Dealing With Heat Stroke by Sonny Ng
In this issue of the Footloose I would like to share with members, besides those who are already in the medical profession and related fields, 2 articles extracted from the Internet on the prevention and treatment of Heatstroke.
What is heat stroke?
Heat stroke is the most severe form of heat illness and is a life-threatening
emergency. It is the result of long, extreme exposure to the sun, in which
a person does not sweat enough to lower body temperature. The elderly, infants,
persons who work outdoors and those on certain types of medications are most
susceptible to heat stroke. It is a condition that develops rapidly and requires
immediate medical treatment.
What causes heat stroke?
Our bodies produce a tremendous amount of internal heat and we normally cool
ourselves by sweating and radiating heat through the skin. However, in certain
circumstances, such as extreme heat, high humidity or vigorous activity in
the hot sun, this cooling system may begin to fail, allowing heat to build
up to dangerous levels. If a person becomes dehydrated
and cannot sweat enough to cool their body, their internal temperature may
rise to dangerously high levels, causing heat stroke.
What are the symptoms of heat
stroke?
The following are the most common symptoms of heat stroke, although each individual
may experience symptoms differently. Symptoms may include:
How is heat stroke treated?
It is important for the person to be treated immediately as heat stroke can
cause permanent damage or death. There are some immediate first aid measures
you can take while waiting for help to arrive.
Intravenous fluids are often necessary to compensate for fluid or electrolyte loss. Bed rest is generally advised and body temperature may fluctuate abnormally for weeks after heat stroke.
How can heat stroke be
prevented?
There are precautions that can help protect you against the adverse effects
of heat stroke. These include:
A person suffering from heat exhaustion will usually be sweating profusely in an attempt to lose excess heat. Someone with heat stroke has stopped sweating, due to a failure in his or her heat control system.
High core temperatures damage the internal organs, especially the brain. The fluid loss can also produce dangerously low blood pressure. Most people who are killed by heat stroke die when their blood stops pumping effectively (circulatory failure). Even people who survive are likely to have permanent brain damage if their core temperature has been over 105°F (40.6°C) for more than an hour or two.
Making the Diagnosis
Heat stroke is unlikely to happen in a doctor's office. You must learn to
recognise the symptoms and take the appropriate action yourself.The heat
stroke victim needs to see a doctor as soon as possible, but the first step
is to get the core temperature under control.
Treatment and Prevention
Everything must be done to cool the heat stroke victim immediately.
The best solution is to immerse the body in cold water, such as a river, stream,
or bathtub. Otherwise, remove most of their clothes, douse them with water,
and fan them vigorously. Wrapping in wet sheets can help increase the rate
of heat loss.
If the victim starts shivering, slow down the cooling treatment, because shivering raises core temperature. Take the person's temperature every 10 minutes if you have a thermometer handy. You should not let the core temperature fall below 100°F (38°C), as this can result in an uncontrollable slide towards dangerously low temperatures (hypothermia). All the while you should be making arrangements to get the victim to an emergency room. Watch for signs of respiratory arrest (breathing failure) and be ready to give mouth-to-mouth rescue resuscitation.
The heat exhaustion victim should also be put in a cool place. Lay them down and give small gulps of liquid every few minutes. "Sports" drinks are best. You should watch carefully for signs of deterioration, but there's no need to rush to a hospital for a normal case of heat exhaustion.
The way to prevent these problems is to drink very large amounts of liquid during heat waves, especially if you're planning on working or exercising outdoors. You shouldn't take salt tablets unless you're also drinking a lot of water. Drink every hour whether you feel like it or not. Thirst is a poor indicator of dehydration. Other prevention strategies include:
What prompted me to share the above articles with you was a turn of events in the Malakoff Duathlon held on Sunday the 18th May, 2003 in Putrajaya. On that Sunday during breakfast with the President after our run, he mentioned that we should go to cheer for Jimmy and also our members who were taking part in the competition. On my journey to Putrajaya I had received a call from a member to say that our Pacesetters member L (name withheld) had fainted and his companion who had sent him to Putrajaya had gone home for an important errant. Upon arrival I had met the caller and also the President in the Paramedic Tent. Runner L was sitting on the stretcher and was talking loudly and behaving strangely. I was sure he was in a state of confusion and disoriented at that time (symptoms of heat stroke). I approached him and immediately asked for a wet tower. There were 2 uniformed personnel paramedic around when I arrived but not one of them was fanning him or assisting him in some way. I started to use the wet tower to sponge him on his forehead, neck area, arms and limbs and at the same time spoke some reassuring words to comfort him. After a while he started to calm down a bit and laid down on the stretcher. I felt his forehead and realized that he was running a temperature. I immediately requested for ice cubes. I wrapped the ice cubes inside the wet tower and began to cool his forehead and limbs. His companion came back. Not long after an ambulance came and the President, his companion and I accompanied him to the Putrajaya Hospital. On our journey I continued to apply the ice pack on him. After a while he called my name and his companion’s name. I was happy that he had come back to his senses. He was warded for “drips” and observation. Later in the afternoon he was discharged and allowed to go home.
Sonny Ng