Health Care and Sunstroke

Summer time is hot, especially in the South and Southwest. And this time of the year can be unseasonably warm in many parts of the country, depending on climate conditions and other weather related issues.

According to Physicians' Desktop Reference (PDRHealth.com), Heatstroke occurs when your body's thermostat cannot keep your body cool. Your body relies on water evaporation to stay cool. As your temperature rises, your body reacts by sweating. When this sweat evaporates, it cools your body. The amount of moisture in the air (humidity) determines how readily sweat evaporates. In very dry air, sweat evaporates easily, quickly cooling your body; but in very humid air, sweat does not evaporate. It may collect on the skin or run off your body without affecting your body's climbing temperature.

Extremely warm and humid temperatures can quickly overwhelm your body's cooling system, according to PDRHealth.com—particularly when the air is not circulating. When sweating can no longer keep you cool, body temperature quickly rises, causing the symptoms of heat-related illness. Sunstroke is a type of heatstroke. Heatstroke is a condition that occurs after exposure to excessive heat. In sunstroke—also called heat illness, heat injury, hyperthermia, heat prostration, and heat collapse—the source of heat is the sun. Other types of heatstroke occur after exposure to heat from different sources. Heatstroke—including sunstroke—is considered to be the most severe of the heat-related illnesses. Heat can have punishing effects on your body. After excessive exercise or physical labor, your body can overheat, and you may suffer heat exhaustion. Heat cramps occur after excessive loss of water and salt; usually resulting from excessive sweating, or after strenuous exercise or labor. During heat exhaustion and heat cramps, the heat-controlling system is still intact, but can be overwhelmed. If this happens, heat exhaustion can progress to heatstroke, a life-threatening medical condition. In severe cases, heatstroke can even cause organ dysfunction, brain damage, and death.

According to About.com, heat stroke is a serious, potentially life-threatening form of heat illness. The body temperature rises to 105° Fahrenheit or higher and you develop neurological changes, such as mental confusion or unconsciousness. At these high temperatures, body proteins and the membranes around the cells in the body, especially in the brain, begin to be destroyed or malfunction. The extreme heat can affect internal organs, causing breakdown of the heart muscle cells and blood vessels, damage to internal organs, and death. There are two main causes of heat stroke:
1.) Exertional heat stroke occurs when someone is vigorously active in a hot environment, such as playing sports on a hot summer day or participating in military training activities. It typically strikes young, otherwise healthy people, those least likely to be concerned about the effects of heat on their health. Because of the lack of concern, early symptoms may be dismissed or ignored.
2.) Nonexertional heat stroke tends to occur in people who have a diminished ability to regulate body temperature, such as older people, very young children or people with chronic illnesses. High heat in the surrounding environment, without vigorous activity, can be enough to cause heat stroke in these people.

Anything that disrupts your body's thermostat can increase the likelihood of sunstroke, according to PDRHealth.com. These may include such factors as underlying medical conditions, medications, physical characteristics, or age. Dehydration contributes to sunstroke. Dehydration happens when your body excretes more water than it takes in. For example, increased water loss through excessive urination is a common side effect of caffeine, alcohol, and many prescription and over-the-counter medications. When the water supply in your body is low, cells begin to pull water from the bloodstream, forcing organs to work harder. Dehydration can also affect the skin's ability to cool the body efficiently. The heart must pump an adequate supply of blood to the skin in order for the skin to cool the body. When you are dehydrated, the blood's volume is reduced, so the cooling process becomes less effective. The taxing effect on the body escalates into the symptoms of heat-related illness.

Prolonged exposure to the sun contributes to sunstroke, as noted by PDRHealth.com. When body fluids are not adequately replenished, sun exposure can cause rapid dehydration. Even on mild or overcast days, the sun can have dangerous health effects. The heat index is a measure calculated by the National Weather Service. It indicates how hot it "feels" outside in the shade when both the air temperature and the relative humidity are considered. In the direct sun, the heat index rises even higher. The following heat indices are associated with these heat-related conditions:
---80°F-90°F: Fatigue possible after prolonged physical activity or sun exposure.
---90°F-105°F: Heat exhaustion, heat cramps, and sunstroke possible after prolonged physical activity or sun exposure.
---105°F-130°F: Heat exhaustion, heat cramps, and sunstroke likely after prolonged physical activity or sun exposure.
---130°F and higher: Sunstroke likely with sustained exposure to the sun.

According to About.com, factors that can contribute to heat stroke include:
--Dehydration from not drinking enough water.
--Wearing bulky or heavy clothing, such as firefighting gear, in the heat.
--Being overweight, which causes the body to generate more heat and reduces the body's ability to cool down.
--Sleep deprivation, which can decrease the rate of sweating.
--Being unaccustomed to the heat, such as moving from a cooler climate to a warmer climate.
--Some medications, most commonly antihistamines (taken for allergies), diuretics (taken for high blood pressure or leg swelling), laxatives (taken to relieve constipation), calcium channel blockers (one type of blood pressure or heart medicine), medicines for Parkinson's disease, some diarrhea treatments and tricyclic antidepressants.
--Being confined to a poorly ventilated or non-air-conditioned living space.
--Having had heat stroke in the past.
--Use of illicit drugs, including cocaine, heroin, amphetamines and ecstasy (MDMA).

Heat stroke can come on suddenly, but warning symptoms often appear first, according to About.com. They include:
--Abdominal cramps
--Muscle cramps
--Nausea
--Vomiting
--Headache
--Dizziness
--Weakness
--Heavy sweat or a lack of sweat
When heat stroke starts, neurological symptoms can include:
--Odd or bizarre behavior
--Irritability
--Delusions
--Hallucinations
--Seizures
--Coma

Most cases of heat stroke can be prevented, according to About.com. When the temperature outside is especially high:
--Drink lots of water throughout the day.
--Stay indoors in an air-conditioned area whenever you feel too warm.
--Wear lightweight, light-colored clothing, preferably with a loose-weave material that lets air get to your skin.
--Avoid strenuous activity in the hottest part of the day (between 10 a.m. and 4 p.m.). If you must participate, take frequent breaks, limit the time that you wear a helmet by taking it off between activities, and avoid wearing heavy uniforms or equipment.
--Drink less caffeine and alcohol, which can contribute to dehydration.
--If you begin to feel tired, dizzy or nauseated, or if you develop a headache, get out of the heat immediately. Seek out an air-conditioned building. Drink water. If possible, take a cool shower or bath or use a hose to soak yourself.

The first step in treating heat stroke is to reduce body temperature by cooling the body from the outside, according to About.com. This can be done by removing tight or unnecessary clothing, spraying the person with water, blowing cool air on the person, or wrapping the person loosely in wet sheets. And alternatively, ice packs can be placed at the neck, groin and armpits to accelerate cooling. If these methods do not lower body temperature enough, a doctor may try to lower temperature from the inside by flushing the stomach or rectum with cold water. Severe cases may require cardiopulmonary bypass, in which the person's blood is diverted from the heart and lungs into a collection machine, cooled, and then returned to the body. In some cases, anti-seizure or muscle-relaxing medications may be given to control convulsions and shivering. Aspirin and acetaminophen (Tylenol) do not help lower body temperature a person has heat stroke, and these medications should be avoided if heat stroke is suspected. People with heat stroke generally need to be hospitalized so they can be tested for complications that may appear after the first day. One common complication is muscle breakdown caused by the heat. In this condition, called rhabdomyolysis, byproducts of the muscle breakdown appear in the bloodstream and can damage the kidneys. Seek emergency help if you or someone else has been in the heat and experiences confusion, faintness, staggering, hallucinations (visions that are not real), unusual agitation or coma. Begin cooling the person immediately. If medical help is sought quickly, heat stroke almost always is treated successfully. Having had heat stroke in the past increases your risk of heat stroke in the future, so you will have to take extra precautions in hot weather. Delaying treatment can have serious consequences, including kidney or liver damage, congestive heart failure or heart arrhythmias, coma or death.

Sunstroke can be very damaging. Make sure that you seek help immediately if you feel like you may be suffering from symptoms. Seek medical attention right away. Follow common sense procedures. Call 911 if there is an emergency situation. Find out how to treat sunstroke before it happens. Watch out for the heat and other factors that cause sunstroke. Be aware of your personal body temperature, especially if you are working outdoors.

Until next time. Let me know what you think.