The Village Doctor, Benjamin G. Newman, MD 207-963-2001

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Heat Exhaustion and Heat Stroke

by Benjamin G. Newman, MD

Publish date: Fri, Jun 1st, 2012

Even during the summertime in Maine, we all need to be concerned about heat exhaustion and heat stroke. Having seen the ravishes of these conditions in the middle east during my military career, I can assure you that these conditions can bring even in the strongest person to their knees.

What is the difference between heat exhaustion and heat stroke? While these problems are similar, they are not the same. Heat exhaustion is the overheating of the body because a large amount of water has been lost. In some cases, heat exhaustion is due to salt depletion. Heat stroke is a form of hyperthermia, with an abnormally elevated body temperature with accompanying physical and neurological symptoms. In the simplest terms, if heat exhaustion is not recognized and treated properly, it could lead into heat stroke. Heat stroke can be fatal and is a medical emergency.

Symptoms of Heat Exhaustion

  • Thirst
  • Vague discomfort
  • Economy of movement
  • Decreased appetite
  • Flushed skin
  • Impatience
  • Sleepiness
  • Tingling
  • Apathy
  • Nausea
  • Sweating profusely

Symptoms of Heat Stroke

  • Indistinct speech
  • Shortness of breath
  • Flushed face
  • Delirium
  • Dim vision
  • No urination
  • Seizures
  • Death

Heat Stroke Treatment

  • Call 911 immediately
  • Get the victim to a shady area
  • Apply cool or tepid water to the skin (you may spray the victim with cool water from a garden hose)
  • Fan the victim to promote sweating and evaporation
  • Place ice packs underneath the armpits and groin
  • Monitor body temperature with a thermometer and continue cooling efforts until the body temperature drops to 101 to 102
  • Do not offer anything by mouth to the patient if they are unconscious or stuporous

Heat Exhaustion and Heat Stroke Prevention

It is important to remember that when you first become thirsty you are already two percent dehydrated. At four percent dehydration you are basically not capable of performing any work. In a high heat environment one should drink eight ounces of water every hour. Your urine should be the guide as to how hydrated you are. If your urine is very dark, you are dehydrated. Sports drinks are not recommended because they usually contain five percent glucose (sugar), which inhibit water from going into the intestines where it is absorbed. Sodium and potassium are two minerals that are very important to consume while you are increasing your fluids. By far, the best way to obtain these minerals is by food and not by sports drinks. Salty foods during this period of time are recommended and potassium can be obtained from fruits, fruit juices and vegetables. Celery is a good source of potassium.

Do not ignore even the subtle changes that occur when one is heat exhausted as it can rapidly advance into a heat stroke situation. Remember – plain water provides the fluids and food provides the salt and potassium you need.