Disease: Heat-Related Illness

    Heat-related illness facts

    • Hyperthermia is overheating of the body.
    • Heat-related illness occurs as a result of heat exposure.
    • Heat-related illnesses include
      • heat stroke,
      • heat exhaustion,
      • heat cramps,
      • heat syncope (fainting), and
      • heat rash.
    • Heat stroke is the most severe form of heat-related illness, and requires immediate medical attention.
    • Certain individuals, such as the elderly, infants and young children, the obese, outdoor workers, and those with chronic medical conditions are at increased risk for developing heat-related illness.
    • Signs and symptoms of heat-related illness vary based on the condition, but may include
      • an elevated body temperature,
      • headache,
      • nausea,
      • weakness,
      • dizziness,
      • fainting,
      • muscle cramps,
      • seizures,
      • confusion, and
      • coma.
    • Treatment for heat-related illness generally includes moving the individual out of the hot environment, implementing cooling measures as needed, rest, and rehydration.
    • Prevention of heat-related illness is best accomplished through proper planning and preparation, such as increasing fluid intake, wearing appropriate clothing and sunscreen, remaining in a cool environment, acclimating yourself to the hot environment, and using common sense.

    What is a heat-related illness?

    A heat-related illness is a medical condition that may occur as a result of heat exposure. Even short periods of high temperatures can cause serious health problems. Heat-related illness encompasses a spectrum of conditions that range from minor illnesses to life-threatening medical emergencies. There are several heat-related illnesses, including heat stroke, heat exhaustion, heat cramps, heat syncope (fainting), and heat rash.

    Summer can bring heat waves with unusually high temperatures that can last for days and sometimes weeks.

    • According to statistics from the Centers for Disease Control and Prevention (CDC), there were 7,415 death due to heat-related illness in the United States from 1999 to 2010, or an average of approximately 618 death per year.
    • Heat waves lead to more deaths annually in the United States than tornadoes, earthquakes, floods, and hurricanes combined.
    • In the summer of 1980, a severe heat wave hit the United States, and approximately 1,700 people lost their lives from heat-related illness; and in the summer of 2003, tens of thousands of people died in Europe from an extreme heat wave.
    • The summer of 2012 heat wave in the United States led to many heat-related deaths, and numerous all-time high temperature records were broken throughout the United States.
    • Most recently, a summer heat wave in Pakistan in 2015 led to more than 1,000 fatalities.
    • High temperatures put people at risk.

    What causes a heat-related illness?

    People suffer heat-related illness when the body's normal temperature control system is unable to effectively regulate its internal temperature. Normally, at high temperatures the body primarily cools itself through the evaporation of sweat. However, under certain conditions (air temperatures above 95 F/35 C high humidity), this cooling mechanism becomes less effective. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Furthermore, without adequate fluid intake, excessive fluid losses and electrolyte imbalances may also occur leading to dehydration. In such cases, a person's body temperature rises rapidly. Very high body temperatures can damage the brain and other vital organs.

    Picture of the layers of the skin including the sweat glands

    Other conditions that can limit the ability to regulate body temperature include old age, obesity, fever, dehydration, heart disease, poor circulation, sunburn, and drug or alcohol use.

    Who is at risk of heat-related illness?

    Those at greatest risk of heat-related illness include:

    • infants and children up to four years of age,
    • people 65 years of age or older,
    • people who are overweight,
    • people who overexert during outdoor work or exercise,
    • people with mental illness, and
    • people who are chronically ill or on certain medications.

    Infants and children up to four years of age are very sensitive to the effects of high temperatures and rely on others to regulate their environment and to provide adequate fluid intake. Moreover, they have a higher metabolic rate and inefficient sweating compared to adults.

    People 65 years of age or older may not compensate for heat stress efficiently, and are less likely to sense and respond to changes in temperature. The elderly population also is at a higher risk because they usually have other pre-existing medical conditions, and they often take medications that can make them more vulnerable to dehydration (for example, diuretics).

    Overweight individuals may be prone to heat-related illness because of their tendency to retain more body heat.

    Any health condition that causes dehydration makes the body more susceptible to heat-related illness. If you or someone you know is at higher risk, it is important to drink plenty of fluids, avoid overexertion, and get your doctor or pharmacist's advice about medications being taken for:

    • High blood pressure
    • Mental illness
    • Poor circulation

    What are the symptoms of heat-related illness?

    Signs and symptoms of heat-related illness vary based on the severity of the illness.

    • Heat rash symptoms: red bumps on the skin, a feeling of prickly or itchy skin.
    • Heat syncope (fainting) symptoms:  dizziness or lightheadedness and fainting, generally due to prolonged exposure to heat, dehydration, or orthostatic hypotension.
    • Heat cramps symptoms: significant sweating, involuntary spasms of the muscles in the body, most often affecting the legs.
    • Heat exhaustion symptoms: nausea and vomiting, headache, muscle cramps, weakness, and profuse sweating.
    • Heat stroke symptoms: dizziness, muscle cramps and aches, nausea and vomiting, fatigue, headache, weakness, confusion and coma. Heat stroke is a medical emergency.

    Heat stroke

    Heat stroke is a medical emergency requiring immediate medical attention. It is the most severe form of heat-related illness, and it can sometimes lead to death or permanent disability. Heat stroke occurs when the body's ability to regulate its internal temperature has failed. The body's temperature rises rapidly in excess of 104 F (40. C), leading to damage to the brain and other vital organs. Generally, the extent of injury depends on the duration of exposure to excessive heat and the peak temperature attained. Heat stroke is sometimes referred to as sunstroke.

    Heat stroke can be categorized as either exertional heat stroke (EHS) or nonexertional heat stroke (NEHS). Exertional heat stroke generally occurs in young, healthy individuals who engage in strenuous activity in hot weather. Nonexertional heat stroke (also referred to as classic heat stroke) typically occurs in the elderly, the very young, or the chronically ill.

    What are the signs and symptoms of heat stroke?

    Warning signs of heat stroke vary but may include:

    • high body temperature (above 104 F or 40 C),
    • skin that is red, hot, and either moist or dry (sweating may have stopped),
    • rapid heart rate,
    • difficulty breathing,
    • headache,
    • dizziness,
    • loss of coordination,
    • nausea and vomiting,
    • confusion and restlessness,
    • seizures, and
    • unconsciousness/coma.
    What is the treatment for heat stroke?

    If you see any of these signs, you may be dealing with a life-threatening emergency. Have someone call for immediate medical assistance while you begin cooling the affected individual:

    • Get the person to a cool indoor or outdoor area and remove restrictive clothing.
    • Cool the person rapidly using whatever methods you can. For example, if possible, immerse the person in a tub of cool water or place them in a cool shower. You may also spray them with lukewarm water and blow cool air from a fan towards them. If the humidity is low, loosely wrap the person's body in a cool, wet sheet and fan him or her vigorously. Alternatively, place ice or cold packs to the armpits, neck, and groin areas.
    • Monitor body temperature, and continue cooling efforts until the body temperature drops to about 102 F or lower (38.8 C), in order to prevent overcooling the affected individual.
    • If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
    • If the affected individual is awake and alert, give them cool fluids to drink. Do not give them alcohol to drink.

    If the affected individual's muscles begin to twitch uncontrollably (seizure) as a result of heat stroke; keep the individual from injuring themselves, and do not place any object in the mouth and do not give fluids. If there is vomiting, make sure the airway remains clear by turning the person on their side to prevent choking.

    Heat exhaustion

    Heat exhaustion is the body's response to an excessive loss of water and salt contained in sweat as a result of engaging in physical activity (work or exercising) in a hot environment. The body temperature may be normal or mildly elevated, but not above 104 F (40 C). It often occurs in individuals who are not accustomed to working or exercising in the heat. The symptoms may range from minor complaints to more pronounced symptoms, however the affected individual will not experience the central nervous system manifestations noted with heat stroke. Many cases of heat exhaustion can be treated outside of the hospital setting however it is important to understand that heat exhaustion can progress to heat stroke if not properly addressed in a timely fashion.

    What are the signs and symptoms of heat exhaustion?

    Warning signs of heat exhaustion include:

    • a normal or mildly elevated body temperature,
    • heavy sweating,
    • pallor (paleness),
    • muscle cramps and muscle pain,
    • fatigue,
    • weakness,
    • dizziness and lightheadedness,
    • headache, and
    • nausea.

    The skin may be cool and moist. The affected individual's pulse rate may be fast, and breathing may be fast and shallow. If heat exhaustion is untreated and heat exposure continues, it may sometimes progress to heat stroke.

    What is the treatment for heat exhaustion?

    Cooling measures that may be effective include:

    • drink cool, non-alcoholic beverages, such as water and sports drinks,
    • eat salty snacks,
    • rest in the shade or in an air-conditioned environment,
    • take a cool shower or bath, and
    • loosen or remove restrictive clothing.

    Seek medical attention immediately if:

    • the symptoms are severe or worsening, or
    • the affected individual has serious underlying health problems (for example, heart disease or diabetes).

    Otherwise, help the person cool off, and seek medical attention if symptoms worsen or last longer than one hour.

    Heat cramps

    Heat cramps usually affect people who sweat significantly during strenuous activity. This sweating depletes the body's salt and moisture. The low salt level in the muscles causes painful muscle cramps, often following exercise. Heat cramps may also be a symptom of heat exhaustion.

    What are the signs and symptoms of heat cramps?

    Heat cramps are muscle pains or muscle spasms (usually in the abdomen, arms, or legs) that may occur in association with strenuous activity. If the affected person has heart problems or are on a low sodium diet, seek medical attention for heat cramps. What is the treatment for heat cramps?

    • Stop all activity, and sit and rest in a cool place.
    • Drink water or a sports beverage, and eat a salty snack.
    • Passively stretch the affected muscles.
    • Do not return to strenuous activity for a few hours after the cramps have subsided as further exertion can lead to heat exhaustion or rarely, heat stroke.
    • Seek medical attention for heat cramps if they do not subside in 1 hour.

    Heat syncope (fainting)

    Heat syncope is a fainting episode that occurs in the heat, either during prolonged standing or exercise, or when rapidly standing from a lying or sitting position. It typically occurs in individuals who are not acclimatized to the heat. Dehydration can also contribute to this condition.

    What are the signs and symptoms of heat syncope?
    • dizziness or lightheadedness, and
    • fainting.
    What is the treatment for heat syncope?
    • Sit and rest in a cool place. The affected individual may also lie down and elevate the legs above the level of the heart.
    • Drink water or a sports beverage.
    • Seek immediate medical attention for repeated episodes of fainting, or if the individual experiences chest pain, seizures, or confusion.

    What causes a heat-related illness?

    People suffer heat-related illness when the body's normal temperature control system is unable to effectively regulate its internal temperature. Normally, at high temperatures the body primarily cools itself through the evaporation of sweat. However, under certain conditions (air temperatures above 95 F/35 C high humidity), this cooling mechanism becomes less effective. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Furthermore, without adequate fluid intake, excessive fluid losses and electrolyte imbalances may also occur leading to dehydration. In such cases, a person's body temperature rises rapidly. Very high body temperatures can damage the brain and other vital organs.

    Picture of the layers of the skin including the sweat glands

    Other conditions that can limit the ability to regulate body temperature include old age, obesity, fever, dehydration, heart disease, poor circulation, sunburn, and drug or alcohol use.

    Who is at risk of heat-related illness?

    Those at greatest risk of heat-related illness include:

    • infants and children up to four years of age,
    • people 65 years of age or older,
    • people who are overweight,
    • people who overexert during outdoor work or exercise,
    • people with mental illness, and
    • people who are chronically ill or on certain medications.

    Infants and children up to four years of age are very sensitive to the effects of high temperatures and rely on others to regulate their environment and to provide adequate fluid intake. Moreover, they have a higher metabolic rate and inefficient sweating compared to adults.

    People 65 years of age or older may not compensate for heat stress efficiently, and are less likely to sense and respond to changes in temperature. The elderly population also is at a higher risk because they usually have other pre-existing medical conditions, and they often take medications that can make them more vulnerable to dehydration (for example, diuretics).

    Overweight individuals may be prone to heat-related illness because of their tendency to retain more body heat.

    Any health condition that causes dehydration makes the body more susceptible to heat-related illness. If you or someone you know is at higher risk, it is important to drink plenty of fluids, avoid overexertion, and get your doctor or pharmacist's advice about medications being taken for:

    • High blood pressure
    • Mental illness
    • Poor circulation

    What are the symptoms of heat-related illness?

    Signs and symptoms of heat-related illness vary based on the severity of the illness.

    • Heat rash symptoms: red bumps on the skin, a feeling of prickly or itchy skin.
    • Heat syncope (fainting) symptoms:  dizziness or lightheadedness and fainting, generally due to prolonged exposure to heat, dehydration, or orthostatic hypotension.
    • Heat cramps symptoms: significant sweating, involuntary spasms of the muscles in the body, most often affecting the legs.
    • Heat exhaustion symptoms: nausea and vomiting, headache, muscle cramps, weakness, and profuse sweating.
    • Heat stroke symptoms: dizziness, muscle cramps and aches, nausea and vomiting, fatigue, headache, weakness, confusion and coma. Heat stroke is a medical emergency.

    Heat stroke

    Heat stroke is a medical emergency requiring immediate medical attention. It is the most severe form of heat-related illness, and it can sometimes lead to death or permanent disability. Heat stroke occurs when the body's ability to regulate its internal temperature has failed. The body's temperature rises rapidly in excess of 104 F (40. C), leading to damage to the brain and other vital organs. Generally, the extent of injury depends on the duration of exposure to excessive heat and the peak temperature attained. Heat stroke is sometimes referred to as sunstroke.

    Heat stroke can be categorized as either exertional heat stroke (EHS) or nonexertional heat stroke (NEHS). Exertional heat stroke generally occurs in young, healthy individuals who engage in strenuous activity in hot weather. Nonexertional heat stroke (also referred to as classic heat stroke) typically occurs in the elderly, the very young, or the chronically ill.

    What are the signs and symptoms of heat stroke?

    Warning signs of heat stroke vary but may include:

    • high body temperature (above 104 F or 40 C),
    • skin that is red, hot, and either moist or dry (sweating may have stopped),
    • rapid heart rate,
    • difficulty breathing,
    • headache,
    • dizziness,
    • loss of coordination,
    • nausea and vomiting,
    • confusion and restlessness,
    • seizures, and
    • unconsciousness/coma.
    What is the treatment for heat stroke?

    If you see any of these signs, you may be dealing with a life-threatening emergency. Have someone call for immediate medical assistance while you begin cooling the affected individual:

    • Get the person to a cool indoor or outdoor area and remove restrictive clothing.
    • Cool the person rapidly using whatever methods you can. For example, if possible, immerse the person in a tub of cool water or place them in a cool shower. You may also spray them with lukewarm water and blow cool air from a fan towards them. If the humidity is low, loosely wrap the person's body in a cool, wet sheet and fan him or her vigorously. Alternatively, place ice or cold packs to the armpits, neck, and groin areas.
    • Monitor body temperature, and continue cooling efforts until the body temperature drops to about 102 F or lower (38.8 C), in order to prevent overcooling the affected individual.
    • If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
    • If the affected individual is awake and alert, give them cool fluids to drink. Do not give them alcohol to drink.

    If the affected individual's muscles begin to twitch uncontrollably (seizure) as a result of heat stroke; keep the individual from injuring themselves, and do not place any object in the mouth and do not give fluids. If there is vomiting, make sure the airway remains clear by turning the person on their side to prevent choking.

    Heat cramps

    Heat cramps usually affect people who sweat significantly during strenuous activity. This sweating depletes the body's salt and moisture. The low salt level in the muscles causes painful muscle cramps, often following exercise. Heat cramps may also be a symptom of heat exhaustion.

    What are the signs and symptoms of heat cramps?

    Heat cramps are muscle pains or muscle spasms (usually in the abdomen, arms, or legs) that may occur in association with strenuous activity. If the affected person has heart problems or are on a low sodium diet, seek medical attention for heat cramps. What is the treatment for heat cramps?

    • Stop all activity, and sit and rest in a cool place.
    • Drink water or a sports beverage, and eat a salty snack.
    • Passively stretch the affected muscles.
    • Do not return to strenuous activity for a few hours after the cramps have subsided as further exertion can lead to heat exhaustion or rarely, heat stroke.
    • Seek medical attention for heat cramps if they do not subside in 1 hour.

    Heat syncope (fainting)

    Heat syncope is a fainting episode that occurs in the heat, either during prolonged standing or exercise, or when rapidly standing from a lying or sitting position. It typically occurs in individuals who are not acclimatized to the heat. Dehydration can also contribute to this condition.

    What are the signs and symptoms of heat syncope?
    • dizziness or lightheadedness, and
    • fainting.
    What is the treatment for heat syncope?
    • Sit and rest in a cool place. The affected individual may also lie down and elevate the legs above the level of the heart.
    • Drink water or a sports beverage.
    • Seek immediate medical attention for repeated episodes of fainting, or if the individual experiences chest pain, seizures, or confusion.

    Source: http://www.rxlist.com

    Heat exhaustion is the body's response to an excessive loss of water and salt contained in sweat as a result of engaging in physical activity (work or exercising) in a hot environment. The body temperature may be normal or mildly elevated, but not above 104 F (40 C). It often occurs in individuals who are not accustomed to working or exercising in the heat. The symptoms may range from minor complaints to more pronounced symptoms, however the affected individual will not experience the central nervous system manifestations noted with heat stroke. Many cases of heat exhaustion can be treated outside of the hospital setting however it is important to understand that heat exhaustion can progress to heat stroke if not properly addressed in a timely fashion.

    Source: http://www.rxlist.com

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