Good morning NIDPC Family,
With the first day of official Summer behind us, I am going to discuss Heat Injuries. This is a topic near a dear to Dr. Silakoski and myself because of our military training. It is one that the military constantly monitors and stays on top of because it will impact our effective force. However, it can be equally dangerous in just our own daily lives.
If it actually gets warm here or we escape the confused season locally and head to warmer climates, there are situations that can get us into trouble with regulation. Knowing the signs can literally save you or your family member’s life.
Our bodies are absolutely amazing in their ability to adapt to weather, however, in Idaho our bodies have adapted to cooler temperatures. When we explore elevated temperatures, it will take several weeks for our bodies to compensate for the new climates.
What increases our risk for heat injury?
With this in mind, we can get into a spot where our body cannot keep up with the demand we put on it. Risk factors for a heat injury include:
- Prior heat injuries
- Certain medications (diuretics, beta blockers, antihistamines, ADHD meds, ect)
- Inadequate climatization
- High humidity
- Prolonged exposure (sauna)
Types of Heat Injuries
Heat Injuries are broken into 3 categories:
- Heat Stress – Core temp stable – <38 C or 100.4 F but with decreased exercise tolerance
- Often times this will be associated with weakness, fatigue and flushing
- Sweating is still present
- Move to a cooler environment
- Provide Oral Rehydration Solution (https://northidahodpc.com/2022/06/08/oral-rehydration-therapy/)
- Excellent – most people will recover without issue
- Heat Exhaustion – Core temp elevated >38 C or 100.4 F with systemic symptoms
- Fatigue, attitude change, nausea, vomiting, dizziness, palpitations, muscle cramps, excessive sweating and thirst
- Cease exercise
- Remove excess clothing
- Move to shaded environment
- Start passive cooling with misting of luke warm water on exposed skin
- Lay the patient flat with elevated legs
- Encourage oral fluids with oral rehydation solution
- Obtain vitals (be alert for a heart rate >90 or blood pressure <100/60)
- Persistent symptoms or signs >20 minutes should prompt emergency department care
- Good – most people with prompt care will recover, however, these people are on the precipice of heat stroke.
- Heat Stroke – EMERGENCY – Core temp elevated >40 C or 104 F with altered level of consciousness
- Symptoms: severe confusion to coma, slurring of speech, inability to walk, hallucinations, and seizures. The skin is often DRY and flushed.
- Get out of the environment
- Rapid cooling with submersion or sheets soaked in ice
- Call 911 – this is life or death
- Fair to Poor – mortality is <10% if treated promptly
Enjoy the weather out there, but remember to stay hydrated and keep your cool (pun intended). If at anytime you would like to discuss anything with us, do not hesitate to reach out to Dr. Silakoski or myself.
M. Ryan Odom, MD
North Idaho DPC