CATES: Heat related illness

By Carol A. Cates, MSN, MBA, RN

Chief Nursing Officer

Odessa Regional Medical Center

Recently, I was cleaning our truck as it sat in the driveway. I emptied the glove box and put the stuff I wanted to keep in the truck into the passenger seat. I then took the stuff I wanted out of the truck into the house and to the trash. I was gone less than 10 minutes. When I got back to the truck, I started putting things back in the glove box. The metal tire gauge I left on the seat was so hot, I couldn’t pick it up with my bare hand. I had to use the tail of my shirt to maneuver it back into the glove box. I’m betting you have had a similar experience. It doesn’t take long in West Texas to realize anything left outside in summer weather, particularly if it’s in the sun, is going to get very hot, very quickly.

Yet, for some reason, while we realize our car seats and steering wheels are going to get hot, metal objects are going to get hot, the pavement is going to get hot, and playground equipment is going to get hot, we forget that we can get overheated too. Heat related illness is something we see far too often in our emergency rooms each summer. In 2021, 201 people died from weather related heat injuries in the United States. The thing that concerns me most about heat-related deaths is that every single one of those deaths could have been avoided, sparing that person and their loved one’s suffering. All it would have taken was for someone to have practiced prevention or caught the symptoms early.

If you are at risk for heat related illness you need to be particularly cautious when it comes to prevention and in recognizing symptoms. People who are at most risk are: anyone who works outdoors or in hot environments, infants and young children, people aged 65 or older, people who are ill, those who have chronic health issues, and those who are on medications that can cause dehydration or make them more sensitive to temperature changes, and/or people who are overweight.

The best prevention for heat related illness is to limit exposure to hot weather. That means get into an air-conditioned space as often as you can when its hot outside. When you must be outdoors or in a hot space, drink lots of fluids, even when you are not thirsty. Water is the best beverage when it’s hot. Add in fruit juice or sports drinks every few drinks to replace salt lost to sweating. Avoid alcohol and energy drinks, they can be dehydrating. Wear loose, lightweight, and light-colored clothing and a hat. Avoid being outside during the hottest part of the day: 11am-3pm. Put on sunscreen and re-apply frequently. Sunburn affects your body’s ability to cool itself. Pace yourself during any exertion like running or manual labor. And never leave anyone, especially a child or a pet, in a car.

Heat exhaustion is the least severe and most reversible heat-related illness. Symptoms of heat exhaustion include pale, ashen, or moist skin, muscle cramps, fatigue, weakness, or exhaustion, headache, dizziness, or fainting, nausea or vomiting, and a rapid heart rate. If you are experiencing these symptoms, get to a shaded or air-conditioned area, drink water or other cool, non-alcoholic beverages, apply cool, wet towels to the neck, armpits, and groin (areas where major blood vessels are close to the surface) or better, take a cool shower if possible. Untreated, heat exhaustion can quickly develop into heat stroke, so treating heat exhaustion quickly is very important.

Heat stroke can be fatal and is a medical emergency. Symptoms of heat stroke include a body temperature over 103 degrees, and skin that is flushed, dry, and hot to the touch. Usually sweating has stopped. Rapid breathing, headache, dizziness, confusion, and other signs of altered mental status can occur. Irrational or belligerent behavior can also occur. Seizures and unresponsiveness are late and very serious signs. If you suspect heat stroke, call 911, move to a cool place, remove any unnecessary clo9thing, cool the victim preferably by immersing up to the neck in cool water. If that is not possible, place them in a cool shower, or cover as much of the body as possible with cold, wet towels. Keep cooling until their body temperature is less than 101 degrees. Monitor breathing and pulse, start CPR if needed. If someone is in heat exhaustion, don’t force liquids, don’t apply rubbing alcohol to the skin, and don’t allow them to take pain relievers or salt tablets.

Remember prevention and early intervention is not just about yourself, it’s reminding and watching for symptoms in those you work with and care about as well. Especially in heat stroke, the person affected might not be able to make a good decision about cooling off. Heat related illnesses are not something anyone can “tough out.” They must be treated quickly, and the best way to do that is by helping each other prevent, recognize, and treat heat related illness.