time, even if the windows are cracked or the car is in the shade. When your car is parked, keep it locked to prevent a child from getting inside.

Take it easy during the hottest parts of the day. If you can't avoid strenuous activity in hot weather, follow the same precautions and rest frequently in a cool spot. Try to schedule exercise or physical labor for cooler parts of the day, such as early morning or evening. Taking breaks and replenishing your fluids during that time will help your body regulate your temperature. (On a personal note, I sometimes take a break from fishing--even on tournament days--and just go for a little boat ride to cool off when we're in the middle of a summer heat wave. I've also fished with others who draped a damp cloth over the back of their neck on hot days.)

Get acclimatized. Limit the amount of time you spend working or exercising in the heat until you're conditioned to it. People who are not used to hot weather are especially susceptible to heat-related illness, including heatstroke. It can take several weeks for your body to adjust to hot weather.

Be cautious if you're at increased risk. If you take medications or have a physical condition that increases your risk of heat-related problems, avoid the heat and act quickly if you notice symptoms of overheating. If you participate in a strenuous sporting event or activity in hot weather, make sure there are medical services at the event in case a heat emergency arises.

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