Heat Injury – Protect Yourself from Heat Stroke

In the winter, we long for summer warmth to come and comfort us, and take the chill off our bones. But when summer does arrive, hot weather, welcome at first, can become a dangerous companion. Prolonged hot weather can be fatal for some. In one year in the US, more people died from heat-related injury than from hurricanes, earthquakes, tornadoes and floods combined.

Ways to protect from heat-related injury or heat illness should be tailored to age, according to experts.

Infants are highly susceptible to heat injury, and simply should not be placed in direct sun or high temperature environments, and must receive ample fluids. Dangerous heat exposure can be detected by unusual behavior or taking the infant’s temperature.

In adults, heat injury is usually classified in three stages.

(1) Heat stress causes unusual discomfort in hot environments, such as muscle cramps.

(2) Heat exhaustion should be suspected if a person has headache, dizziness, nausea, vomiting, or mood changes, while the skin is warm and moist, according the US Occupational Safety and Health Agency (OSHA).

(3) Heat stroke or sun stroke is the most dangerous condition—it can be fatal. Heat stroke affects the brain, and may show up as mental confusion, unconsciousness, or seizures. In young otherwise healthy people like competing athletes or soldiers on maneuvers, sweating has usually stopped, so the skin is dry and warm. But heat stroke can occur rapidly, and the skin might be still moist from sweat. In older people or those on certain medications, sweating is impaired. The skin may never get moist, and if circulation is failing, the skin may be cold.

To protect from heat injury, workers in hot environments should drink a cup of water every 20 minutes, OASHA recommends. Avoid alcohol, heavy meals, and caffeinated drinks (which can contribute to dehydration). Workers who have been away from the hot environment five days or more require acclimatization, which starts off as 50% of the usual work load.

Further advice comes from the US Centers for Disease Control and Prevention. Pace yourself (don’t get carried away by the challenge of the game); have a buddy system, to act if one of you gets confused; and use sun screen outdoors (nothing to do with heat injury, but prevents skin cancer). Salt tablets are generally not recommended in the US, where the typical diet is high in salt. To replace fluid lost by sweating, drinking a sports beverage that may have some salt may be useful, if you are not on a salt-restricted diet.

Older people require special consideration. Older people are less likely to sweat, so encouraging them to drink high volumes may lead to fluid overload and heart failure, especially if there is decreased kidney efficiency that often occurs with age. Also, they probably haven’t lost salt (no sweat, no salt loss), so taking salty beverages would not be helpful. Since older people are less likely to sweat, sitting in front of a fan, expecting it to cool by evaporating sweat, won’t work. Older people need air conditioning in extreme heat conditions, it’s just that simple, unless they are very healthy and already acclimated to extreme heat.

In the desert: All ages are especially vulnerable to the low humidity and high temperature of the desert. Fans and wind will blow hot dry air, sucking water out of the body. Desert conditions require other special measures.