As we get into the summer months, things always start heating up. For us adults we tend to find ourselves working all day (for some of us, performing our job outdoors) and then spending even more time outside cutting loose and enjoying everything that summer has to offer us. We tend to forgo the water and replace it with sweet tea, mixed drinks, or [insert your favorite adult beverage here], and end up creating the perfect storm for heat related illnesses.
In the United States, heat waves claim more lives than all other weather-based exposures and/or events combined. We tend to average approximately 800 heat related deaths (8,081 deaths between 1999 and 2010) and tens of thousands of heat related injuries every year. This happens in schools, at festivals, walking down the street, if you are outdoors during the summer months, heat related injuries can and likely will (to one extent or another) happen to you.
Naturally, the best course of action is to avoid heat related injuries all together by staying hydrated and making sound decisions. Monitor your level of hydration using the following urine color chart.
If you work outdoors during the summer months, make sure to implement proper work/rest cycles. This is a chart similar to what we used in the military.
But what is a heat related injury?
There are two common forms of heat related injury that most people remember, and those are Heat Exhaustion and Heat Stroke. However according to the National Institute for Occupational Safety and Health, there are 5 most notable conditions ranging from least to most severe.
Heat Rash
This condition is the least severe and presents as skin irritation which is caused by excessive sweating during hot and or humid weather.
Symptoms:
- Looks like red cluster of pimples or small blisters. - Usually appears on the in folds of skin, on the neck and upper chest, and in junctional areas (such as the groin, armpit, knee’s etc)
First Aid:
- Keep the area as dry as possible
- Use a dry powder such as gold bond or baby powder
- DO NOT USE ointments or creams
Heat Cramps
Heat Cramps are still on the less severe side of the spectrum but can cause issues. Heat cramps usually affect people who sweat a lot during strenuous activity (athletes, construction workers etc), and is the result of low sodium (salt) and hydration levels in muscles which causes painful cramps. Our bodies use salt to regulate muscle contraction, nerve function and blood volume through the regulation of fluid levels in your body. Low sodium can cause dehydration, muscle cramps and organ failure. Symptoms:
- Muscle Cramps, pain, or spasms in the abdomen, arms, or legs
First Aid:
- Drink sips of water or a sports drink (Gatorade/Powerade/Propel) every 15-20 minutes. Something high in carbohydrates, and with electrolytes (sodium and sugar)
- DO NOT take salt tablets
- If cramps do not subside in 1 hour, or if the person is known to have heart problems get medical assistance immediately
Heat Syncope (fainting)
On the severe side of the spectrum, Heat Syncope is an episode of dizziness or even fainting that occurs with prolonged standing or sudden rising from a sitting or lying position (we see this in military formations A LOT). This fainting or dizziness occurs when adequate blood flow to the brain is not provided and is typically caused by dehydration and a lack of acclimatization to the heat and or environment.
Symptoms:
- Fainting for a short duration
- Dizziness
- Light-headedness during prolonged standing or when suddenly getting up from a seated position
First Aid:
- Move to a cool place and rest
- Slowly drink water, clear juice, or a electrolyte base sports drink
Rhabdomyolysis
This is a severe medical condition caused by heat stress and prolonged exercise. Rhabdomyolysis is the rapid breakdown, rupture, and death of muscle tissues. When these tissues die, they release electrolytes and large proteins into the bloodstream which damages the kidneys and cause irregular heartbeat and seizures.
Symptoms:
- Pain or cramps in the muscles - Soda or tea colored urine (blood in the urine) - General weakness
First Aid:
- Stop all activity - Drink water (you do not want to introduce more electrolytes to the body, you want to flush out the current over-abundance of proteins and electrolytes) - Go to the nearest medical facility - Request and complete a blood analysis for creatine kinase
Heat Exhaustion
The body’s response to an excessive loss of the water and salt, accomplished typically through excessive sweating is called Heat Exhaustion. Most people who are prone to heat exhaustion are those that are elderly, have high blood pressure, and those exposed frequently and for long periods of time, to a hot environment.
Symptoms:
- Headache - Nausea - Weakness - Irritability - Thirst - Dizziness - Heavy sweating - Elevated Body Temperature (hyperthermia) - Decreased Urine output
First Aid:
- Stop all activity, remove the person from the hot area and give cool liquids. - Remove unnecessary clothing including shoes and socks. - Cool the person down with a cold compress or rinse with cool water on the neck, head, wrists, and junctional areas. - Take the person to the emergency room for evaluation and treatment. - If medical care is not readily available call 911 - Encourage frequent sips of water (NOT a sports drink)
Heat Stroke
The most severe type of heat injury is Heat Stroke. Heat Stroke occurs when the body becomes unable to control its temperature through perspiration. The body’s temperature rises rapidly and the body is unable to cool down. When heat stroke occurs, the body temperature can rise to 106°F or higher within 10 to 15 minutes. Heat stroke can be FATAL or cause permanent disability if emergency treatment is not given.
Symptoms:
- Rapid heartbeat without physical activity - Rapid, shallow breathing - Weakness - Unconsciousness - Seizures - Dizziness - Severe Headache - Little to no sweating - Elevated Body Temperature (hyperthermia) - Confusion, disorientation, staggering - Nausea and vomiting
First Aid:
- Immediately call 911 and stay with the person until 911 arrives.
- Move to a cool and shaded area, remove outer clothing.
- Cool the worker quickly with cold water or an ice bath if possible.
- Wet the skin with cold water or soak clothing with cold water.
- Fan the person to promote and increase cooling.
- Pack ice or cold and wet clothing into the groin and armpits, as well as on the neck, wrists, and head
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