Avoiding heat exhaustion and heat stroke


ST. LOUIS – The dog days of summer are not only uncomfortable, they can be downright dangerous.

“Heat exhaustion is when we feel hot. When we begin the process of being overheated. When our internal cooling system begins to get taxed,” said Rachel Tarr, a physician assistant with SSM Health Medical Group. “In general, people are able to stand, they’re able to talk, they’re still able to be mobile, they just don’t feel good.”

This can progress into heat stroke.

“People at that point can become confused. There can be a loss of consciousness. There can be vomiting where there’s an excessive loss of fluids,” Tarr said. “When those types of things happen, there’s a small window of time, about 30 minutes, before some tissue damage can start to set in if someone is unconscious.”

Quickly becoming a medical emergency.

“They’re dizzy and they’re strong bounding pulse. And their skin is either wet from sweating or it’s dry, which is more dangerous. So if anybody would come across someone that has real red skin and they’re dry, that’s a problem and that’s the time to call 911,” said Deputy Chief Nick Harper, Monarch Fire Protection District.

It’s not just heat; humidity is a big factor.

“Sweating, the goal of that is to take heat away from the body, so as it evaporates off the skin into the air. But if the air is saturated with fluid, that water on the skin is not going to go anywhere. So then it’s not doing its job of cooling the body as it evaporates,” Tarr said.

First responders get busy when St. Louis heats up.

“When we get a heat index of 105, it’s full-blown. We expect the calls. We put ice buckets in the back of the ambulance with towels and prepare,” said Harper.

And the usual culprit is lack of preparation.

“They haven’t been drinking water, they don’t have their hat on. They get out there and they start working and they start working hard,” Harper said. “Construction workers and the older folks that are doing yard work on the weekends. We do see athletes. We have several city and state parks around and they’re out there working out in the heat.”

Heat doesn’t mean you can’t work or exercise outside, but you need to be smart about it.

“People can acclimate after the process of all of us getting used to the temperatures. The beginning of a warm season or beginning of a new training cycle for certain types of athletes. There can be more danger periods because people are not acclimated. The body is not as good at cooling itself,” Tarr said. “You go out in the middle of the afternoon you might be in trouble.”

Wear light colored clothing, a hat, and Dri-Fit-style clothing.

“What those do is they wick away moisture. Think of it as little straws pulling all that excess moisture right off of our skin. It helps that process of the heat leaving the body,” said Tarr.

Most importantly — hydrate.

“The recommendations are to take in a cup of water, which is about 8 ounces every 15 minutes,” Tarr said. “A lot of people feel like this is too intimidating or might limit their athletic performance. But if you think of a Dixie cup is only 3 ounces and take that every 5 to 10 minutes, that’s very doable.”

And electrolytes. We often underestimate how much salt comes out in our perspiration.

“It’s how the whole engine works in all of our parts. Our muscles, our brain, our heart. And if that becomes imbalanced, those things don’t work right,” said Tarr.

When is it time to call 911?

“If they’re not thinking correctly. If they can’t talk correctly. If have short-term memory loss. ‘Hey, Uncle Joe, how are you doing? Where are you? What’s going on?’ Or they don’t know where they are or they don’t recognize you, that’s a problem,” said Harper. “They’re weak and they can’t function. Lose dexterity. Sometimes they faint. That’s the time to call.”

And while you wait for help get them out of the sun and into the shade. If they’re on the sidewalk or concrete get them onto the cooler grass.

“Cool first, transport second. So while you’re waiting, begin the cooling process. Try to get them to swallow fluids if they can,” said Tarr.

Before spending time in the heat, it’s necessary to prepare.

“That’s the most important. Drink plenty of water. If you know you’re going to be cutting the grass in the afternoon. Drink water all morning,” said Harper. “Take it easy. Take breaks when you’re out there if you’re going to be out there for a long time.”

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