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As the hot weather arrives we should be aware of what heat disorders are and what we can do to protect ourselves. Understanding what causes them and which groups of people are more susceptible makes it easier to prevent and treat them. Heat disorders range from mild to life threatening and should be taken seriously.

When the body's ability to regulate its own temperature is impaired, problems can occur. Overexposure to high temperatures can cause heat exhaustion, heat stroke, and heat cramps.

Heat Exhaustion
Heat exhaustion is a condition that results from exposure to heat for many hours. There is an excessive loss of fluid, especially during hard labor or strenuous exercise. Vital salts (electrolytes) are lost with the fluid. This can disturb the brain's functioning as well as upsetting the circulatory status. Heat exhaustion may take hours or days to manifest and is usually easy to treat.

Some of the symptoms experienced are weakness, fatigue and anxiety. Drenching sweats will usually accompany these symptoms. A person may feel faint when they stand, their heart rate may become weak and slow. The loss of fluids can decrease blood volume, which in turn decreases blood pressure. This may cause dizziness, fainting or collapse. The skin may also become cold and clammy to the touch.

The main goal of treatment is to replace the body's fluids. Drinking cool, slightly salty beverages, i.e., salted tomato juice, cool bouillon, or commercial electrolyte beverages, will help. If the person is dizzy they should lie flat with their head lower than the rest of the body. Wet towels to the face and neck will help revive someone in heat exhaustion. After rehydration the person will recover fully and rapidly.

Heat Stroke
Heat Stroke is a life threatening condition that requires immediate medical attention. It results from long, extreme exposure to heat. During heat stroke the person can't sweat enough to lower their body temperature. When this occurs the body temperature rises dangerously high, rapidly causing heat stroke.

Heat stroke can develop rapidly with barely any warning symptoms. Some people do experience headache, vertigo (a spinning sensation) and extreme fatigue. The skin becomes hot and flushed, it is usually dry to the touch as sweating is decreased. The heart rate can jump from normal values between 60 and 100, to rates of 160 to 180 beats per minute. Breathing rates will also increase during heat stroke. The blood pressure rarely changes. Body temperature should be taken rectally if possible, as it's the most accurate. A rectal temp could range between 104 and 106 F during heat stroke. Oral temperatures will be over 103 F. A temperature of 106 can be very serious and one degree higher can be fatal. A person can become confused, unconscious or have convulsions with these higher body temperatures.

Heat stroke can cause permanent damage or death; very old people and alcoholics are at very high risk. People that have a medical condition which interferes with their ability to sweat are also at a much higher risk.

Treatment is based on symptoms. Emergency life saving measures should be immediate. A person who can't be moved to the emergency room right away should be wrapped in wet bedding or clothing. If outdoors, the person can always be immersed in a lake or stream; indoors ice can be applied or the person put into a cool bath. It is important not to cool the individual too quickly and never give them fluids to drink. Once at the hospital IV fluids and medications may need to be administered. After recovering from the initial attack, a few days of bed rest may be needed. The person may experience temperature fluctuations for a few weeks.

Heat Cramps
Severe muscle cramping can result from heavy sweating during exertion in extreme heat. The body loses fluids and electrolytes (sodium, potassium and magnesium mostly) from heavy sweating during exercise. This is common in people who work as laborers, or in steel mills and engine rooms.

Heat cramps usually start suddenly in the hands, calves or feet. They can be both painful and disabling. The muscles become very hard, tense and difficult to relax.

Treatment is fairly simple. Eating slightly salted foods or drinking salted beverages will usually help the cramps. Some people use salt tablets, but these may cause upset stomach or fluid retention. Rarely will a person require IV fluids or any serious treatment for this condition.

Risk Factors and Prevention

People who are at risk during hot weather are the very old and very young. Alcoholics, extremely obese people and those who take antipsychotic drugs are also in this category. Those who do outside labor at also at a higher risk.

The best prevention is to use your common sense. Never over exert in high humidity, closed unvented areas or hot outdoor temperatures. Wear appropriate, loose fitting clothing, drink plenty of fluids; one liter or quart per hour during exertion is recommended. Take it easy and don't exert yourself in hot, humid weather if you are part of a high risk group. Try to do outdoor tasks and exercise in the early morning or evening when it is cooler. When outdoor wear a hat that covers your head and neck, wear a sun screen as sunburned skin reduces the body's ability to sweat as needed.

Heat disorders can be avoided with proper protection and a little common sense. Take care of yourself in the coming warmer weather.