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When symptoms kick in, every second counts. Here’s how to tell if someone has heatstroke — and what to do right away.
With summer upon us, you’re probably excited for beach days, fun runs and other outdoor activities. But with temperatures rising, you need to watch out for heat-related illnesses — especially heatstroke. It can come on fast, and when it does, speed is critical. It’s best to have a heatstroke plan ready before you need it. Here’s what you should know.
Heatstroke occurs when your body makes more heat than it can dissipate through means such as sweating. “Once the body is over 104.5 F, it’s a medical emergency that must be treated within 30 minutes in order to limit any short-term or long-term damage and to prevent fatality,” says Robert Huggins, PhD. He is a kinesiology and exercise-science researcher. He's also the president of research and athlete performance and safety at the University of Connecticut’s Korey Stringer Institute in Storrs.
In severe cases, heatstroke can lead to endotoxemia. This is a condition in which your cells break down and leak their contents into your body. It triggers inflammation followed by cell death and eventually multi-organ shutdown, says Huggins. But this is rare: According to the Centers for Disease Control and Prevention, heat-related death occurs only about 700 times per year on average in the United States. And if you know what to look for, you’ll be able to act fast before the heat does any serious damage. (If treatment or recovery includes prescription medication, Optum Perks can help you pay for your medication. Learn how.)
There are 2 types of heatstroke:
There are 2 telltale signs of heatstroke.
Core body temperature above 104.5 F. This is the threshold for cell damage. The more time a person spends above 104.5 F, the higher the risk of lasting harm. Unfortunately, core temperature isn’t something you can easily measure while you’re at the beach or pool. “The only way to confirm the core temperature in an outdoor setting is by rectal thermometer, so it needs to be performed by a trained health care provider, such as a doctor, sports medicine doctor or another medical professional that has the tool,” says Huggins.
Mental status changes, such as loss of consciousness, confusion or disorientation. This is the more obvious clue: If someone you’re with seems lost, unreasonably irritated or angry, you could be dealing with heatstroke.
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When it comes to heatstroke, you must act fast, says Huggins. You need to begin cooling immediately. Here are your options for rapid treatment:
Contrary to popular belief, placing ice packs on arteries isn’t effective. It’s too slow. “It’s almost as bad as just sitting there and passively getting rid of the heat,” says Huggins. “You’re better to put a person in a cold shower, or if you’re out in nature, put them in a cool river or stream — the colder the better.” (If you’re spending a lot of time outdoors, you might also want to bone up on your summer allergy treatment options.)
Keep in mind that a person who is experiencing heatstroke may not realize it. “By the time someone is experiencing heatstroke, the person already has an altered mental state and thus is not thinking clearly,” says Samuel H. Werner, DO. He is a board-certified family medicine physician. He’s also currently completing a residency in osteopathic neuromusculoskeletal medicine at the Edward Via College of Osteopathic Medicine in Blacksburg, Virginia. “The brain is one of the most heat-sensitive organs, which is why it is so critical to watch for signs of confusion, agitation and, of course, loss of consciousness or seizures.”
Cooling the person down is the first priority, but calling 911 should be a close second. If you can, have somebody else make the call while you begin cooling. Then keep cooling until emergency medical services or someone with more medical training arrives.
Some people with heatstroke may resist help or become combative. They could also be unconscious. After calling 911, do your best to help the person stay calm while you cool them as efficiently as possible.
When medical help arrives, they will continue to cool down the person, give IV fluids, check vital signs and transport the individual to the hospital after cooling is complete. At the hospital, they might also run blood and urine tests along with tests to check the individual's heart, liver and lung functions. If the patient is shivering and agitated, they might be given a benzodiazepine, which acts as a sedative. (Benzodiazapines include Xanax® and Ativan®.)
Heat exhaustion is another one to watch out for. It’s a sign of severe dehydration, and it can look a lot like heatstroke. “Heat exhaustion also manifests itself in disorientation, nausea and confusion, but you don’t have a core temperature of over 104.5 F,” explains Huggins. “It is unlikely that you will experience heat exhaustion at the same time as heatstroke, but know that it’s not a progression — you don’t go from heat exhaustion to heatstroke.” (Dehydration has other serious health implications. It might even cause anxiety.)
Heat exhaustion isn’t as life-threatening as heatstroke. But since you probably won’t know whether it’s heatstroke or heat exhaustion, you should treat any heat-related confusion the same way: Cool the person down using the methods above, and make sure the individual is drinking cool water.
Prevention is the best way to limit damage. The first step? Keep drinking water while you’re in the sun. “The old saying, ‘If you feel thirsty, you're already dehydrated’ is a good motto to live by during the summer,” says Dr. Werner.
If you’re working out in the heat, do so with a buddy who can catch signs of overheating. Try to acclimate to the higher temperature: Don’t run a race in 90-degree weather if you haven’t already done some training at that temperature, for instance. And wear loose-fitting clothing, which helps your body shed heat.
Remember: It’s okay to take it easy as the temperature rises. The important thing is that you stay safe.
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Additional sources
Risk factors for Heat Stroke: National Institute on Aging
Heat-related deaths in the United States: Centers for Disease Control and Prevention
Medical treatment for heatstroke: StatPearls Publishing
The threshold for cell damage: Prehospital Emergency Care (2018). “Consensus Statement- Prehospital Care of Exertional Heat Stroke.”