Heat illness for the weekend warrior

The Upstate of South Carolina and the surrounding areas are full of unlimited outdoor activities for athletes of all varieties. During the summer, the heat can be intense, but this should not stop you from enjoying your favorite pastimes. As long as you are well prepared and know the signs of heat illness, you can enjoy the summer weather safely.

Heat illness is a spectrum of illnesses, from “nothing to worry about” to potentially life-threatening pathology. The most benign of these is heat edema, which is typically limited to swelling of the hands and feet. Elevation and rest should resolve these symptoms. Heat “cramps” may develop, most commonly presenting as muscle cramping of the legs. Hydration, rest and salt replacement should help improve these symptoms.

Heat exhaustion and heat stroke

A more serious illness, heat exhaustion, is a combination of exertional heat illness, dehydration and sodium depletion. Signs of heat exhaustion include profuse sweating, skin flushing, nausea, vomiting, fast heart rate or even “goose bumps”.  If any of these symptoms develop, you must cool yourself in a shaded area immediately until these symptoms resolve or until help arrives. If possible, use a fan or air conditioning, place ice packs on your skin, or take a cold shower or bath to cool yourself off.

Exertional heat stroke is the most severe form of heat illness. The body’s core temperature may reach 108 F. The body is no longer able to regulate its temperature, which leads to organ failure if not brought back to a normal temperature very quickly. The person may stop sweating and will have hot, dry skin.  He or she may become confused, disoriented, uncoordinated or unable to walk in a straight line. The individual may develop seizures or progress into a coma. This is a true medical emergency, and the person must be cooled immediately to prevent long term complications or death. Call for help and do your best to cool the patient until help arrives.

Multiple factors contribute to developing heat illness. The first is obviously the temperature outside; however, you must also consider radiant heat from the sun and humidity. There are also non-weather factors that may place an individual at a higher risk to develop heat illness including age (young children and older adults are more susceptible), uncontrolled diabetes, obesity, acute illness and sunburn. Multiple medications and substances also may put you at higher risk, including alcohol, stimulants, beta-blockers, antihistamines and diuretics.

Preventing heat illness

What can you do to prevent heat illness in yourself and your family members? Pick more shaded activities or pick a time when the sun is not at its strongest. Wear lightweight, loose-fitting, moisture-wicking clothes. Do not forget sunscreen on exposed areas to prevent sunburn. Pack lots of water and if you are planning prolonged activities, take electrolyte/sodium rich fluids with you. Remember, some individuals may lose up to three liters of fluid an hour in the heat! If you begin to worry you are too hot, sit down in a shaded area and take a break. Do not forget that children, the elderly and even your pets are more prone to heat illness. Stay safe, enjoy the Upstate, and keep moving!

Dr. Stephanie Bailey is an orthopedist with Prisma Health. She sees patients in Greenville at Steadman Hawkins Clinic of the Carolinas and in Laurens at Laurens Family Medicine.

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