Heat Cramps, Exhaustion, and Stroke: An Escalating Series of Warnings

Out bodies create a lot of heat. This happens even in cold weather. Most of the heat we create is from our normal metabolic activities even while at rest. As soon as we start to move around the heat we create increases. If we did not have a method of maintaining an ideal internal body temperature our organs and metabolic functions would quickly shut down.

Our bodies function best around 98.6 degrees Fahrenheit (37 degrees Celsius). This number can vary slightly depending on where on the body the temperature is taken. And slightly means +/- 0.4 degrees, which isn't very much. During the course of the day a person's body temperature may also change a bit, e.g. if they are sleeping and where they are in their sleep cycle, or if they are awake and it's morning or afternoon, or what they are doing at the time. However, again, the fluctuation is minimal.

In order to maintain this ‘ideal' internal body temperature our bodies have ways of getting rid of excess heat. These include: heat coming from our breath; heat radiating from our skin (not the same as sweating); through conduction, which occurs when we are touching a colder object; and the most important one, evaporation of perspiration on our skin.

Evaporation is the number one method for our bodies to eliminate heat. This is why we sweat. As the sweat evaporates it takes a lot of heat off our skin with it. Making a note of this point, any time evaporation is limited it means sweating will be limited. Which in turn means the removal of heat will be limited and the body will have difficulty maintaining its normal body temperature. Things that can limit evaporation of perspiration include: clothing, especially the non-breathable kind; a malfunction in the person's ability to sweat; high humidity in the air; and dehydration, as the body tries to hold onto water.

The good thing is our bodies will give us warning signs that our temperature is rising above normal. The bad thing is most of us are good at ignoring these warning signs. If we ignore them, or because of the circumstances we cannot do anything about it, then we risk a heat emergency. The rate at which the heat emergency progresses, and the severity of it will depend on how much difficulty our bodies have at getting rid of extra heat.

Heat Cramps

Heat cramps are the least serious of the three types of heat emergencies. However, someone suffering from heat cramps can easily progress to the more serious condition of heat exhaustion. It is therefore important to be aware of the signs and take immediate first aid action.

Signs and Symptoms

• Painful involuntary, muscle contraction usually in the calves or abdomen.
• Sweating or moist skin.
• Tired, irritable, and thirsty.

First Aid for Heat Cramps

Being the least serious of the heat emergencies, it is quite easy to recover from heat cramps with some simple first aid techniques.

• Removing the person from the source of heat.
• Gently stretch/massage affected area.
• Slowly rehydrate with cool water, juice, or sport drinks.
• Rest for several minutes or even a couple of hours.
• Avoid alcohol and caffeinated drinks as they will worsen the condition by promoting dehydration.

Heat Exhaustion

Heat exhaustion is the second type of heat emergency. It is not as serious as heat stroke, but can lead to it if not dealt with properly.

Signs and Symptoms

• Sweating.
• Tired.
• Irritable.
• Thirsty.
• Lethargy.
• Slight headache.
• Nausea.
• Dizziness or weakness.
• May have slightly elevated body temperature.

First Aid

• Remove from source of heat.
• Slowly rehydrate by drinking water, juice, or sport drinks.
• Rest is very important to prevent a re-occurrence.
• Remove sweaty clothing.
• Fan or gently cool the skin with cool towels or ice packs.
• Avoid alcohol, caffeinated and/or carbonated drinks as they will only make the condition worse by promoting dehydration.
• If vomiting occurs you should activate EMS.

Heat Stroke

Heat stroke is the least common but the most serious of the 3 types of heat emergencies. It occurs when the signs and symptoms of heat exhaustion are ignored. When the body can no longer cool itself it can quickly stop working resulting in a rapid rise in temperature and a vicious cycle. Eventually, vital organs such as the brain and the circulatory system will cease to function.

Signs and Symptoms

• Elevated body temperature often as high as 106 degrees Fahrenheit.
• Irritable, bizarre, or combative behavior.
• Sweating may stop – this is not a good sign.
• Severe headache.
• Red, hot dry skin especially in the elderly.
• Rapid, weak pulse becoming irregular.
• Rapid, shallow breathing.
• Progressive loss of consciousness.

First Aid

• Remove the person from the heat source.
• Place in recovery position.
• Contact EMS immediately.
• Monitor and treat ABCs.
• Remove sweaty clothing.
• Fan or otherwise gently cool skin perhaps with cool towels or ice packs.
• Do not douse with cold water – this may cause shock.
• Do not place the person in a tub of water is this may make it hard to maintain an open airway.
• At this point it is too late to give fluids by mouth as it may induce vomiting.

The best way to avoid a heat emergency is to avoid situations where the body cannot eliminate extra heat produced.

For example;

• Avoid heavy physical exertion when it is hot and humid. Choose cooler morning or afternoon times to be active.
• If you enjoy saunas, steam rooms, or hot tubs, limit your time to 10-15 minutes.
• Your clothing should be loose, made of breathable material, and light in color to reflect the sun's rays.
• Stay well hydrated so perspiration will not be hindered.
• If indoors during hot and humid weather use an air conditioner to bring the indoor temperature down, or use a fan which promotes the evaporation of sweat.
• If you must perform physical activity, e.g. because of work, take regular breaks in shaded areas to allow your body some cooling time.
• If you are an athlete and will be competing in a hot environment try to allow a few days of acclimatization. For example, if in another country go there a few days before the competition.

Some conditions can make a heat emergency occur quicker. For example; certain medical conditions, taking certain medications, pregnancy, age (young or old), and natural body discrepancies among individuals.