During the hottest days of summer the terms “heat stroke,” “heat exhaustion,” “sunstroke,” “heat cramps,” and others are often used interchangeably in an attempt to describe our bodies’ responses to extreme heat. But did you know that each of those terms describes a different medical condition? And each has its own set of symptoms requiring different First Aid responses? Here’s a guide to help you identify different types of heat stress and how to respond.

Jeff Meckling, PA-C
Jeff Meckling, PA-C

Those particularly susceptible to heat stress are:

  • infants and young children
  • elderly people
  • individuals with heart or circulatory problems or other long-term illness
  • people who work outdoors
  • athletes and people who like to exercise–especially beginners
  • individuals taking medications that alter sweat production
  • people with substance use disorders.

Heat Stroke

This is the most serious of the heat-related disorders. It occurs when the body is unable to regulate its own temperature and requires an emergency response.

With heatstroke, a person’s body temperature can shoot up to 106 degrees Fahrenheit within the space of 10 to 15 minutes, and can result in death or permanent disability without emergency treatment.

Symptoms of heatstroke include:

  • hot, dry skin that may be red, blue(ish), or mottled in appearance
  • hallucinations
  • chills
  • throbbing headache
  • racing pulse
  • high body temperature (103 degrees or higher)
  • confusion/dizziness
  • slurred speech
  • seizures.

First Aid steps for heat stroke should include:

  •  Call 911 immediately.
  • Move the person to a cool, shaded, or air-conditioned area.
  • Cool the person by whatever means available. Soak their clothes with water, spray, sponge, or shower them with water and fan their body.
  • Put cold compresses or ice packs under the victim’s armpits and on the neck and groin.

Heat exhaustion

This occurs due to an excessive loss of the body’s water and salt, usually through heavy sweating. People most prone to heat exhaustion are those who are elderly, have high blood pressure, or work in a hot environment.

Symptoms of heat exhaustion include:

  • Heavy sweating
  • Extreme weakness or fatigue
  • Dizziness, confusion
  • Nausea
  • Clammy, moist skin
  • Pale or flushed complexion
  • Muscle cramps
  • Slightly elevated body temperature
  • Fast and shallow breathing

First Aid steps for heat exhaustion:

  • Rest in a cool, shaded or air-conditioned area.
  • Drink plenty of water or other cool, nonalcoholic beverages.
  • Take a cool shower, bath, or sponge bath.

Heat cramps

Heat cramps usually affect people who sweat a lot during strenuous activity, depleting their body’s salt and moisture levels. Low salt levels in muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion.

Symptoms of heat cramps include muscle pain or spasms, usually in the abdomen, arms, or legs.

First Aid for heat cramps:

  • Stop all activity, and sit in a cool place.
  • Drink clear juice or a sports beverage.
  • Refrain from strenuous work for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke.
  • Seek medical attention if any of the following apply:
  • The person has heart problems.
  • The person is on a low-sodium diet.
  • The cramps do not subside within one hour.

Heat rash

This is a skin irritation caused by excessive sweating during hot, humid weather. Symptoms of heat rash include:

  • A red cluster of pimples or small blisters.
  • Heat rash is more likely to occur on the neck and upper chest, in the groin, under the breasts, and in elbow creases.

Anyone experiencing heat rash should:

  • Try to get into a cooler, less humid environment.
  • Keep the affected area dry.
  • Use dusting powder increase comfort.

With all heat-related illnesses, prevention is always the best approach. Steps to protect yourself from heat stress include:

  • Schedule jobs like yard work and home repairs for the cooler part of the day.
  • Slowly get used to the heat by increasing your exposure gradually over a period of a few weeks.
  • Hydrate! Drink a lot more water than you think you need, and don’t wait until you are thirsty to start. Caffeinated, alcoholic, and sugary beverages have a dehydrating effect on the body, so don’t count them as part of your daily fluid intake.
  • Build plenty of rest and water breaks into your outdoor activities.
  • Wear light-colored, loose-fitting, breathable clothing such as cotton. Avoid non-breathing synthetic clothing.

Be a good friend and neighbor to anyone you know who may be particularly susceptible to heat stress. Elderly people with heart, circulatory, and pulmonary issues who live alone and without air conditioning are vulnerable to heat stress in the warmer months.

Many older people take diuretics, which cause them to dehydrate more quickly in hot weather. You can help by making frequent visits to elderly neighbors and family members. Make sure that they have access to fans, and lots of water to drink.

Children are often out having a great time in the summer playing and swimming.  But they may resist taking breaks to hydrate and re-apply sunscreen. Even if they are spending the day in a pool or lake, children can become dehydrated without even knowing it. Have them take rest periods in the shade. Insist they drink plenty of water – not just fruit juice or soda.

Summer is a great time to be active outdoors. And with your new awareness of how to prevent, recognize, and respond to heat stress we encourage you to make the most of the season!

Jeff Meckling PA-C is a certified physician assistant at Brattleboro Family Medicine, a Department of Brattleboro Memorial Hospital. He can be reached at 802- 251-8455.