It’s officially Summer, and “The Great Outdoors” is calling! Now is the time when thousands of people regularly flock to beaches, pools and parks for fun in the sun, alternately soaking up rays and splashing in the water to make the most of their long vacation days. When it comes to safety, however, sunburn and bug bites aren’t the only worries to be had. Heat, humidity, and increased activity can cause heat illness, which can often go unrecognized, particularly in children and the elderly.

There are three major types of heat illness, each leading to the next (sometimes quickly). Here are some ways recognize and treat heat illness, along with some prevention tips so more time can be spent having fun instead of worrying.

Signs and Symptoms

The first stage of heat illness begins when a person becomes dehydrated from sweating. Called heat cramps, they are similar to charley horses, and affect the legs and abdomen, first. People may be seen limping, leaning over to hold their sides, or having difficulty swimming. They may breathe heavily despite not moving very much.

Heat Illness Cramp

The second stage, heat exhaustion, causes increased sweating, weakness, headache, nausea/vomiting and dizziness. A person’s skin may feel cold, despite a possible fever of around 102 degrees Fahrenheit. Pale skin, red circles on the cheeks, and complaints of fatigue are physical signs for parents to keep a watch for in children. Crankiness and passing out can happen with both children and adults.

The third and most serious stage of heat illness is heat stroke, which requires immediate medical attention. While there are two types of heat stroke (extertional and classic), exertional is more likely with outdoor activity, and can happen within one to two hours. In addition to the symptoms of heat exhaustion, a person will be clumsy, have trouble making simple decisions, and may have a personality change (anger, irritability, sudden crying). The body’s internal temperature can reach 104 to 106 degrees Fahrenheit, which begins to damage the brain and internal organs. This can cause seizures or a coma, and even death without prompt treatment.


Treatment Options

Any of the above symptoms is a sign to get to a shaded area and have an energy drink to replace electrolytes. The Army Study Guide recommends one quart (32 ounces), sipped slowly. Gently massage muscles to help ease the pain of heat cramps. It is recommended to stay indoors (or in the shade with moving air and available cold beverages) and rest for at least 12 hours to recover.

Heat Illness

In addition to hydration, seek cooler air and/or air conditioning and remove excess clothing to help heat exhaustion. Apply cold towels to the neck and forehead, splash cold water onto legs and arms, and fan air onto the skin to help draw heat out via evaporation. A trip to the hospital may be necessary. When a person has heat exhaustion, they are more likely to get it again within a week, so being outdoors for prolonged periods should be avoided. It can take up to 48 hours to fully recover.

A person with exertional heat stroke should be put into a cold shower or ice bath with circulating water, if available, to help rapidly cool the body while waiting for an ambulance to arrive. If neither is available, douse the body in cold water while fanning. Do not attempt to “wait it out” – immediately call 9-1-1.


Prevention

Drink 20 ounces of water two to three hours before outdoor activity, and drink another 8 to 16 ounces every active hour. Wear UVA/UVB sunscreen with an SPF of at least 30, light, loose clothing and a wide-brimmed hat. Any break in activity should be in the shade, and sports drinks or juice should be kept on hand to keep electrolytes balanced. The CDC has a great page with more details.

Heat Illness

Let kids know that it’s important to tell a trusted adult when they don’t feel well while playing outside. Children should never play outside without being monitored, and babies shouldn’t be out in the sun for long due to lowered ability to sweat. Do not leave children in the car.

With careful prevention, fast recognition and timely treatment, dealing with heat illness this Summer should be no sweat!


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