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Every year there are headlines about teens and young adults in the USA dying while exercising in summer heat. With global warming, deaths from heat stroke are even more common in places that historically do not have extremely hot summers.

Essential Information for Avoiding Heatstroke

While people who live in dependably hot summer climates like Arizona, Texas, and Saudi Arabia build up resistance to heat, people who try to maintain their outdoor exercise routines during unusually hot heat spells are at special risk of heat stroke.

What Is Heatstroke?

Heat-related illnesses exhibit a continuum of symptoms ranging from prickly heat, which is the irritation of the skin caused by heat, to heatstroke, in which body temperatures in excess of 106° F (42° C) literally coagulate the proteins of the brain. Warning signs that heatstroke may be on the way include twitchy muscles (tetany), loss of consciousness (syncope), and extreme fatigue.

Exertional heatstroke is most common in teens and young adults. This form of heatstroke occurs during heavy exercise outdoors in extreme heat. Exertional heatstroke is most likely to occur in areas that get regular hot weather, when young athletes underestimate their need for fluids.

Classic non-exertional heatstroke is most common in infants and the elderly. This form of the heatstroke is unrelated to exercise. It occurs when perspiration simply cannot keep up with the need to cool the body. This can occur in babies because they do not have enough skin surface area to cool themselves. It can occur in the elderly because their peripheral nervous systems have been damaged and no longer trigger a sweating response, or because they take medications that prevent sweating. Non-exertional heatstroke usually occurs during heatwaves that bring unusual heat and humidity.

How Common Is Heatstroke?

In the United States, heatstroke is rare except among athletes in the hot summer states. In other parts of the country, however, on average 334 people a year die of heatstroke, less than half of them elderly persons suffering non-exertional heatstroke. In Russia in 2010, over 40,000 people died of heatstroke during their highest ever recorded summer temperatures.

In the United States, heatstroke is the second leading killer of teenaged athletes, most commonly teens who had recently arrived at hot-summer location from a cool-summer location. Untreated, 80% of cases of heatstroke result in death.

What Can You Do About Heatstroke?

The most important thing teammates and observers can do when they see someone showing signs of heat exhaustion or heatstroke is to treat symptoms as if they were heatstroke. Heatstroke usually involves a body temperature of over 105° F (41° C) and anhidrosis, the inability to sweat, but brain damage can occur at lower temperatures and even when there is some ability to sweat. Muscle cramps, abdominal cramps, shortness of breath, dizziness, weakness, and "brain fog" may indicate heat exhaustion or they may indicate heatstroke. To be on the safe side, treat them as if they were heatstroke.

Survival from heatstroke depends on getting the victim to medical treatment during the first hour. Place the heatstroke victim or potential heatstroke victim in a position that keeps airways open. Remove restrictive clothing and apply cool cloths. Do not attempt to pack the victim in ice—it's possible to overshoot the desired body temperature and cause hypothermia. Getting medical treatment as quickly as possible saves lives. But there are also measures you can take to avoid heatstroke and heat exhaustion from ever setting in.

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