This summer is a scorcher, with scenes of people being loaded into ambulances now a staple of the evening news. In California alone, scores of people have died from the heat, with temperatures soaring over 100 degrees in places more used to refreshing lake or ocean breezes.
The line on the thermometer is not the only way weathermen define heat. They have created a Heat Index, which combines heat and humidity to create a sort of 'misery index.' The temperature may be 100 degrees, but combined with humidity (which inhibits sweat from evaporating off the skin and cooling the body), the Heat Index may climb into the danger zone at 105 degrees or higher.
By danger zone, they mean: danger of vomiting in public, collapsing, or even dying.
Who's Most Likely to Suffer?
According to the CDC, the elderly, children under 4, people who are overweight, those who become dehydrated, the mentally ill, people with medical conditions or those who are on certain medications seem to be the most susceptible targets of a heat wave.
"You know who we see a lot?" asks Bruce Bonanno, M.D., an emergency medicine physician in the New York and New Jersey areas. "We see young people coming in. One place I work is a beach community. They drink the night before, and think their fancy little drinks are hydrating them — when they are doing the exact opposite. Then they go to the beach the next day, fall asleep, bake in the sun, and each day get a little more behind on their fluids. Eventually, they end up in the ER."
People suffer a heat-related illness when the body's temperature system is overloaded. The body is sweating, but the sweat is not evaporating due to humidity. Eventually, like a runny egg white, the brain begins to "cook."
The most common heat-related illness is heat exhaustion. This usually builds up over several days of activities in a hot environment without proper replacement of fluids. Wham, it can hit you. The symptoms are:
To help the person, provide cool fluids immediately — anything nonalcoholic, but preferably water. Have the person lie down inside or take a cool bath or shower and then rest.
If the person's symptoms are severe or there are pre-existing medical problems, such as high blood pressure or heart disease, get medical attention right away.
In the ER, Bonanno says, they have sports drinks on hand. If the person is not sick enough to warrant an IV, they can sip the drinks in the waiting room.
If someone experiencing heat exhaustion isn't treated (see below), it can progress to heatstroke, also known as sunstroke. This is very serious. Heatstroke occurs when the body simply cannot control its temperature anymore and the body's temp rockets to 106 degrees or higher within 10 minutes to 15 minutes. This can cause permanent brain damage or death if not treated immediately.
The symptoms of heatstroke are:
If someone faints or stops making sense near you:
Heat cramps are due to muscle spasms, usually in the abdomen, arms, or legs. This is usually a result of so much sweating that the body is low on sodium. People on a low-sodium diet have to watch for this.
People with heart problems or who are on low-sodium diets need to seek medical attention right away for heat cramps. If you or someone you know gets heat cramps, stop all activity and get inside. Drink a clear juice or sports drink (if you are on a low-sodium diet, check with the doctor first). Do not go back outside for several hours, even if the cramps subside, because further exertion could lead to heat exhaustion or heatstroke. If the cramps last more than an hour, check with a doctor.
This is more common in youngsters, but anyone can get it. Heat rash is an irritation of the skin that comes from excessive sweating. Common areas that develop heat rash are the neck, upper chest, groin, under the breasts, and in elbow creases. The solution is to keep the area clean and dry. Avoid using creams because they can form a barrier keeping the area moist and hot making heat rash worse.
Dos and Don'ts for Extreme Heat
Staying safe in high temperatures is relatively simple: Don't take chances when Mother Nature is turning up the heat.
SOURCES:: Bruce Bonanno, M.D., emergency medicine physician, New York, New Jersey, and Iowa; spokesman, American College of Emergency Physicians. CDC Web site.
By Star Lawrence
Reviewed by Louise Chang, M.D.
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