Oh my, I didn't see this post, but I really need to reply to some of the
statements made!! Some are very much in error!!!
1) There exist 3 basic heat related syndromes (for lay purposes), which
consist of : heat cramps, heat exhaustion, and heat stroke; listed in order
of increasing severity.
2) heat cramps are caused by electrolyte imbalances in muscles,
representing potassium and sodium shifts, following exertion. Although
called heat cramps, they often occur based on significant exertion, without
the presence of high ambient (outside) temperature or any elevation in body
temperature. Here rest of the affected muscle groups, along with fluid
replacement, in the form of a balanced electrolyte solution (not free salt..
see below for more info. as to why) is indicated.
3) heat exhaustion can occur with overexertion syndromes in non-elevated
ambient temperatures, as well as the more classically thought of higher
ambient temperature (especially if the humidity is high, as the sweat
(evaporative) mechanism can no longer function properly). Symptoms are
cardiac, neurologic, and gastrointestinal, with neurologic often occurring
first, as the brain is very heat sensitive..
4) when you sweat, you lose far more free water than salt. When you measure
serum (blood) sodium/chloride levels in these patients (heat exhaustion)
they are often elevated. You do NOT want to add any additional salt to the
fluid intake. That is an old concept and is wrong! You want to treat with
immediate cessation of exercise, removal to a cooler environment (if high
ambient temperatures are present), controlled fluid intake (you don't want
to chug down a quart of water.. the colder water (colder relative to your
internal body temperature) going down the esophagus can precipitate atrial
fibrillation (an irregular heart rhythm)). We classically see this with fast
action sports (ie tennis), when the players sit down and drink a "cold"
beverage quickly. I have seen this in tennis, basketball, etc players in
their late teens, twenties, etc. Incidence goes up with increasing age.
5) If you are still sweating odds are you are experiencing exhaustion, BUT
your temperature elevation can still be dangerously high. There is
morbidity/mortality seen with heat exhaustion! Don't let anyone tell you
otherwise. You don't need to stop sweating (ie heat stroke) first to develop
a high core (internal) temperature resulting in significant brain/heart
injury and death.
6) The ONLY way to reliably check your body's temperature in a heat related
event, is by a RECTAL temperature. In exhaustion/stoke oral, axillary
(armpit), and tympanic (ear) temperatures are absolutely worthless, and can
be very dangerous if you rely on them to determine whether you may need
care!! That decision should be based on your symptoms!
7) Getting into a shower to cool down, even when using room temperature
water has resulted in heart attacks in a number of heat exhausted victims.
The mechanism is that elevated body temp. meets with cooler than body temp.
(notice I didn't say cold water) water, which results in significant
vasoconstriction of the skin, in a person who has been sweating up to that
point. This causes increased cardiac workload as systemic vascular
resistance (think of this as clamping down on hoses, and what this does to
the workload of pumps) stresses the heart. To make things worse the
vasoconstriction cuts down on the heat loss mechanism, shunting warm
(relatively hot in this case) blood away from the skin where it was being
dissipated, (if any shivering occurs it is far worse, as even more internal
heat is generated), and the internal core temperature rises even further
causing more, and often irreversible damage to the brain/heart, etc..
8) induced vasoconstriction is one way heat exhaustion - heat stroke! The
distinction between the 2 blurs as there is overlap between the 2 syndromes,
as far as brain/heart injury. etc goes
9) heat stroke is most commonly seen in elderly patients, well as in those
with other systemic disease processes, such as collagen vascular diseases,
certain endocrine diseases, diabetes, etc. It may occur without any
exertion, and in fact in the absence of any high ambient temperature, which
may (fatally) delay the diagnosis, if it is not thought of and confirmed by
checking rectal temperature. With heat stroke the body's sweat mechanism has
failed (patient no longer shows sweating if they were initially sweating (ie
heat exhaustion now progressing into heat stroke), although they may still
be wet from previous sweating, (which tends to fool quite a few medical
residents)) and core temperature rises dramatically, and often fatally. Even
if the patient survives, usually there is brain damage due to the core
temperature elevation. These patients often need significant volume (fluid)
replacement, but NONE ORALLY, they need it IV. They are prone to aspiration
if given oral fluids, as the stomach is atonic due to the elevated body
temperature.
10) In summary, if you develop ANY neurologic symptoms (dizziness,
significant headache, weakness, visual changes, etc), any cardiac symptoms
(palpitations, shortness of breath, or difficulty in breathing, chest
tightness, etc) or any gastrointestinal symptoms (vomiting), then you
should:
a) immediately stop what you are doing
b) get into a sheltered area
c) call 911, like the EMT suggested earlier in this thread.. (that was the
correct advice!)
d) while help is on the way, slowly drink plain water, avoiding all salt,
all caffeine containing and/or carbonated beverages, etc.
DO NOT WAIT TO CALL EMS while:
checking your temperature.
taking a shower or bath
waiting to see if rest/drinking replacement fluids will make you feel better
(many go lay down to "rest" for a bit and never wake up again)
WHY not wait a bit to see if you improve??.. if your temperature continues
to rise you can easily experience irreversible damage to your heart/brain
which can manifest it quite suddenly.
Common sense applies he
Now I am not saying if you are over exerting yourself on a hot day and you
get a little out of breath (because you are not in shape to begin with) you
need to immediately call 911. You need to use some common sense. What I am
saying is that you can't waste ANY time in the presence of
neurologic/cardiac symptoms, while you try "home remedies".
Remember that only 10 or 15 minutes of continued elevation of internal
temperature can make the difference between subsequent complete recovery and
significant neurologic damage.
The best Rx is prevention:
DO Drink supplemental fluids, predominately free water. If you do insist on
"balance electrolyte" solutions, as many athletes due, (usually for cramps,
or very low level exhaustion) we advise them, based on substantial data,
that it be no more than one part balanced electrolyte solution to 3 or 4
parts free water (it should never be free salt, as you need a balance which
includes potassium, to avoid fatal irregular heart rhythms, etc). so one
glass of "Gatorade" for every 3 or 4 glasses of free water may be
acceptable.
DO Drink small amounts frequently, avoiding large amounts at any one time.
DO Drink them room temperature if the day is hot/you've been
exerting/exercising yourself.
DO Avoid exertion in midday sun.
DO Avoid excessive exertion, especially without previous conditioning
(weekend warrior/athlete syndrome, classically in middle aged people, who
haven't kept in shape, but act like they have on weekends.. you know the
ones)
DO Pace yourself, the job will still be there tomorrow....
I want you to be here tomorrow, (so I can read more about your ponds)!
Greg
"mad" wrote in message
...
my sweetie is the best of men and i love him. but one night i was wheezing
my head off and he said, "why don't you go use your inhaler?" it was on
the
table next to his chair as he was sitting there. all he had to do was hand
it to me. sigh...
mad
--
Diaper backwards spells repaid. Think about it.
Marshall McLuhan
On 25 May 2003 19:08:29 GMT, ESPMER (K30a) wrote:
Ingrid wrote Men surrounded by women are pampered, women
surrounded by men are on their own.
I went to a conference once. Arranged for DH to pick up the kids from
school,
let's see I think we were 6, 6 and 2 at the time. Two year old was with
me.
Came home. Opened the door, could hear my DD wheezing from up the
stairs.
Dropped everything and put her on the nebulizer. DH was sitting two feet
from
her.
aaaaaarrrrrrrggggggggghhhhhhh!!!!!!
k30a
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