Heat Related Illnesses - Recognize and Act Fast


Healthy Living - July 19, 2016
JP Stowe, ATC

It’s that time of year from mid-July to late-August when heat waves and the humidity arrive to give us almost no reprieve from the sweltering conditions. With it comes the increased risk of developing a heat-related illness, especially when outside for long periods of time. These conditions can turn deadly fast and we have lost far too many young athletes to a very preventable injury. They can happen to anyone whether you’re an adult on a hike, an athlete or referee in the field, or an elderly individual on a walk.

Early recognition and immediate care of heat-related illnesses is essential and there are four common conditions to understand: dehydration, heat cramps, heat exhaustion, and heat stroke.

Dehydration: Because our bodies are working harder and producing more sweat, we lose fluids rapidly, which is why it is important for athletes to stay hydrated. When we don’t, we can become dehydrated, a condition that can be potentially life threatening. Early symptoms of dehydration include:
Heat Cramps: The mildest form of heat illnesses, heat cramps are painful cramps in the stomach, arm, and leg muscles. These cramps are caused by not replacing salt, electrolytes, and fluids during intense, prolonged exercise in the heat. Symptoms include:
Heat Exhaustion: Heat exhaustion is more severe than heat cramps and results from a loss of water and salt in the body. It occurs in conditions of extreme heat and excessive sweating without adequate fluid and salt replacement. Heat exhaustion occurs when the body is unable to cool itself properly and, if left untreated, can progress to heat stroke. Symptoms include:
Heat Stroke: Heat stroke, the most severe form of heat illness, occurs when the body's heat-regulating system is overwhelmed by excessive heat. It is a life-threatening emergency and requires immediate medical attention.
Illness Symptoms Immediate Care
  • Headache
  • Dizziness
  • Thirst
  • Feeling less alert
  • Muscle cramps
  • Decreased urine output
  • Urine that is dark in color
  • Move to a cool place to rest. Do not continue to participate in activity
  • Give cool water or sports drink containing salt and sugar
  • Remove excess clothing or equipment
Heat Cramps
  • Thirst
  • Flush, moist skin
  • Intense muscle spasms
  • Nausea
  • Move to a cool place to rest. Do not continue to participate in activity.
  • Remove excess clothing or equipment if appropriate.
  • Give cool sports drinks containing salt and sugar.
  • Stretch cramped muscles slowly and gently.
Heat Exhaustion
  • Muscle cramps
  • Pale, moist skin
  • Usually has a fever over 100.4° F (or 34° C)
  • Nausea
  • Vomiting
  • Diarrhea
  • Headache
  • Fatigue
  • Weakness
  • Anxiety, and faint feeling
  • Move to a cool place and rest.
  • Remove excess clothing and place ice bags on armpits and groin area
  • Give cool sports drinks containing salt and sugar.
  • If no improvement or unable to take fluids, take to an emergency department immediately or call 911. IV (intravenous) fluids may be needed.
Heat Stroke
  • Warm, dry skin
  • high fever, usually over 104° F (or 40° C)
  • Rapid heart rate
  • Loss of appetite
  • Nausea
  • Vomiting
  • Headache
  • Fatigue
  • Confusion
  • Agitation
  • Lethargy
  • Stupor
  • Seizures, coma, and death are possible
  • Move to a cool place and rest.
  • Call 911 or your local emergency medical service. Heat stroke is a life-threatening medical emergency and needs to be treated by a doctor.
  • Remove excess clothing and drench skin with cool water; fan skin.
  • Place ice bags on the armpits and groin areas.
  • Offer cool fluids if alert and able to drink.
Easy to follow prevention tips to avoid heat-illnesses:
  1. Hydrate!
    • Before activity drink 17-20 oz of fluid within the 2 hours before exercise
    • During activity drink 7-10 oz every 10-20 minutes during your workout
    • After activity drink 16-24 oz per pound of body weight lost during exercise
    • Avoid beverages that contain alcohol and caffeine. These are diuretics and will add to the dehydration
    • Eat foods with high water and electrolyte content such as fruits and vegetables
    • Weigh athletes before and after each activity. Athletes should replace all of their weight lost during any exercise period prior to the next exercise period
  1. Schedule activities during the coolest parts of the day (early morning or late afternoon/evening); consider cancelling or delaying an activity under extreme conditions
  2. Allow athletes to gradually adjust to exercising in hot, humid weather by increasing activities slowly over the first 2 weeks of practice
  3. Avoid the use of excessive clothing and equipment and wear light colored clothing
  4. Schedule breaks every 10 to 15 minutes during any activity that lasts longer than 1 hour
  5. Identify athletes at high risk, such as athletes who are obese, are poorly conditioned, are not acclimated, have a current illness, are taking certain medicines, or have a history of previous heat-related problems
  6. Plan for emergencies—measure body temperature, call 911, cool immediately
  1. Heat-Related Illnesses (Heat Cramps, Heat Exhaustion, Heat Stroke)." Johns Hopkins Medicine, Based in Baltimore, Maryland. N.p., n.d. Web. 19 July 2016.
  2. Heat Injury and Heat Exhaustion-OrthoInfo - AAOS." Heat Injury and Heat Exhaustion-OrthoInfo - AAOS. N.p., n.d. Web. 19 July 2016.
  3. Howe, Allison S., and Barry P. Boden. "Heat-Related Illness in Athletes."American Journal of Sports Medicine 35.8 (2007): 1384-1395. Web.