Toddler trying to keep cool in the shade

Summer means cookouts, pool parties, camping, and soccer games—but we don’t always think about the health risks that go along with all this fun in the sun. The vacation season brings with it high temperatures and an increased risk of heat-related illnesses, some of which can be life-altering or even deadly. According to the Centers for Disease Control and Prevention, 7,415 people in America died from heat-related causes between 1999 and 2010, putting the average at 618 people per year.

It should be said before we dive in that if you or someone you know experiences symptoms of a heatstroke— such as vomiting, rapid heartbeat, quick breathing, changes in behavior, confusion, fainting, or hot, dry skin—it is imperative that you call (or have someone call) 911 immediately. To prevent the bystander effect from kicking in, single someone out (“You in the red shirt …”), point to him or her, and specifically ask that person to call for help.

Then administer the emergency first aid procedures we’ll discuss later in this article. You have just 30 minutes to treat heatstroke and lower body temperature before cell damage begins, so quick action is vital.

Now that we’ve made the severity of heat-related illness clear, you should also understand that heat exhaustion and heatstroke are almost always avoidable. Here’s a rundown of what you can do to prevent them.

What Is Heat Exhaustion?

Heat exhaustion occurs as a result of overexposure to high temperatures and subsequent excessive sweating. Salt and water levels drop so low that the body becomes distressed. Without medical care, heat exhaustion can lead to heatstroke, which can be fatal. Heatstroke comes in two forms: classical (as when children or older adults have heatstroke in hot weather) and exertional (a result of exercising in the heat). Exertional heatstroke is among the top three causes of death for soldiers and athletes in training.

How to Recognize Heat Exhaustion

If you’ll be outdoors in the heat for long periods—especially taking part in strenuous activity, such as manual labor or sports—be on the lookout for signs of heat exhaustion in yourself and in those around you.

Symptoms of heat exhaustion include:

  • Cramping
  • Fatigue
  • Headache
  • Excessive thirst
  • Dizziness
  • Weakness
  • Heavy sweating
  • Cold, clammy skin
  • Irritability
  • Dark-colored urine or very little urine
  • Elevated body temperature

What to Do in Case of Heat Exhaustion

  • The very first step to take if you suspect heat exhaustion is to get out of the heat. An air conditioned area is ideal, but if that isn’t available, look for a shady spot under a tree or next to a building.
  • Remove any unnecessary clothing, such as shoes, socks, hats, or extra layers.
  • Try to lower your body temperature however possible. Use fans, douse the face and head with cool water from a hose or water bottles, use a cool compress, or take a cool shower, bath, or sponge bath.
  • Drink water, sports drinks, or other fluids—but nothing that includes alcohol or caffeine.
  • If symptoms get worse or don’t improve within 15 minutes, seek medical assistance immediately.
  • If symptoms subside, you should continue to rest for the remainder of the day.
  • If you’re left with a minor headache and no other symptoms, take over-the-counter acetaminophen.

What Is Heatstroke?

Heatstroke occurs in high-heat situations when the body is unable to regulate its temperature, often as a result of not sweating enough. When this happens, body temperature can spike to 106 degrees Fahrenheit or more in just 10 to 15 minutes. Heatstroke is the most serious heat-related illness there is—so treat suspected heatstroke as an emergency situation. Untreated, it can cause serious damage to muscles and vital organs, such as the heart, brain, and kidneys. Heatstroke can even be fatal, but immediate medical attention reduces these risks.

How to Recognize Heatstroke

While symptoms of heat exhaustion and heatstroke often overlap, there are specific signs that a person may be experiencing the latter. Note that while heat exhaustion can lead to heatstroke, heatstroke can also occur without warning.

Signs of heatstroke include:

  • Body temperature of 104 degrees Fahrenheit or higher
  • Nausea or vomiting
  • Confusion or changes in behavior
  • Fainting or loss of consciousness
  • Fast, weak pulse
  • Shallow, quick breathing or hyperventilating
  • Decrease in sweat production
  • Warm, dry, flushed skin (note that heavy sweating is still a possibility)
  • Throbbing headache
  • Convulsions or seizure

Emergency First Aid for Heatstroke

Call 911, or have someone call 911, before you do anything else. Emergency medical treatment is essential for preventing muscle damage, organ damage, and death. As we mentioned earlier, if you need someone else to call 911 for you, it’s most effective to single one person out to make the call. If you ask a group of onlookers, each may assume someone else will handle it.

If you have to wait any amount of time for emergency responders, take these steps.

  • Remove the person from the hot environment to the best of your ability.
  • Remove any unnecessary garments.
  • Try to lower their body temperature to 102 degrees Fahrenheit (registered on a rectal thermometer if available—ear and mouth thermometers are too inaccurate for this situation) as quickly as possible and by whatever means available. You can use fans; pour cold water on the face and head; apply wet cloth or ice packs to as much of the body as possible, especially the armpit, neck, and groin; put the person in an ice bath or cold shower; soak their clothing; or cover them in cold, wet sheets.
  • If the person is conscious, help them take sips of nonalcoholic, uncaffeinated fluids if they’re physically able. You may need to hold their head up to keep them from choking. Do not try to give someone liquids if they are unconscious, vomiting, seizing, or too confused or agitated to drink.
  • If they are vomiting, put them on their side so they do not choke.
  • If they begin to seize, catch them, help them lower to the ground, and protect their head from injury. Here’s a helpful guide to assisting someone who’s having a seizure.
  • If they are unresponsive (not breathing, coughing, or showing other signs of circulation), administer CPR to the best of your ability. Remember that the Good Samaritan Law protects you from liability in all 50 U.S. states and Washington D.C. Even if there is a chance you could injure the affected person, injury is better than death in a life-threatening situation.
  • If a child is unresponsive, begin rescue breathing.

Medical Treatment and Testing for Heatstroke

  • At the hospital or in the emergency response vehicle, medical professionals will use techniques like we’ve described above, such as water immersion or ice packs, to lower the body temperature. They may also use special cooling blankets or evaporation techniques that involve spraying water on the skin and then fanning warm air on it. This strategy brings body temperature down as the water evaporates.
  • These techniques sometimes cause shivering, and the doctor might administer muscle relaxers to help with that. However, medical professionals must use serious discretion when choosing to do so. These medications can raise body temperature, rendering other treatments less effective.
  • Doctors may administer blood tests to check sodium and potassium levels and gas content, which helps measure damage to the central nervous system.
  • A urine test may be needed to determine kidney function.
  • Muscle function tests can check for rhabdomyolysis or muscle tissue damage.
  • X-rays and other imaging tests help determine whether damage has been done to internal organs.

Risk Factors for Heat Exhaustion and Heatstroke

  • A heat index of 91 degrees Fahrenheit or higher means to take precautions. The heat index combines the actual temperature with the humidity level to determine how hot it High humidity will make it more difficult for your body to cool itself off because sweat will not evaporate as easily.
  • Sudden heat waves or traveling to a warmer environment than you’re used to will increase risk of heat-related illness.
  • People over the age of 65 and children under 4 have a higher chance of suffering heat exhaustion or heatstroke.
  • Medications such as diuretics, antihistamines, beta blockers, tranquilizers, and antipsychotics may inhibit your body’s ability to stay hydrated and regulate its temperature.
  • Certain illegal drugs, such as cocaine and amphetamines, can raise the body’s core temperature.
  • Alcohol consumption can contribute to dehydration and temperature regulation problems.
  • Engaging in strenuous activity when it’s hot outside is a major risk factor.
  • Wearing too much clothing, or tight-fitting clothing, can inhibit sweat evaporation—and therefore body temperature regulation.

How to Prevent Heat Exhaustion and Heatstroke

As you can see, heat exhaustion and heatstroke are serious business. These heat-related illnesses need to be handled with care and efficiency. The most ideal route is to avoid them altogether whenever possible. Here’s what you can do to reduce your risk.

  • The first and most obvious way to prevent coming down with a heat-related illness is to avoid high temperatures whenever you can. Pay attention to the weather, and take shelter during heat advisories by staying indoors or chilling in the shade.
  • Never, under any circumstances, leave a child in a vehicle when it is even remotely warm outside. The temperature in a parked car can rise by 20 degrees Fahrenheit in just 10 minutes.
  • Try to avoid strenuous activity when it’s hot, but if you must, take plenty of breaks in the shade or air conditioning, and drink extra fluids to stay hydrated.
  • Avoid consuming alcohol or other recreational drugs that can inhibit body temperature regulation.
  • Talk to your doctor about medications if you take them, and ask specifically whether hot weather will affect you.
  • Wear sunscreen and otherwise protect yourself from the sun. Sunburn can make it difficult for your body to cool down when it needs to.
  • Wear light-colored, lightweight, loose-fitting clothing when spending time in the heat.
  • If there is a sudden spike in temperature or you travel to a warmer climate, let your body get acclimated to the heat before spending too much time in it.

Have fun this summer—but do so with caution. Always keep an eye out for signs of heat exhaustion or heatstroke in yourself and those around you if you’re in a hot environment. And remember the tips above to reduce the likelihood that you or anyone else will have to perform emergency first-aid procedures.

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