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In the News

Heat Injuries

By Jock Simon, M.D., Attending Physician at 75th St. & 126th St. Medical, Ocean Pines Medical & Doctors Weight Control & Wellness centers, Ocean City, MD.

Each summer, excessive heat waves not uncommonly result in many people suffering from heat exhaustion and heat stroke. No one is immune to heat-induced injuries, not even the most finely conditioned athelete. Heat exhaustion is caused by water depletion, a condition that occurs when excessive loss of body fluid results in a rise in body temperature. The first symptom is likely to be increased thrist, followed by loss of appetite, headache, dizziness, rapid heartrate, pallor, and a general flu-like feeling that may include nausea and even vomiting.

Heat stroke is a major malfunction of the body's thermoregulatory mechanism; the internal temperature of the body characteristically rises precariously high. Symptoms of heat stroke can be similar to those of heat exhaustion. In addition, the person affected may become very disoriented and even agitated. When the body is no longer able to regulate its own temperature, the victim of heat stroke typically ceases sweating. Shock and kidney shutdown may ensue.

Several population groups are at particular risk for heat-induced injuries, including children, the elderly, the chronically ill and debilitated, and alcoholics. The sweat glands and other means of heat dissipation are less efficient in infants and children, who typically generate more heat during exercise than adults. The elderly are at increased risk because of impaired cardiac performance and decreased capacity for sweating. Those with a history of heat stroke or patients taking certain medications that alter the production of sweat, such as antihistamines, antipsychotics or antidepressants, are also at greater risk.

Most heat-related illness, and heat stroke in particular, is preventable. Gradual acclimation to the heat is an important concept and requires repeated exposure to heat stress over a two week period, permitting the thermoregulatory system to adapt. By beginning workouts at moderate intensity during this period, a gradual increase in length of exercise and in exertion levels will allow for a more healthy adaptation to the heat. Air conditioning is advisable during periods of high ambient heat or humidity; even maintaining a cool breeze with the use of a fan is helpful. Avoid activities in direct sunlight; accomplish what you have to do outdoors early and late. Taking short baths or showers in cool water are also beneficial. Wearing well-ventilated, wide brimmed hats affords protection for the head as well as the neck.

People who are exposed to heat for prolonged periods regularly neglect to drink enough fluids to replace losses; maintaining adequate fluid intake is crucial. The primary ingredients for any rehydrant formula should consist of sugar, sodium and potassium. Caffeine and alcohol speed up dehydration and make you sweat more; nicotine constricts blood vessels and impairs the smoker's ability to acclimate to heat.

If heat exhaustion or stroke does occur, first aid should be administered. Splash the person with cool water, move him or her to an air-conditioned environment, and force fluids, provided the person is conscious. Getting the person to a doctor as soon as possible for further emergent care and observation lessens the risk of residual injury.

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