Avoid Heat Illnesses

This month we will be talking about heat illness.  I know most of you spend the majority of your day in your air-conditioned truck; however, there are some of you who spend a considerable amount of time outside your truck.  Just like your trucks, your body can overheat in extreme conditions.  We are going to talk about how to field diagnose those symptoms and prevent you and your coworkers from suffering a heat related illness.

The cab of your truck is probably pretty cool and comfortable when you have the key on.  Did you know that 56 percent of drivers do not use an alternative to idling?  So, while heat stress is a rare issue when the truck is running, there is a clear danger for many drivers who are securing a load, inspecting a truck, or simply parked in a strict no-idle spot on a hot day.

Heat stress happens quickly.  On a hot day, you can become “heat sick” in as little as 30 minutes if you’re not careful.  While the Centers for Disease Control tell people working in the heat to rest, drink, and find shade from the sun, you can’t always do that.  Heat does not “stop the clock.”

Heat is stressful to the fittest of people and extremely dangerous to those with poor physical stamina, weight issues, underlying medical issues like high blood pressure, and medications like diuretics, which can make you dehydrated.

Heat illness is a broad term that encompasses several conditions, ranging from mild heat cramps to life-threatening heat stroke.  The three main conditions are heat cramps, heat exhaustion, and heatstroke.  All of these conditions occur as our core temperature increases and we become overheated, dehydrated, and hyponatremia (low salt).  Although the exact cause of heat illness is not known, some researchers suggest that it is due to a failure in our body’s thermal regulation system.

HEAT CRAMPS.  One of the first signs of heat illness is heat cramps which usually involve muscle cramping that occurs during or after intense or prolonged exercise in extreme heat conditions.  The most common location for these cramps is in the lower legs such as the calf muscles or feet.  The most likely causes of this condition include lack of acclimatization to the heat, low sodium (salt), and dehydration.  Treatment is quite simple involving rest, cooling, massage, and hydration.  Fluids should be taken by mouth and can consist of any cool liquids.  Sports drinks such as Gatorade are beneficial in this situation as they help replenish electrolyte levels.

If mild overheating is not treated in a timely fashion, it may progress to a more severe condition called heat exhaustion.

HEAT EXHAUSTION.  Heat exhaustion is the body’s response to an excessive loss of water and salt, usually through excessive sweating. 

In most cases, the core body temperature is below 103 degrees F.  Those most prone to heat exhaustion are elderly people or people who have high blood pressure, or those who are severely overweight, or those working or exercising in a hot environment.

It is vital that this condition be recognized and treated accordingly as it can quickly progress to a life threatening condition called heat stroke. 

Heat exhaustion has many symptoms including:

¨ Heavy sweating

¨ Weakness

¨ Lightheadedness

¨ Nausea or vomiting

¨ Muscle cramps

¨ Occasionally flu-like symptoms.

¨ Fast & weak pulse

¨ Heavy sweating

¨ Extreme weakness or fatigue

¨ Dizziness, confusion

¨ Clammy, moist skin

¨ Pale or flushed complexion

¨ Slightly elevated body temperature

¨ Fast & shallow breathing

If you are suffering from heat exhaustion, get to an air-conditioned area; drink plenty of water (or cool, nonalcoholic beverage).  If you can, take a cool shower or sponge yourself off.  If you are helping someone else, follow the same routine.  If you see, someone experiencing any of the symptoms for heat exhaustion immediately helps them stop all physical activity, start resting, cool off, and hydrate.

HEAT STROKE.  Heat stroke is the most dangerous and is actually a form of hypothermia if you can believe it.  It has both physical and neurological symptoms which can do significant damage to your body and even lead to death.  Again, heatstroke is a result of dehydration and extreme temperatures within your body.  It occurs when your body becomes unable to control its core temperature.  Your body’s temperature rises rapidly, sweating fails, and your body is unable to cool down.  When heat stroke occurs, your body temperature can rise to 106 degrees or higher within 10 to 15 minutes.  Heatstroke can cause death or permanent disability if emergency treatment is not given. 

As you may have guessed, this is a medical emergency and needs to be treated with rapid cooling under close supervision.  If this happens to you, there is a good chance that you will need intravenous fluid.

 Heatstroke symptoms include:

¨ Hot, dry skin

¨ Hallucinations

¨ Chills

¨ Throbbing headache

¨ Confusion/dizziness

¨ Slurred speech

¨ Very high body temperature

¨ No sweating just a red face

¨ Difficulty breathing

¨ Disorientation

Heatstroke is a medical emergency and needs to be treated immediately.

What separates heat exhaustion from heatstroke is that people suffering from Heat Stroke have a significant change in mental status.  These people are usually confused, disorientated, or agitated.  Severe forms of heat stroke can lead to coma or seizures. 

If you think you might be having a heat stroke, get help.  If you are first on the scene for a coworker, call 911.  Move them to a cooler or shadier area, and try to cool him/her down with water.

FAINTING.  “Heat syncope” is when you overheat and faint.  It may be heat exhaustion or heat stroke.  Both can cause blacking out (syncope).  You can tell the difference by paying attention to some simple details.  Was your skin red hot and dry or was it sweaty and cool?  As we mentioned earlier, heatstroke is when you quit sweating.  Heat exhaustion is when you sweat excessively.  Whichever one it was, you need to replace your fluids and electrolytes immediately.

Once you have either condition, you are more prone to having it again.  Make this important note to yourself: Don’t underestimate the sun.

This summer temperatures have been soaring well into the 90’s and even peaking above 100.  For many, this sort of extreme heat can typically be an afterthought.  Heck, you’re in your cab enjoying the air conditioning compared to the unlucky souls who have to climb up onto a roof and swing a hammer for most of the day, what’s there to worry about?  Easy, it’s not the climate-controlled living but the second half of your job, like unloading.  We’ve had several reports already this summer about drivers experiencing different forms of heat fatigue from heat exhaustion all the way up to heatstroke.  Take the tips from this newsletter to make sure you’re not going to be counted among these rising statistics.

These tips will help you and your coworkers to avoid a Heat related illness.

Get Plenty to Drink.  Sweating removes the needed salt and minerals from the body. When it is hot, drink more water, juice and sports drinks. Avoid drinks with caffeine (tea, coffee, and soda) and alcohol. Be sure to eat regularly.

Stay Cool Indoors.  The best way to beat the heat is to stay in an air-conditioned area.  If you don’t have an air conditioner, go to a shopping mall or public building for a few hours.  A cool shower or bath is also a good way to cool off.

Wear Light Clothing and Sunscreen.  Wear as little clothing as possible when you are at home.  Choose lightweight, light-colored, loose-fitting clothing.  In the hot sun, a wide-brimmed hat will keep the head cool.  If you will be in direct sun, use sunscreen with a sun protection factor (SPF) of 15 or higher and follow package directions.  Reapply every 2 hours while in the sun.

Schedule Outdoor Activities Carefully.  Try to be less active during the hottest part of the day, late afternoon.  If you must be out in the heat, plan your activities so that you are outdoors either before noon or in the evening.  While outdoors, rest often in a shady area.  Never leave kids or pets in a parked car.

Pace Yourself.  If you are not used to working or exercising in hot weather, start slowly, and pick up the pace gradually.  Take frequent, regularly scheduled breaks.  If activity in the heat makes your heart pound or leaves you gasping for breath, stop the activity, get into a cool or shady area, and rest.  Especially if you become lightheaded, confused, weak, or feel faint.

Use a Buddy System.  During a heatwave, check on your friends and family and have someone do the same for you.  If you know someone who is elderly or has a health condition, check on him or her multiple times a day during a heatwave.  Watch for signs of heat exhaustion or heat stroke.  High temperatures can cause serious health problems.  Know the symptoms of heat-related illness and be ready to help.

From a first responders perspective, there are very limited options to treat heatstroke in the field.  The name of the game at this point is to get the individual into the shade, remove most; if not all of the victims, clothing and try to begin to cool the body, which could read temperatures of over 106 degrees.  A garden hose or cool water is a good start, as an ice bath might shock the body.  Try to keep track of the temperature if you can with a thermometer and call paramedics who can come and help while providing further coaching to you to aid the victim.

As I always say, prevention is the best treatment. 

Heat exhaustion is a real concern and should not be ignored.  If you follow some of the simple prevention tips in this newsletter it will greatly reduce your chances of suffering from heat illness.  Until next month, stay cool and drive safely.