• Bill Brandenburg, MD

Stay Safe in the Heat

The western United States is hot! Over the last 2 weeks the temperatures have been over 100F most all days in the Boise area.


Heat waves are dangerous. They make power outages more common. Without AC, many people, and especially the elderly, are vulnerable. Additionally, plants, animals, and other organisms are unable to take shelter from the heat. As we are intricately connected to these organisms, I am afraid for both them and us.


Over 600 people die every year in the United States from heat exposure. Even more heartbreaking, about 50 babies/children die from heat every year due to vehicle entrapment. The most common cause of vehicle entrapment is care-givers forgetting kids are in the car…..yikes!


Many medical illnesses can be caused by prolonged exposure to heat. These include:

- Muscle cramps

- Limb swelling

- Skin rashes

- Loss of consciousness

- Heat exhaustion

- Heat stroke


Risk Factors for Heat Illness

- Old age

- Medications like stimulants and thyroid hormone

- Dehydration

- Chronic health issues


Prevention

- Stay cool, wear proper clothing, and do not cover your face (take off your mask!)

- If outside, take frequent breaks in the shade or temperature-controlled environment

- Acclimatize yourself to heat by slowly increasing the amount of time you spend outside over a few weeks.

- Stay well hydrated and consume adequate electrolytes like potassium, magnesium, sodium, and other salts/minerals.

- If the below signs of heat exhaustion occur, seek out a cool place immediately.

- Exercise and stay in good shape

- If power goes out, take several cool baths throughout the day


Symptoms

1. Heat Exhaustion: feeling mildly ill, thirsty, weak, uncomfortable, anxious, dizzy, fatigued, body temperature between 37 – 40C (104F)

2. Heat Stroke: The above symptoms, plus impaired coordination, walking difficulty, speaking difficulty, altered mentation, delirium, seizure, coma, and temperature > 40C (104F). About 10% of people with heat stroke will die.


Treatment

• Heat Exhaustion: Seek shade or ideally a cool temperature-controlled environment. Rehydrate and consume electrolytes. Stop exercising.

• Heat Stroke: Assess airway, breathing, and circulation (perform CPR if needed). Utilize the above strategies for heat exhaustion and actively cool. Cold water emersion is the best method. Removing clothing, drenching with fluid, and fanning is also effective. Initiate transportation to the nearest hospital via emergency medical services. If properly trained, start and IV and administered cool fluids. Avoid medications for fever as these will not help and could cause harm.


References

- Lipman et al. WMS Practice Guidelines for the Prevention and Treatment of Heat-Related Illness. Wild & Env Med. 2014.

- O’Brien et al. Clinical Management of Heat-Related Illnesses. Ch. 13. Auerbachs, Wilderness Medicine.

- Gaudio FG, Grissom CK. Cooling Methods in Heat Stroke. J Emerg Med. 2016

- Wikipedia – Heat Stroke

- Personal experience as a physician and athlete





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