Heat Wave
Author: Sara Rider

“Summertime, and the livin’ is easy.” Unless you’re outside in 102 degree weather with 98 percent humidity. Then, there can be trouble.

As temperatures climb this summer, the heat isn’t just unpleasant, it can be deadly. Exposure to high temperatures can have health consequences that range from heat cramps to heat stroke and even death. Each year, the news media carries stories of children who die in hot cars, teens who collapse at training camps and elderly people who die during prolonged heat waves. But with simple precautions, these things don’t have to happen.

The problem with heat
According to the American Academy of Pediatrics, sweating is the main way that the body gets rid of excess of heat. Unfortunately, for people who live in Central Texas, as the humidity rises, sweating becomes a less effective means of cooling the body. If the body is unable to get rid of heat, the body temperature will rise, resulting in heat illness or injury.

“The body naturally relies on the evaporation of sweat to cool itself down,” explains Diane Garza, a pediatrician with The Austin Diagnostic Clinic. “But during hot, humid weather, the body’s self-regulating sweating mechanisms can become overwhelmed and break down. When this happens, the body’s core temperature begins to rise, which can lead to heat exhaustion and heat stroke.”

Heat injuries fall into three main categories: heat cramps, which are painful muscle contractions that usually occur while exercising; heat exhaustion; and heat stroke.

According to Pat Crocker, M.D., chief of emergency medicine at Dell Children’s Medical Center, this summer’s heat will bring children and teens with either heat exhaustion or heat stroke to the Dell ER.

Young and active
“We usually see heat exhaustion in older children who are more active. These are often kids aged four to 18,” states Dr. Crocker. “In the summer, kids who are active need a 10-minute rest in the shade every hour. And they need to drink plenty of cool water. This gives their bodies a chance to dissipate the heat they have generated through activity.”

For children who are involved in athletic activities such as football, soccer or softball, Dr. Crocker recommends adding a sports drink like Gatorade to their fluids so that they can reclaim some of the electrolytes they lose by sweating.

Heat exhaustion and heat stroke
Both heat exhaustion and heat stroke are classified as heat injuries.

“The problem with heat injuries is that they accumulate over time,” explains Dr. Crocker. “The first stage is a mild heat exhaustion. That’s the point where the child needs to get out of the sun, cool off and rest. And it’s important if they experience symptoms of heat exhaustion that they not return to the activity that day.”

According to Dr. Garza, the signs of heat exhaustion can include a body temperature of up to 104 degrees, fatigue, nausea, vomiting, dizziness, fainting and flushed, moist skin.

Signs of heat stroke can include a temperature greater than 104 degrees, disorientation, confusion, combativeness, seizure, stroke, shock and cardiac arrest.

“The on-site treatment for heat exhaustion is to stop the activity and move the child to a cool shady area or air-conditioned facility. Cool water and sports drinks will also help with rehydration,” Dr. Garza states. If someone suffering from heat exhaustion does not improve with treatment, then you need to call 911. “Heat stroke is an emergency and requires immediate medical attention,” she warns.

“When you have the hallmark signs of heat stroke like confusion, combative behavior and not making sense, that’s a sign that the body temperature is likely over 106 degrees and that the patient needs to be cooled rapidly,” explains Dr. Crocker. “The thing we have learned about heat strokes is that it is the total time that the body is overheated that can lead to brain damage or death. So the sooner the child is cooled off, the better. You don’t let them lay in the sun and wait until EMS gets there.”

First aid in a suspected case of heat stroke includes applying cool water to clothing or skin. If ice is available, ice bags should be applied to the groin, under the arms and around the neck until EMS arrives.

Playing in cars
Children who are very young face another type of danger in the summer.

“Unfortunately, Texas has led the nation in annual childhood deaths for children left in cars for two of the past three years,” reveals Dr. Crocker. “We’ve had two deaths so far this year, both in Houston.”

“Surprisingly, about half of all of the deaths are children who are forgotten in the car, usually on the way to daycare. It may be someone who is not the usual person to take them to daycare or the person may get sidetracked. These children are just accidentally forgotten,” he says.

To avoid this type of tragedy, Dr. Crocker suggests leaving your purse, briefcase or cell phone on the backseat by your child. “That way, even if you have forgotten that you are the one taking the child to daycare, or you’ve gotten sidetracked about work, you’ll be forced to look in the backseat. That can prevent a tragedy.”

According to Dr. Crocker, another 30 percent of deaths occur in children who are older and go into the car to play and are overcome by the heat.

“The inside of a car can become life-threateningly hot in just 20 to 30 minutes when it is only 80 degrees outside,” he warns. “When you get out of the car, lock your car doors all the time and make sure all of the kids are out before you lock it!”

Children who have special physical challenges – or not ambulatory or are nonverbal – can also be left in a car by accident.

Medications can also decrease the body’s ability to dissipate heat. “Drugs like antidepressants or psychiatric medications can have that effect,” says Dr. Crocker. “So if your child is on any of those medications you may want to talk to your doctor about any special precautions you need to take.”

Special threats for the elderly
Your parents, grandparents and elderly friends and neighbors can also be at risk for heat exhaustion and heat stroke.

“With the elderly, the heat accumulates in their bodies over hours to days. If you have a long heat spell, the elderly person accumulates heat through each of those days because they can’t really eliminate or dissipate the heat,” explains Dr. Crocker. “Sometimes it’s because of a medication, sometimes it’s a lack of mobility or in some cases the older you get, the less active your sweat glands are, so it becomes harder and harder for you to eliminate heat.”

When we are faced with a series of 100 degrees-plus days, it’s a good time to start checking daily on elderly family and friends, particularly those who don’t have air conditioning or can’t afford to run their AC.

“If you call and [he] sound’s like [he is] sleepy, or lethargic, or not making sense, then that is someone who needs to be checked immediately, because it could be an accumulating heat stroke,” cautions Dr. Crocker.

You can help avoid that type of crisis as the hot days add up by taking him or her to a place with air conditioning for a few hours each day.

“Go to the mall or bring [him or her] over to your house if you have air conditioning. [He] will dissipate some of that accumulated heat and have a safety margin,” continues Dr. Crocker. “But a simple box fan can be a lifesaver.”

“Heat injury isn’t a single entity. Each age group has its own vulnerability, partly because of the physical capacity: an infant can’t rescue [herself] from a car, a two-year-old who climbed in the car and closed the door may not really know how to get out and elderly people have a special vulnerability. And in each case, the risk factors are a little different and so is the solution.”

Sara Rider is a native Austinite who has worked with physicians and hospitals throughout Texas. She frequently writes freelance articles on health topics for newspapers and magazines.


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