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Thursday, June 9, 2016

Heat Injuries

With a little over a week until the official beginning of summer, the temperatures are rising for most of us. Here in the upper Midwest we're looking at highs near 100° F for the next week; the poor souls in AZ are at 105° F and above. Humans are adaptable, though, and given a couple of weeks in a hot climate we become acclimated to the heat. That's the only excuse I can think of, other than insanity, for living in areas where temps spike over 120° F. 

If you're like me and work outside most of the time, you already know the tricks to staying out of the hospital, but many folks don't experience summer heat for much longer than it takes for the AC in the car to start working. In the event that TSHTF, that AC isn't likely to be available, so you should know the basics of heat injuries and how to prevent them.

Causation
Heat injuries are mainly caused by a combination of high ambient temperature and high relative humidity. Up to a certain temperature, low humidity will let your body's natural cooling mechanisms keep your core temperature in a normal range, but once humidity prevents sweat from evaporating, or the temperature climbs to a point where you can't produce enough sweat to keep up, your body temperature will start to go up from the (roughly) 98.6° F that is normal. Once your body temperature gets above 104°F, brain cells start to cook and other organs are damaged. Alcohol use, as well as several drugs and diseases that cause fluid loss, can make a person more susceptible to heat injury. 

Types of Heat Injury and their Treatment

Heat Cramps
Also known as dehydration, its main symptoms are;
  • Painful muscle cramps and spasms from loss of salts through sweating
  • Profuse sweating
  • Hot, red, damp skin
Treatment for heat cramps involve replacing lost electrolytes (salts), cooling the body by removing tight clothes and applying wet cloths to the skin. Get into shade and rest, stretching out the cramped muscles slowly.

Heat Exhaustion
Heat exhaustion is more serious and needs to be treated as soon as possible. Symptoms include:
  • Headache
  • Confusion
  • Pale, damp skin
  • Cramps
  • Body temperature over 100°F
  • Nausea, vomiting, diarrhea
Treatment is the same as for heat cramps with the addition of intravenous (IV) fluids if unable to take water by mouth. A trip to the ER may be in order if symptoms don't go away in a few hours.

Heat Stroke
Heat stroke can kill. It is a result of the body's cooling mechanisms being completely overwhelmed and shutting down. Once you stop sweating, you only have minutes to get things back under control before permanent damage starts. It is usually identified by:
  • Hot, dry, skin. The body can no longer produce sweat.
  • Loss of appetite
  • Rapid heart rate
  • Seizure or coma possible
  • Mental confusion
  • Body temperature over 104° F
Treatment:
  • Get the victim into shade.
  • Remove all clothing, place the victim in cool (not cold) water or pour cool water over them if available.
  • Place ice packs in armpits and groin (high concentrations of blood vessels close to the skin), and seek medical aid if available.
  • Don't try to get an unconscious person to drink, they'll just choke on it. If they're awake and alert, get water and replacement salts into them at a slow rate.

Prevention
It is easier to avoid heat injury than it is to treat it.
  • Take it easy the first two weeks of hot weather. Adults take about that long to get acclimated; children and teens take a bit longer. Older folks and infants may not acclimate at all, since their heat regulating systems are not working properly.
  • Take frequent breaks. Drink small quantities of water or your favorite uncaffeinated sport drink  often, rather than chugging large quantities and hoping it will last (it will just fill your bladder instead).
  • Plan activities for the cooler parts of the day. Evenings and mornings are the best time to get things done that require physical activity, while the afternoons are a good time to find shade and rest. The “siesta” is not a sign of laziness; it is a viable way to work around oppressive heat when air conditioning isn't available.
  • Wear light-colored clothes, preferably made of a fabric that will wick away sweat. Poly-anything is a poor choice during the summer, since it doesn't absorb much sweat and doesn't “breathe” very well. Looser knits, natural fibers, light colors will make you more comfortable.
  • Use a water mister or place damp cloths around your neck and wrists (both good places to remove excess body heat). Getting wet will cool you off.
  • The average American diet has more than enough salt in it to replenish what you'll lose through sweating, but changes in diet can remove some of that excess salt and make you more prone to heat injury. Watch for cramps; they are normally the first sign that your body is lacking sodium and/or potassium.

After-effects
Having both treated and been treated for heat exhaustion, I can tell you that it is not fun. It tends to wipe out all of your energy for at least a few days, leaving you unable to do much more than get to the bathroom and the dinner table. 

I've seen heat stroke a couple of times, but we were able to send them to a hospital where they got proper treatment. Once or twice I've caught myself working in the heat and noticed that I'd stopped sweating, and that's my cue to tell the boss I'm going to go sit down for a while. No job is worth my life, and heat stroke isn't something to toy with; it's one injury is high on my list to avoid suffering in a SHTF situation.

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