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Heat Illness by paulshikleejr
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It's A Dry Heat, But It Can Still Kill You: Heat Illnesses
Compiled and edited by paulshikleejr

Here's important topline information about dangerous heat illnesses (but you'd do well to read the detail below):

Symptoms of Heat Stroke (THIS IS A SERIOUS MEDICAL EMERGENCY)
  • Dry, hot skin with no sweating.
  • Mental confusion or losing consciousness.
  • Seizures or convulsions.
  • Death.
Symptoms of Heat Exhaustion
  • Headaches, dizziness, lightheadedness or fainting.
  • Weakness and moist skin.
  • Mood changes such as irritability or confusion.
  • Upset stomach, nausea, or vomiting.
Preventing Heat Stress
  • Know signs/symptoms of heat-related illnesses; monitor yourself and hiking partners.
  • Block out direct sun or other heat sources.
  • Use cooling fans/air-conditioning; rest regularly.
  • Drink lots of water; about 1 cup every 15 minutes.
  • Wear lightweight, light colored, loose-fitting clothes.
  • Avoid alcohol, caffeinated drinks, or heavy meals.
What to Do for Heat-Related Illness
  • Call 911 (or local emergency number) at once.
While waiting for help to arrive:
  • If at all possible, move the hiker to a cool, shaded area.
  • Loosen or remove heavy clothing.
  • Provide cool drinking water.
  • Fan and mist the person with water.
The preceding information was lifted and adapted from http://www.osha.gov.

Avoiding Heat Stress and Heat Illnesses During Hot Weather

I've been an avid fan of HikeArizona.com since I began hiking in early 2010. As I was getting started, I read materials about the dangers of hot environments and activities (such as hiking) in the spring and summer heat of Arizona. The information I scanned early on specifically about heat illnesses probably saved my life recently. In the above information and in the following information, you may notice that some information seems out of place with regard to the subject of hiking. When this is the case, it's because that information was in the source material and I felt that it needed to be said for general cautionary purposes. Heat illnesses are a serious matter and so sacrificing some stylistic niceties is wholly appropriate.

Remember, the basic rule to protect your health when temperatures are extremely high, is to keep cool and use common sense:
  • Monitor your yourself and those for whom you are responsible for signs of heat distress.
  • Drink plenty of fluids and replace salts and minerals in your body. Do not take salt tablets unless under medical supervision.
  • Eat appropriately to keep your body fueled and carry light snacks to reasonably replenish your energy as you hike.
  • Avoid hot foods and heavy meals - they add heat to your body.
  • Dress infants and children in cool, loose clothing and shade their heads and faces with hats or an umbrella.
  • Limit sun exposure during mid-day hours and in places of potential severe exposure such as beaches or the open desert.
  • Be on the look-out for potential sources of shade such as boulders, trees, large bushes, and large cacti (but beware of rattlesnakes and coyotes).
  • Do not leave infants, children, or pets in a parked car.
  • Provide plenty of fresh water for your pets, and leave the water in a shady area.
Monitor Yourself and Those at High Risk

Know your body and be sensitive to your own level of heat stress. Don't discount what your body is telling you. Remember that prevention or (failing prevention) early detection is the best treatment.

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 effects of high temperatures and rely on others to regulate their environments 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.
Monitor adults at risk and closely watch them for signs of heat exhaustion or heat stroke. Infants and young children, of course, need much more careful watching.

Drink Plenty of Fluids

During hot weather you will need to increase your fluid intake, regardless of your activity level. Don't wait until you're thirsty to drink. By the time you feel thirsty, you are already becoming dehydrated. During heavy exercise in a hot environment, drink two to four glasses (16-32 ounces) of cool fluids each hour.

Warning: If your doctor generally limits the amount of fluid you drink or has you on water pills, ask 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. When you hike or exercise, drink two to four glasses of cool, non-alcoholic fluids each hour. A sports beverage can replace the salt and minerals you lose in sweat. However, if you are on a low-salt diet, talk with your doctor before drinking a sports beverage or taking salt tablets.

Don't Run on Empty

Hiking can be a strenuous activity and your body will be burning fuel to keep you moving onward and upward. Remember to eat appropriately (an all-you-can-eat buffet on the way to the trailhead is not appropriate) 30 to 60 minutes (or whatever is right for you) before hitting the trail and monitor your energy level as you hike. Carry trail mix or heat tolerant food bars with you to snack on as needed and necessary. Don't overdo snacking on the trail, but don't ignore your body's signals that you're out of gas and running on fumes or batteries.

Wear Appropriate Clothing and Sunscreen

Wear as little clothing as possible and appropriate. 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. When you go outdoors, protect yourself from the sun by wearing a wide-brimmed hat (also keeps you cooler) 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

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.

Use a Buddy System

When hiking, exercising, or engaging in other activities in the heat, monitor the condition of your partners 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.

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.

Continuously look for sources of shade for use as rest areas and for places of refuge in emergencies. In my estimation, the best shade is provided by rocks and boulders: they are solid and no direct sun will penetrate. When you're in serious need of shade, nothing satisfies as much as total blockage of sun. Trees (even low-lying, stunted desert trees) are a close second, but they'll probably let some sunlight through. Even large bushes are better than nothing as are large saguaro. Be aware, though, that shade is a scarce resource on many hikes and there may be snakes or animals already occupying that sheltered area.

Do Not Leave Children in Cars (Always needs to be said...)

Even in cool temperatures, cars can heat up to dangerous temperatures very quickly. Even with the windows cracked open, interior temperatures can rise almost 20 degrees Fahrenheit within the first 10 minutes. Anyone left inside is at risk for serious heat-related illnesses or even death. Children who are left unattended in parked cars are at greatest risk for heat stroke, and possibly death. When traveling with children, remember to do the following:
  • Never leave infants, children or pets in a parked car, even if the windows are cracked open.
  • To remind yourself that a child is in the car, keep a stuffed animal in the car seat. When the child is buckled in, place the stuffed animal in the front with the driver.
  • When leaving your car, check to be sure everyone is out of the car. Do not overlook any children who have fallen asleep in the car.
Hot Weather Health Emergencies

Even short periods of high temperatures can cause serious health problems. When planning a hike and when traveling to the trailhead, 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 and/or spending too much time in the sun can cause heat-related illnesses. Know the symptoms of heat disorders and overexposure to the sun, and be ready to give first aid treatment.

Note: you'll notice that first aid for the more serious conditions require lots of water to even approximate what's recommended. If at all possible, always carry more water than you think you'll need. I usually bring four liters of water (five liters if it's hotter or the hike is a bit longer) for a five mile hike. I'm going to try and take even more water if I'm at all concerned about what I'm about to do. Most times, I get back to my car with two or three liters and that's fine. Recently, I used up all five liters as I drank sips and mouthfuls, poured water on myself, and swabbed my arms, torso, and legs with my soaked t-shirt to facilitate cooling. I would have been better off with six liters of water, but I was lucky.

Heat Stroke

The best treatment is prevention. If at all possible, don't let milder forms of heat illness escalate to heat stroke.

Heat stroke occurs when the body is unable to regulate its temperature. The body's temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Body temperature may rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not provided.

Recognizing Heat Stroke

Warning signs of heat stroke vary but may include the following:
  • An extremely high body temperature (above 103°F, orally)
  • Red, hot, and dry skin (no sweating)
  • Rapid, strong pulse
  • Throbbing headache
  • Dizziness
  • Nausea
  • Confusion
  • Unconsciousness
What to Do

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°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 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.

Recognizing Heat Exhaustion

Warning signs of heat exhaustion include the following:
  • Heavy sweating
  • Paleness
  • Muscle cramps
  • Tiredness
  • Weakness
  • Dizziness
  • Headache
  • Nausea or vomiting
  • Fainting
The skin may be cool and moist. The victim's pulse rate 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 any of the following occurs:
  • Symptoms are severe
  • 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 1 hour.

What to Do

Aggressively seek to treat and lessen the severity of distress so as to avoid progression to more serious conditions such as heat stroke.

Cooling measures that may be effective include the following:
  • Cool, nonalcoholic beverages
  • Rest
  • Cool shower, bath, or sponge bath
  • An air-conditioned environment
  • Lightweight clothing
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 heat cramps. Heat cramps may also be a symptom of heat exhaustion.

Recognizing Heat Cramps

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 for heat cramps.

What to Do

If medical attention is not necessary, take these steps:
  • Stop all activity, and sit quietly in a cool place.
  • Drink clear juice or a sports beverage.
  • 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 1 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.

Recognizing Sunburn

Symptoms of sunburn are well known: the skin becomes red, painful, and abnormally warm after sun exposure.

What to Do

Consult a doctor if the sunburn affects an infant younger than 1 year of age or if these symptoms are present:
  • Fever
  • Fluid-filled blisters
  • Severe pain
Also, remember these tips when treating sunburn:
  • Avoid repeated sun exposure.
  • Apply cold compresses or immerse the sunburned area in cool water.
  • Apply moisturizing lotion to affected areas. Do not use salve, butter, or ointment.
  • Do not break blisters.
Heat Rash

Heat rash is a skin irritation caused by excessive sweating during hot, humid weather. It can occur at any age but is most common in young children.

Recognizing Heat Rash

Heat rash looks like a red cluster of pimples or small blisters. It is more likely to occur on the neck and upper chest, in the groin, under the breasts, and in elbow creases.

What to Do

The best treatment for heat rash is to provide a cooler, less humid environment. Keep the affected area dry. Dusting powder may be used to increase comfort.

Treating heat rash is simple and usually does not require medical assistance. Other heat-related problems can be much more severe.

This information was adapted from http://emergency.cdc.gov as provided by NCEH's Health Studies Branch (http://www.cdc.gov).

WARNING! Keep in mind that I, the compiler of this info, am not a doctor and, therefore, can not provide and am not providing medical advice. This information was adapted from what I believe are reliable sources, but if you have any questions, ask your healthcare provider.

WARNING! Hiking and outdoor related sports can be dangerous. Be responsible and prepare for the trip. Study the area you are entering and plan accordingly. Dress for the current and unexpected weather changes. Take plenty of water. Never go alone. Make an itinerary with your plan(s), route(s), destination(s) and expected return time. Give your itinerary to trusted family and/or friends.

2010-08-24 paulshikleejr

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