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Avoiding Heat Stroke, Exhaustion

July 25, 2006

By Peggy and Terry McDannold, The Cincinnati Post

Whatcha doin`?"

It`s the usual question when Peg is on the phone with one of her golfing buddies. Peg answered: "Sitting at the computer trying to come up with a good topic for this week`s column."

"Have you written about the heat?" It did seem like the obvious topic since everyone is talking about it. You hear it at church, the grocery, work and especially at the golf course. "Is it hot enough for you?"

It is definitely hot enough to be a health risk and it is important to know how to protect yourself from heat illness.

Heat illness is divided into two major categories: heat exhaustion and heat stroke. Both illnesses arise when the body is unable to dissipate heat generated on its own and gained from the environment. When the regulatory system is moderately impaired, heat exhaustion occurs. If this is not corrected promptly and the system shuts down, the patient will go on to develop heat stroke.

The two most important ways the body transfers heat away are by radiation of heat and evaporation of perspiration. If there is a temperature difference between the body and the air, then a large percentage of heat is dissipated through radiation.

When the air temperature exceeds 95 degrees, the body can no longer lose heat in this way. Evaporation then becomes the only means of heat loss. But when the humidity reaches 100 percent, evaporation of sweat is no longer possible and the body loses its ability to dissipate heat.

As the body tries to correct the rising temperature and cool itself, it shunts more blood to the skin and away from vital organs, causing a kind of shock -- heat exhaustion. If not recognized and treated, this will progress to heat stroke in which the temperature can rise so high that brain damage and even death can occur.

Signals of heat exhaustion include cool, moist, pale, flushed or even red skin; heavy sweating; headache; nausea or vomiting; dizziness. Body temperature will be near normal.

Heat stroke is characterized by hot, red and dry skin (but cessation of sweating can be a very late sign); changes in consciousness; rapid, weak pulse; and rapid, shallow breathing. Body temperature can be as high as 107 F.

In one of these emergencies, act quickly. Call 911. Get the person to a cooler place if possible, loosen tight clothing, apply cool, wet cloths and fan the victim. Ice packs can be applied to the neck, armpits and groin areas. Airway, breathing and circulation may need to be supported with basic CPR measures. Your quick response may prevent irreversible damage or even save a life.

All heat-related illnesses are preventable. Wear lightweight, light-colored clothing. Hats or umbrellas can be used to protect from direct sunlight. Drink water even if not thirsty. Avoid alcohol and caffeine. Eat small meals. Slow down. If you must engage in strenuous activity, do it during the cooler part of the day (usually early morning). Check on the elderly and those without air conditioning. Never lock children in the car and always lock your car when not in use.

There is a difference of opinion in our household regarding the heat. Terry loves hot, humid nights sitting on the deck, enjoying a warm summer breeze. Peg enjoys hot days but would prefer a cool evening breeze so she can open up the windows. And Moses, our big golden retriever, can`t wait for the first frost!

Peggy and Terry McDannold, who live on a farm in Campbell County, are doctors as well as husband and wife. Both practice internal medicine in Northern Kentucky.

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