The months of July and August are believed to be the hottest months of the year in Anguilla. It is a time when many resident and visitors are outdoors exposed to very high temperatures – increasing the chances of sunburn and heatstroke which can result in serious complications including death.
What is heatstroke?
Heatstroke is a condition caused by your body overheating, usually because of prolonged exposure to, or physical exertion in, high temperatures. Heatstroke can occur if your body temperature rises to 104 F (40 C) or higher.
Heatstroke requires emergency treatment. Untreated heatstroke can quickly damage your brain, heart, kidneys and muscles. The damage worsens the longer treatment is delayed, increasing the risk of serious complications or death.
Why do you get heatstroke?
Heatstroke can occur because of:
• Exposure to a hot environment. In a type of heatstroke, called nonexertional or classic heatstroke, being in a hot environment leads to a rise in body temperature. This type of heatstroke typically occurs after exposure to hot, humid weather, especially for prolonged periods such as two or three days. It occurs most often in older adults and in people with chronic illness.
• Strenuous activity. Exertional heatstroke is caused by an increase in body temperature brought on by intense physical activity in hot weather. Anyone exercising or working in hot weather can get exertional heatstroke, but it is most likely to occur if you are not used to high temperatures – for example like many of our tourists coming from North America and Europe.
In either type of heatstroke, your condition can be brought on by:
• Wearing excess clothing that prevents sweat from evaporating easily and cooling your body
• Drinking alcohol which can affect your body’s ability to regulate your temperature
• Becoming dehydrated by not drinking enough water to replenish fluids lost through sweating
Who gets heatstroke?
Anyone can get heatstroke, but heatstroke mainly affects people over age 50. It also takes a toll on healthy young athletes as well. Infants and children up to age 4, and adults over age 65, are particularly vulnerable because they adjust to heat more slowly than other persons.
What are some signs and symptoms of heatstroke?
Symptoms and signs of heatstroke might vary from one individual to another but common signs and symptoms include the following:
• High body temperature. A body temperature of 104 F (40 C) or higher is the main sign of heatstroke.
• Altered mental state or behaviour. Confusion, agitation, slurred speech, irritability, delirium, seizures and coma can all result from heatstroke.
• Alteration in sweating. In heatstroke brought on by hot weather, your skin will feel hot and dry to touch. However, in heatstroke brought on by strenuous exercise, your skin may feel moist.
• Nausea and vomiting.
• Flushed skin. Your skin may turn red as your body temperature increases.
• Rapid breathing. Your breathing may become rapid and shallow.
• Racing heart rate.
• Headache.
Treatment
If you suspect that someone has a heatstroke, immediately call 911 or transport the person to a hospital. Any delay seeking medical help can be fatal.
While waiting for the paramedics to arrive, initiate first aid. Move the person to an air-conditioned environment — or at least a cool, shady area — and remove any unnecessary clothing.
Heatstroke treatment focuses on cooling your body to a normal temperature to prevent or reduce damage to your brain and vital organs. To do this, your doctor may take these steps:
• Immerse you in cold water. A bath of cold or ice water can quickly lower your temperature.
• Use evaporation cooling techniques. Some doctors prefer to use evaporation instead of immersion to lower your body temperature. In this technique, cool water is misted on your skin while warm air fanned over your body causes the water to evaporate, cooling the skin.
• Pack you with ice and cooling blankets. Another method is to wrap you in a special cooling blanket and apply ice packs to your groin, neck, back and armpits to lower your temperature.
• Give you medications to stop your shivering. If treatments to lower your body temperature make you shiver, your doctor may give you a muscle relaxant such as a benzodiazepine. Shivering increases your body temperature making treatment less effective.
It is recommended not to use ice for older patients, young children, patients with chronic illness, or anyone whose heatstroke occurred without vigorous exercise, as this can be dangerous.
Prevention
It is better to prevent heatstrokes than treating them. You can prevent heatstroke by taking these steps:
• Wear lightweight, light-coloured, loose-fitting clothing, and a wide-brimmed hat.
• Use a sunscreen with a sun protection factor (SPF) of 30 or more.
• Drink extra fluids. To prevent dehydration, it is generally recommended to drink at least eight glasses of water, fruit juice, or vegetable juice per day.
• Take additional precautions when exercising or working outdoors. The general recommendation is to drink 24 ounces of fluid two hours before exercise, and consider adding another 8 ounces of water or sports drink right before exercise. During exercise, you should consume another 8 ounces of water every 20 minutes, even if you do not feel thirsty.
• Reschedule or cancel outdoor activity. If possible, shift your time outdoors to the coolest times of the day, either early morning or after sunset.
• Never leave anyone in a parked car. This is a common cause of heat-related deaths in children. When parked in the sun, the temperature in your car can rise 20 degrees F (more than 6.7 C) in 10 minutes.
• Be cautious if you are at increased risk. If you take medications, or have a condition that increases your risk of heat-related problems, avoid the heat and act quickly if you notice symptoms of overheating. If you participate in a strenuous sporting event or activity in hot weather, make sure there are medical services available in case of a heat emergency.
Avoid fluids containing caffeine or alcohol because both substances can make you lose more fluids and worsen heat-related illness. Also, do not take salt tablets unless your doctor has told you to do so. The easiest and safest way to replace salt and other electrolytes during heat waves is to drink sports beverages or fruit juice.
Conclusion
Heatstroke is a potentially serious condition that can occur if you get too hot. This usually happens when it gets very hot, but can also occur when you are doing very strenuous physical exercise. In a heatstroke, the body is no longer able to cool itself and a person’s body temperature becomes dangerously high. (Sunstroke is when this is caused by prolonged exposure to direct sunlight.) Heatstroke can put a strain on the brain, heart, lungs, liver and kidneys, and can be life-threatening. If not treated early and effectively it can result in serious complications including death.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
