Joshua Strommen MD, FACEP
It is approaching summer time in central Texas, and a few facts about the potential danger of the summer heat are fitting. The most at-risk individuals for heat related injuries are the elderly, high school athletes, military personnel, firefighters, and construction workers.
RISK FACTORS FOR HEAT INJURY
· Strenuous exercise in high temperatures and high humidity
· Dehydration
· Obesity
· Poor physical fitness
· Prior heat illnesses or injury
HEAT REGULATION
The body’s key mechanism for regulating heat is through evaporation. Evaporation occurs when water vaporizes from the skin, through sweating. You also lose water through your respiratory system, by just breathing. When the humidity is high, cooling in this way is limited in its effectiveness, which is why heat injury occurs more when the humidity is highest.
TYPES OF HEAT INJURIES
Heat Cramps
Cause
Dehydration, with loss of sodium and/or potassium
Symptoms
Muscle pain, muscle spasm, persistent muscle contractions
Heat Syncope
Cause
Prolonged standing or prolonged exertion in the heat, causing blood to not perfuse the brain temporarily
Symptoms
Light-headedness, tunnel vision, pale skin, sweating, and collapse
Heat Exhaustion
Cause
Dehydration and exertion that is so severe, there is an inability of the heart to keep pace with the body’s needs
Symptoms
Elevated temperature over 101 F, extreme weakness, heart rate above 100, low blood pressure, headache, abdominal pain with nausea and vomiting
Heat Stroke
Cause
Similar to heat exhaustion, but there is additional confusion
Symptoms
Elevated temperature over 104 F, confusion, collapse, seizures, low blood pressure, elevated heart rate
WHAT YOU CAN DO BEFORE MEDICAL HELP ARRIVES
1. Remove excessive equipment and clothing.
2. Cool the individual by:
a. Move to the shade
b. Pour cold water on them
c. Use fans to assist in evaporation/cooling
3. Call 911 or transport to the closest Emergency Department if there is confusion, passing out, vomiting, or significant weakness
Patients who experience heat injuries are to be taken very seriously. If an individual has had prior heat related injuries they are at high risk of having them again. Those most at risk are adolescents and children. If there is ever any question, at PremiER we can evaluate and treat any of the above heat related illnesses in our Emergency Room.
