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Heat exhaustion and heatstroke are not small public health problems. Every year just in the United States, the Centers for Disease Control estimate, between 1,000 and 10,000 people die of heatstroke, heat exhaustion, and other heat-related illnesses, and between 100,000 and 1,000,000 people are admitted to emergency rooms or hospitals.
Even in the USA, once heat strokes in, 80% of people die without prompt medical treatment. Outside the United States, even more people die annually from heat, especially during heat waves in Central Asia, Pakistan, Bangladesh, and India.
That's why beating the heat isn't just a matter of comfort, it can be a matter of basic survival. Here are seven things everyone needs to know about surviving a summer heat wave, starting with basic information that can save a life.
1. Exertional heatstroke, the kind of heatstroke that active people experience, can start with subtle symptoms.
Exertional heatstroke is severe heat exhaustion that occurs after strenuous physical activity, although what is strenuous for one person may not be strenuous for another. Exertional heatstroke most often occurs in healthy, active, young individuals, and people who suffer exertional heatstroke retain their ability to sweat. Predisposing factors for exertional heatstroke include a recent viral illness, use of cocaine or methamphetamines, obesity, recent arrival to a heat (although acclimated individuals may also experience heatstroke), lack of sleep, fatigue, and dehydration.
The symptoms that heatstroke is on its way include headache, shortness of breath, nausea, vomiting, diarrhea, dizziness, and loss of consciousness, all of which may occur before the actual heatstroke, when core body temperature soars to 41 degrees Celsius (105 degrees Fahrenheit) or higher and there is intense sweating as well as loss of sensation or hallucination. Exertional heatstroke calls for medical attention.
2. Nonexertional heatstroke, the kind of heatstroke that occurs in inactive people who are unable to control their environment or their water intake, is usually marked by absence of sweat.
Nonexertional heatstroke is most common in babies, in the elderly, and in people who are confined to bed. This kind of heatstroke is characterized by anhidrosis, a failure to perspire, along with core body temperatures exceeding 41 degrees Celsius (105 degrees Fahrenheit) and a variety of psychological symptoms, such as hallucinations, delusions, and loss of sensation. People experiencing nonexertional heatstroke may not be aware that they are hot.
This kind of heatstroke can occur in people who have heart disease, in people who take psychiatric drugs or drugs for overactive bladder that interfere with the ability to perspire, and in people who have brain injuries, as well as other at-risk groups. Early treatment, taking the victim of nonexertional heatstroke to the ER by ambulance, is essential for survival.
Core temperature, by the way, refers to the temperature of the body's internal organs. The most accurate way to determine core temperature is with a rectal thermometer. But it is always more important to get a person who may be suffering heatstroke cooled off than it is to take their temperature, preferably during the "golden hour," the first hour after symptoms set in, when internal organs can be saved.