dr krampIt’s summertime again and whether you believe in global warning or not, it’s been hotter than ever.  I am a member of the local chapter of CERT, Community Emergency Response Team.  We just had a review of first aid for heat illness and I thought now would be the perfect time to pass on a seasonal reminder about symptoms of heat illness and what to do about it.

As we all know it’s hot in Florida.  Imagine Florida a hundred years ago without air conditioning.  Not many people lived here because it was hot and miserable for months out of the year.  Air conditioning changed all of that.  It’s a wonderful thing as long as you can stay in it.  The joy of living with warm winters the way we do comes partially at the price of the oppressive heat of summer.

To review what we are all told about prevention, drink plenty of fluids and take breaks when working in the heat.  Wear light colored clothing.  Try to avoid working in the hottest parts of the day if possible.  Diabetics, those taking certain medications, and those with certain neurological or other conditions need to take extra care as they can be more susceptible to the heat.

Commonly, a big deal is made about the difference between heat exhaustion and heat stroke.  People are taught several criteria to diagnose and separate the two based on temperature and symptoms.  This distinction is largely arbitrary and unnecessary.

Let’s look at this a different way.  Getting overheated is not good for you.  The hotter a person gets, the worse the outcome can be.  The short story is that the way that the chemical reactions that keep our bodies going only operate properly in a narrow range of salinity, acidity, and temperature.  Go too far outside of those ranges and the body simply stops working.  Before that happens, things slow down.  We start to see symptoms like muscle fatigue and cramping. Thinking slows down resulting in confusion.

If a person is hot and not sweating or thinking clearly, they are beyond first aid and need to go to the hospital.  These are the defining characteristics of heat stroke.  This usually happens at a temperature somewhere around 103 to 104 F, but it is rare that someone providing first aid happens to have a thermometer on them.

As long as the person is still sweating, that means that dehydration is not too severe and they can sweat and continue to try to cool down.  As long as they are still thinking clearly, they can probably drink fluids.  In these cases, we can attempt first aid.

First aid consists of cooling and rehydrating the victim.  They need to be taken out of the heat into a cooler place.  Water can be applied internally and externally.  Electrolyte solutions and sports drinks can be used, but water is generally best.  Clothing can be removed, ice can be applied to the neck, armpit, and groin.

First aid is meaningless without recognition of the presence of illness.  Elderly neighbors need to be checked on.  People should be careful to not work in the heat alone.  People who work in the heat regularly need to be aware of the signs of heat illness and know how to respond to it.  When we work together and watch out for each other we can make summers in Florida safer.