Avenging heat

— Dave Grusin (b. 1934) US composer; Alan (b. 1925) and Marilyn (b. 1929) Bergman, US lyricists, “The Trouble with Hello is Goodbye” (1974)

THOSE gutsy city sweepers doing their job under the sun have one thing coming: A heat emergency. Those widebrimmed hats and cloth draping their ears and cheeks, are okay but maybe not enough.

Common Causes. All of these contribute to the onset of heat emergencies: • High temperatures or humidity. • Prolonged or excessive exercise. • Heavy, layered clothing. • Alcohol use (causes dehydration).

• Medication such as diuretics (given in hypertension, usually).

Summer means Dehydration. It’s almost certain that this is the best time of the year to get into the bottled water business. That’s if people know what dehydration is and its symptoms. It’s especially important to recognize heat stress in children because they are most prone yet least defensible. They have more body surface per pound of weight compared to adults. Early dehydration symptoms are thirst, fatigue, irritability, dry mouth, and just plain feeling hot.

Heat Cramps and Syncope. A mild form of heat illness is muscle cramping and it happens mostly to athletes exercising under the sun with little hydration. Immediately, get that person into the shade, stretch the affected muscle and rehydrate with water. If there’s a sports drink available, the high sodium content is a plus. However, if more than 8% of the drink is carbohydrate, absorption would not be as fast as H2O. In a hot environment, fainting or dizziness can result after getting up suddenly from a standing or sitting position. Sometimes all it takes to conk out is prolonged standing. This kind of fainting is called heat syncope. Return the person to a lying position and try to give water when revived. Bring the patient to the emergency room if unconscious.

Heat Exhaustion. More worrisome in increasing severity of signs and symptoms is heat exhaustion. Aside from excessive thirst, muscle cramps, agitation or irritability, there will also be nausea, vomiting, headache, weakness, and profuse sweating. Unless the victim is immediately brought to a cool, shaded place and given fluids, the worst heat emergency will occur.

Heat Stroke. This is now a MEDICAL EMERGENCY in the true sense because coma or even death is the endpoint. No doubt, many soldiers who died in the infamous 1942 Bataan Death March suffered from heat stroke. It presents as:

• Hyperthermia (very high temperature). • Extreme confusion. • Dry, hot, and red skin. • Rapid, weak pulse. • Irrational behavior. • Seizures. • Loss of consciousness. What to Do. The victim needs immediate medical attention. As first aid, cold compresses or ice bags can be placed in the armpits, neck, and groin. Do NOT apply rubbing alcohol. Do NOT give fever medication like acetaminophen or aspirin. If outdoors, bring the victim to a cool place and elevate the feet. For the rest of the skin, apply wet cloth soaked in cold water. An alert victim can be given oral fluids like water or a sports drink.

Prevention. Heat emergencies can be prevented by wearing light weight clothing. On hot days, try not to exercise under the sun. Always drink plenty of fluids before, during, and after exercise. It also helps to seek shade and to rest frequently when outside.

Our summers are as hot as hell. Don’t let a heat emergency, an accident just waiting to happen, happen.