June 24, 2022 by John Fernandez
Hot Topic: Staying Safe as Temperatures Rise
As summer begins to sizzle, babies and elderly people are most vulnerable to heat-related illnesses. But you might be surprised at who is more likely to end up in the emergency department: athletes who push themselves beyond safe limits.
“Anybody can get heat stroke. It has nothing to do with what a good athlete you are — how fast or how strong,” explains Jose Portuondo, M.D., chief of emergency medicine at Doctors Hospital. “The important thing is really for people to recognize it.”
Throughout the country, the last Friday in May is designated National Heat Awareness Day. “Heat causes more deaths in the United States each year than any other weather phenomena, including hurricanes and floods combined,” Dr Portuondo notes. “I hope that catches people’s attention.”
In South Florida, people are already well aware of the heat, but whether they take steps to protect their health is another matter.
Dr. Portuondo is concerned for the most vulnerable — the very young or old whose bodies may not be able to adapt as efficiently, people with chronic medical conditions such as heart disease or high blood pressure, pregnant women, people who are overweight, and those on certain medications such as antihistamines, antidepressants and beta blockers.
But he also worries about those who have outdoor jobs, young people who play in demanding sports leagues or tournaments, and healthy adults determined to stick to their training schedules.
“I still see plenty of people working out in the middle of the day, which is totally inappropriate for this time of year,” Dr. Portuondo says. “It’s really amazing what some people will do. Some people think that the more they sweat, the more weight they’ll lose — when in fact that has absolutely nothing to do with anything. They put themselves at risk.”
What You Should Know
Your body normally cools itself naturally through sweating, but sometimes it can’t keep up. Heat-related illnesses — including heat cramps, heat exhaustion and heat stroke — occur when a person’s temperature rises to dangerous levels and body fluids are thrown off. In these cases, a person’s temperature can rise faster than the body’s ability to cool itself. This can cause damage to the brain and other vital organs.
Immediate action should be taken when a person shows signs of overheating, Dr. Portuondo says. This includes moving the person to a cooler, shady location or an air conditioned space; providing water to drink; loosening or removing clothing so sweat can evaporate; and cooling them off by fanning and/or misting them with water. “You can have them jump in a swimming pool if there is one accessible, hose them off with a garden hose, have them take a cool shower — any, and all, of those,” Dr. Portuondo advises. The person should be monitored carefully to make sure they improve.
If the person instead gets worse and experiences severe cramps, vomiting, disorientation or loss of consciousness, they may be experiencingheat stroke, which is life-threatening. It’s time to call 911.
“You have an inside-body thermostat in the recesses of your brain, and that can shut down when you reach a certain body temperature. The body realizes, ‘I’m losing fluid,’ and it goes into sweat shutdown. If you stop sweating, your body can’t cool itself and your temperature continues to increase. Any time you reach a temperature of 104, you are approximating heat stroke.”
Playing It Safe
With less severe symptoms like dehydration, heat exhaustion or heat cramps, a trip to the hospital may not be required. Early preventative action should help the person improve within an hour. The key is helping them cool down and take in adequate fluids, Dr. Portuondo says.
If you suspect a person is experiencing heat stroke, seeking prompt medical attention can mean the difference between life and death. Dr. Portuondo recalls the widely publicized case of a football player who collapsed at practice several years ago and was brought to Doctors Hospital. His core temperature of 109 degrees was so high, incredulous emergency personnel rechecked it three times. Quick action helped save his life, although he spent 12 days in a coma and took many months to recover.
“Water is fine — it doesn’t have to be salty or anything, it doesn’t have to have supplements, you don’t have to buy it at a grocery store. You can just give them water, and the vast majority of them will get better,” he says.
Even when the person starts to feel better, however, they should not resume what they were doing. After a heat-related incident, a person should take time to recover.
“It will probably take a minimum of 12 hours, or preferably until the next day, for people to normalize once they reach this problem,” Dr. Portuondo says. “I would recommend that they cease activities and stay in a comfortably cool place for the rest of the afternoon or evening.”
Prevention is Best
While responding quickly is important, avoiding the problem is even wiser.
“Here, unfortunately it’s very hot, but also very humid — and that raises the heat index. If the heat index is over 91, you need to be aware and careful of that,” Dr. Portuondo cautions. “In Miami you can assume that by early June it is going to be 90 or above, and that will probably last through September.”
Protect yourself by following these tips:
• Drink water. Replenish your fluids before you feel thirsty. Staying hydrated helps manage your body’s temperature. Carry water with you.
• Dress for the heat. Wear a hat and loose-fitting, lightweight clothing made of breathable fabric like cotton. Choose light colors, which reflect some of the sun’s energy.
• Slow down. If you must do strenuous activity, do it during the coolest part of the day, which is usually before 7 a.m.
• Take frequent breaks. Find a shady spot to cool down. Stop activity if there are signs of a heat-related illness.
• Be aware. Monitor weather reports so you can make wise decisions. And remember, it’s not just the heat, it the humidity.
• Wear Sunscreen. Sunburn affects the body’s ability to cool down and can make you dehydrated. (By the way, National Sunscreen Day also takes place on May 27 as a reminder of the importance of protecting your skin from the sun’s harmful rays.)
• Never leave a child in a car. Make a habit of double checking your backseat when exiting your car. If you have a toddler, lock your car in your own driveway. Kids may wander outside get trapped inside. A reported 23 children died in hot cars in 2021.