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Keep a Cool Head on Hot, Humid Days to Avoid Heat Stroke

Keeping cool on hot, humid summer days is good advice for more reasons than sheer comfort. It's vital for good health - even staying alive. That's the message from the Pennsylvania Medical Society, warning young and old alike that heat stroke is a deadly illness to be avoided at all costs - even if it means sacrificing a day at the beach.

"Heat stroke is not an accident," says Marilyn J. Heine, M.D., an emergency physician in Bucks County and a member of the Pennsylvania Medical Society. "Over the summer, we see too many cases of heat-related illness in the emergency room, but it's a condition that generally can be prevented with a little effort and lots of common sense."

Still, it happens all too frequently. There have been several highly publicized reports of athletes dying from heat stroke in recent years, most notably Minnesota Viking Korey Stringer, who died August 1, 2001, after developing multi-organ system failure. Players at the high school and college level fell victim in recent years too.

However, you don't need to be an athlete to be felled by heat stroke. Dr. Heine recalls a 78-year-old woman who was transported by ambulance to the emergency department after a neighbor noticed she hadn't been out of her apartment for two days. During that time, the temperature surpassed 90 degrees Fahrenheit and the humidity was stifling. The woman was dehydrated, with a temperature of 104.7 degrees and a decreased blood pressure of 100/70. Fortunately, she was resuscitated with intravenous fluids and then hospitalized.

The Pennsylvania Medical Society believes you're more likely to avoid this scenario and win the battle against the heat when armed with a little knowledge.

Heat stroke is an injury to internal organs caused by an excessively high body temperature. It can damage the central nervous system, including the brain, spinal cord, and other organs. Sometimes, as in Stringer's case, the outcome is death.

There are two types of heat stroke, and everyone is susceptible, athletes and couch potatoes alike. Classic or non-exercise-induced heat stroke affects those exposed to extremely hot environments for an intolerable length of time. Dr. Heine explains, "Most at risk are elderly persons and infants, those with chronic illness like cardiovascular disease, and people on certain medications. Individuals who drink large amounts of caffeine and alcohol during this time also are more susceptible."

Exertional or activity-induced heat stroke, on the other hand, "primarily affects athletes, laborers, and soldiers - persons who overdo physical activity in very hot temperatures," according to Dr. Heine. Football players - who wear body-covering uniforms and practice in the hottest temperatures - are especially prone to dehydration and heat stroke.

So, how can you predict when the heat is most likely to take its toll? Relative humidity of at least 70 percent and temperatures of 95 degrees Fahrenheit or 35 degrees Celsius are your first warning signs. Also, be alert to other heat-related afflictions such as heat cramps - characterized by muscle spasms and a normal temperature; and heat exhaustion - evidenced by pale, moist skin; headache; dizziness; nausea; increased heart rate; low blood pressure; elevated temperature; and profuse sweating. Any of these can be precursors to a full-blown case of heat stroke.

"If you exhibit any of these symptoms," Dr. Heine advises, "get out of the heat, rest, and drink plenty of cool fluids, preferably containing sugar and salt."

Heat stroke's symptoms, similar to those mentioned above but even more severe, initially include profuse sweating; then hot, dry, red skin; high fever; vomiting; confusion; seizures during cooling; and unconsciousness. The blood pressure may be low or high, and lack of sweating is common, though athletes may perspire. The body temperature ofte n will be 105 degrees or higher.

The Pennsylvania Medical Society advises immediate treatment if any of these symptoms are present. "After calling 911," Dr. Heine says, "move the victim to a cooler location, remove heavy clothing, fan the body and wet it down with a cool sponge or cloth, and encourage the individual to drink cool fluids." At the hospital, the patient probably will be given fluids intravenously.

The key to beating the heat, of course, is prevention. Dr. Heine offers the following tips for keeping cool and healthy despite the sweltering sun and humidity.

Don't overexert yourself. Drink a quart of fluids an hour. Wear loose clothing light in color and fabric, as well as a hat and sunblock, and stay in the shade or indoors if possible. Open windows and use fans, or turn on air conditioning. If you don't have air conditioning, go to a public place that does, like a mall, library, or movie theater. Avoid caffeine and alcohol, which can speed up dehydration. Finally, be a good neighbor - check on elderly and chronically ill persons regularly to make sure they're bearing up under the heat.


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