Entries in Heat Stroke (6)


How to Stay Cool as Heat Wave Hits US

Jupiterimages/Thinkstock(NEW YORK) -- Summer doesn't officially start until Wednesday evening, but in some parts of the country the sweltering summer heat came early as the temperature in Denver and Phoenix eclipsed 100 on Monday.  And over the next few days, parts of the East Coast will bake as well.

Thousands of people end up in hospitals because of heat-related illnesses every year and according to the most recent data from the Centers for Disease Control and Prevention, nearly 3,500 people died after exposure to excessive heat between 1999 and 2003.

Despite the dangerously high heat and humidity, medical experts say there are simple but important ways people can stay cool on oppressively hot days and avoid problems like heat exhaustion and heat stroke.

Dr. Jeffrey Rabrich, director of EMS and disaster preparedness at St. Luke's & Roosevelt Hospitals in New York, expects to see quite a number of people come to the emergency room with heat-related symptoms over the next few days as temperatures in New York City climb into the 90s.

"Generally, whenever we have a heat wave or high humidity, we get a lot of patients in with symptoms that include dehydration, lightheadedness and passing out," Rabrich said.  "Most people are not too severe and we can treat them by cooling them off and giving them fluids.  But every once in a while, we get a couple of cases of heat stroke."

Heat stroke is a life-threatening condition that requires immediate medical attention. Doctors warn it can be caused by being out in high temperatures for too long or by being overly active in very hot weather.

People should monitor themselves and others for the classic signs of heat stroke.

"Watch out for symptoms like fatigue, dizziness, lightheadedness, nausea, or if the skin becomes hot or sweating stops," Rabrich said.

Heat exhaustion is less serious, but if not treated, can progress to heat stroke.  According to the American Red Cross, symptoms of heat exhaustion include cool, moist skin, headache, dizziness and nausea.

There are simple steps people can take to avoid experiencing any hot weather symptoms.

"Avoid outdoor activities during the hottest part of the day, typically between 10 a.m. and 4 p.m.," Rabrich said.  "People also must stay hydrated by drinking fluids like water or Gatorade."

Avoid alcohol, he advised, since it can act as a diuretic and lead to dehydration.

There is, however, the danger of overhydration -- also known as "water intoxication" -- so Jeffrey Pellegrino, who serves on the National Scientific Advisory Council for the American Red Cross, advised drinking around half a cup of water every 20 minutes or so if out in the heat.

Proper wardrobe choices will also help keep cool -- wear loose-fitting clothing and a hat if out in the sun.

Copyright 2012 ABC News Radio


Boston Marathoners Run Risk of Heat Stroke

Hemera/Thinkstock(BOSTON) -- The Boston Marathon kicked off Monday morning under cloudy skies, but organizers have warned runners to put health before hustle as the temperature approaches 80 degrees.

The fiery forecast prompted an unprecedented offer to 27,000 runners that spent the last year qualifying and training for the event: a deferment.

Runners keep cool by sweating.  But heat and high humidity impede the body’s cooling process, according to Dr. Corey Slovis, chair of emergency medicine at Vanderbilt University Medical Center in Nashville, Tenn.

“In temperatures above 70 degrees, the body begins to lose its ability to cool itself.  And once the temperature hits 80 degrees, people begin to suffer heat illnesses, such as heat exhaustion and heat stroke,” Slovis said.

Runners with heat exhaustion might feel faint or dizzy, and have a headache or muscle cramps.  If they don’t take it easy, the condition can worsen to heat stroke, a serious heat illness marked by a 104-degree body temperature causing confusion and even the loss of consciousness.

Staying hydrated can help stave off heat illness.  But drinking too much water can cause a dangerous imbalance in sodium and other electrolytes.

“It’s probably best to drink a combination of water and dilute sports drinks,” Slovis said.  “Mixing and matching is a great way to go.”

Slovis said marathon runners would normally acclimatize themselves to heat in advance of a hot race to avoid heat illness.

“But it shouldn’t be this warm so early in the year,” he said, explaining that many runners haven’t had the chance to train in 80-degree weather.  “I very much hope that people do well and we don’t see a lot of it.”

The Boston Athletic Association said it’s prepared for medical emergencies along the 26-mile course.  But runners should listen to their bodies and bow out before they need emergency care, Slovis said.

“Trying to run through a cramp or knee pain is one thing.  But if people start to have difficulty concentrating, difficulty with vision, or start getting a chill in the heat, it’s time to pull over to rest, drink and consider whether you want to continue walking or stop altogether,” he said.

Copyright 2012 ABC News Radio


Student Athletes Encouraged to Take Heat Safety Precautions 

Comstock/Thinkstock(MAYWOOD, Ill.) -- Just because summer vacation winds down, doesn’t necessarily mean the heat does, too.

HealthDay reports that athletic health officials are encouraging high school sports players to take heat safety precautions as they begin their fall training.

Loyola University Health System athletic trainer Jennifer Janczak urged players and coaches to take “common-sense precautions to prevent heat exhaustion and heat stroke," she said in a university news release.

The release cited that four high school football players died in 2010 due to heat stroke.

The following tips are offered for high school athletes:

• Drink water before practice and during breaks, even if you're not thirsty.
• Don't drink beverages with caffeine.
• Monitor your urine. If it's dark, you're not drinking enough water.
• Alert your coach or athletic trainer if you experience signs of heat exhaustion, which include dizziness, nausea, difficulty concentrating, headache or heavy sweating. Rest in an air-conditioned room or in the shade.
• Untreated heat exhaustion can lead to potentially deadly heat stroke, which requires immediate medical attention. Symptoms of heat stroke include skin that feels hot but not sweaty, shortness of breath, confusion, vomiting and loss of consciousness.

Copyright 2011 ABC News Radio


Heat Safety Tips for the Summer Heat Wave

Kevork Djansezian/Getty Images(NEW YORK) -- As record temperatures continue to bake the country's midsection, heat-related hospital visits are on the rise.

Excessive heat warnings are in effect for a large swath of central United States, according to the National Weather Service.  And the scorching temperatures are expected to linger for the next couple weeks.

Central air conditioning and portable air conditioners can get expensive, so what can you do to avoid the heat?  Can you recognize the signs of heat exhaustion?  And would you know what to do if someone started to show symptoms of it?

Dr. William P. Bozeman, an associate professor of emergency medicine and the emergency services director at Wake Forest University, shared some tips with ABC News that will help you keep cool and recognize the signs of heat overexposure, and the steps to take if you experience those symptoms or see them in someone else.

Bozeman cautioned that it is important to be aware of the temperature. Temps in the 90s and higher are dangerous, and become more dangerous the higher they go and the longer they last.  The very young and the very old are at the highest risk, as their weight and age can impair their ability to handle high temperatures.

11 Tips for Staying Cool This Summer

1. Be aware of the heat.
2. Pay attention to your hydration status and be sure to drink plenty of fluids.
3. Try to stay in relatively cool areas, even when outside.
4. Avoid hot, enclosed places, such as cars.
5. Use a fan, if available.
6. Stay on the lowest floor of your building.
7. Eat well-balanced, light and regular meals.
8. Wear loose-fitting, lightweight and light-colored clothing.
9. Cover windows that receive a significant amount of sun.
10. Weather stripping and proper insulation will keep cool air inside your home.
11. Cool beverages are good for cooling down the body, while alcoholic drinks can impair the body's ability to regulate its temperature.

8 Signs of Heat Overexposure

1. Heavy sweating -- though if heat stroke sets in, the body can no longer compensate and stops sweating.
2. Pale skin.
3. Muscle cramps.
4. Feeling tired and weak.
5. Altered mental status (confusion or disorientation).
6. Headache.
7. Becoming semi-conscious or passing out.
8. Nausea or vomiting.

6 First Steps to Take After Recognizing Heat-Induced Illness

1. Call 911.
2. Get the person out of the sun and into a cool area.
3. Apply water to help the person cool off.
4. Apply ice to the neck or armpits, where large blood vessels are close to the surface.
5. Remove any heavy clothing.
6. Immerse the body in cool water, either at a swimming pool or in a bathtub.

Copyright 2011 ABC News Radio


How to Avoid the ER in the Upcoming Heat Wave

Jupiterimages/Thinkstock(NEW YORK) -- As the Northeast prepares for nearly record-breaking temperature spikes over the next several days, urban hospitals are bracing for heat-related illnesses that invariably strike the elderly during the dog days of summer.

The National Weather Service is predicting temperatures reaching into the 90s and 100 degrees with high humidity for the East Coast and Southeast states -- compared with the normal highs for this time of year in the upper 70s to low 80s.

"The main issue is that the elderly are not thinking about [the risks]," says Phillip Russertt, 38, a registered nurse for MJHS Homecare who provides home care for the elderly in Queens, New York. "They don't get warm like we do; they tend to drink fewer fluids on a regular basis.  They feel like they're fine but that doesn't mean they are not at risk."

Because of this, Russertt says the first thing he is checking for in the patients he visits is dehydration.

"It's a real public health issue," says Dr. Michael Stern, co-director of the Geriatric Emergency Medicine Fellowship at New York-Presbyterian Hospital/Weill Cornell Medical Center. "Between the 1980s and early 2000s there were more heat-related deaths than deaths from all natural disasters combined."

The National Weather Service has issued heat advisories for the Baltimore-Washington region and parts of Ohio, Indiana and Michigan.  Air quality concerns, which cause problems for children, the elderly and those with respiratory problems, were issued along the Northeast and Mid-Atlantic coastline.

As always with summer heat waves, everyone is susceptible to heat exhaustion or the more severe heat stroke, but the young, the elderly and those with chronic medical conditions, especially heart disease, are most at risk.

Since temperatures have been on the rise in New York City, Dr. Stern says they are seeing more patients with heat exhaustion -- the precursor to heat stroke.

"They present with headache, nausea, dizziness, muscle cramps and excessive sweating," he says. "The more dangerous cousin to this is heat stroke, which is when the body stops sweating and loses its ability to cool itself. The body temperature rises to 103 or higher, and you run the risk of organ failure, coma, and death."

Among young, healthy individuals, heat stroke can occur after exerting oneself outside in the heat, but for the elderly, especially those on certain medications that affect hydration and body temperature, simply sitting in a hot, un-air-conditioned apartment in the summer can result in heat stroke "in a matter of hours," Stern says.

This is why "hydration is so key" among the elderly, or anyone exerting themselves outdoors in the heat, says Stern.  Two to four eight-ounce glasses of water per hour is the rule of thumb for those working outside on a day with temperatures in the 90s, he says.  And everyone at risk for dehydration should be avoiding alcoholic, caffeinated and/or sugary beverages as they will only dehydrate further.

Copyright 2011 ABC News Radio


Fran Crippen Death: Likely Heat Stroke or Heart

Photo Courtesy - Getty Images(NEW YORK) -- Doctors may never know precisely what killed open water swimmer Fran Crippen, the 26-year-old who died during a race in Abu Dhabi over the weekend, but they agree that strenuous exercise in hot water could result in fatal heat stroke.

Had a safety boat been near the elite swimmer when he lost consciousness, he might have been cooled down and been saved, they say.

"It's pretty straightforward -- he died of one of two things," said Dr. Mark Morocco, associate professor of emergency medicine at the UCLA School of Medicine.

"He drowned of a cardiac arrhythmia or he died of drowning because he passed out," said Morocco, who has never treated Crippen. "Both were directly related to over-exertion, which is a terrible garbage-can diagnosis and does not speak to what happened."

"In the age of kayaks, jet skis and outboard motors, this sort of thing should never happen to an elite swimmer," he said. "No one was there to help him up out of the water."

USA Swimming said Monday it would commission a full, independent investigation into Crippen's death.

Some earlier reports indicated that the Olympic-bound athlete died of a heart attack. The findings of an autopsy by local authorities have not been released, and even that may not give definitive answers.

Heat stroke, for example, could only be determined if doctors got an internal body temperature right after Crippen died. His body wasn't found until two hours after the race ended -- about 400 meters from the finish line.

The International Swimming Federation (FINA) said doctors ruled the cause of death as severe fatigue.

Crippen's sister Maddy, herself an Olympic swimmer, told ABC News that her brother had been voicing concerns for months about inadequate safety.

Crippen had told Shoulberg just 12 hours before the race that the outside temperature was 100 degrees and that the water was 87 degrees. Several swimmers complained of dehydration and disorientation and three were taken to the hospital.

"l have heard lot people complaining about the water being too warm," said Bill Volckening, a former editor of Swimmer magazine for U.S. Masters swimming. "There are some dangers of hyperthermia that have not really come to light yet and I hope there is some major reform in the sport of open water swimming with regard to safety."

Those who trained with Crippen said he also used GU energy gel, a replenishing liquid that contains high amounts of caffeine. The swimmer reportedly consumed 10 to 15 packs during a typical two-hour swim.

Doctors say, however, that caffeine is generally "pretty safe."

"It's probably not that likely, but certainly a possible factor in the picture," said Morocco. "Caffeine can cause arrhythmias in sensitive individuals."

The more likely cause of death was hyperthermia, which led to heat stroke.

"During physical exertion as the muscles are working, part of the byproducts is heat, like a power plant," said Dr. Ted Benzer, chief of clinical operations in the emergency department and attending physician at Massachusetts General Hospital.

"The challenge is to get rid of the heat and the body doesn't have that many ways to do that," he said. "The human body underwater is not like a fish or a whale. The primary way it releases heat is through evaporative losses like sweating."

Sweat on the surface of the body creates a cooling effect on blood just under the skin. Unlike a dog, humans can't pant to get rid of the heat.

"It is an intriguing concern that [Crippen] had major exertion submersed under very hot water," said Benzer. "But this is very unusual -- I have never seen this in all the years I have worked in emergency medicine."

When the body's temperature reaches 106 to 107 degrees, it starts to cause death of tissue and organ failure.

One of the first warning signs is confusion and delirium as the brain begins to dysfunction. If not treated by cooling the body down, it can cause death.

"It's hard to say what happened," said Benzer. "Who knows who was watching and how closely. Basically, he may have become confused and his actions might have been unpredictable. Maybe he started getting heat stroke, was delirious and then drowned."

However, doctors say there are other conditions that can cause sudden death in a young athlete -- heart valve problems, an electrolyte imbalance, congenital thickening of the heart muscle, cerebral aneurysms and even undetected arrhythmias like long QT syndrome.

UCLA's Morocco agrees that many of those medical events could have been treated had there been more attention paid to safety.

"A lot of the responsibility is on the folks who put the race together," he said. "When you are 500 feet in the water, you are as far away as being in wilderness 20 miles in Yosemite. If you don't have someone in a rescue boat, you are in trouble. Anything can happen."

"The other problem is elite athletes are not very good patients," said Morocco. "They don't want to get out of the race, even if they feel poorly. They are well-trained, but are also pressured to perform. Oftentimes a great athlete cannot advocate for himself. But those running the race should advocate for him."

Copyright 2010 ABC News Radio

ABC News Radio