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Surviving a
Heat Stroke

Dr. Mehtab Ghazi Rahman

The Bangladeshi summer has been much harsher than usual this year, bringing with it plenty of electricity cuts, water shortages and health problems. The papers are filled with news of heat waves and the discomfort and illnesses it has brought to the population all over the country, both rich and poor. Extreme heat can tire us out badly, and it is essential that we look after ourselves carefully during this time. One of the commonest health problems during hot summers is hyperpyrexia, more commonly known as a 'heat stroke'. This article will discuss the ways to diagnose a heat stroke, how we can prevent it and what we should do when someone becomes unconscious following a heat stroke.

First things first, it is essential that you understand that a heat stroke is extremely serious. A heat stroke is a medical EMERGENCY, and a person who has suffered a heat stroke must be treated urgently.

What is a heat stroke?
A heat stroke is an emergency medical condition that occurrs when the body's temperature becomes too high. This causes a person to have a number of physical and neurological symptoms, eventually leading to uncon

sciousness. A heat stroke is caused by extremely high temperatures (during the summer) during which the body may become overheated. Dehydration can also cause a heat stroke as not drinking sufficient water means a person will not produce enough sweat to cool the body when the body's temperature is elevated.

Is a heat stroke dangerous?
Yes! A heat stroke is a medical emergency. This is because a very high body temperature will cause a lot of harm to your body's organs and cells, and if the body temperature goes above 40 degrees, it will cause irreversible brain damage.

Who is at risk of a 'heat stroke'?
Infants, children, sportsmen and women (who practice outdoors for long hours during the day; this also includes teenagers who participate in outdoor activities during mid-day at school/college) and the elderly (especially those who suffer from heart, lung or kidney disease) are at increased risk of suffering from a heat stroke.

How do I know if I am getting a heat stroke?
If you have spent a significant amount of time under the sun or in a warm area, and you find that your skin is becoming red, your cheeks are burning, your body feels hot to the touch, you find it difficult to breathe and your heart is racing, you could very well be in the first stages of getting a heat stroke and must immediately get back indoors and lie down in a cool shaded area as soon as possible. People who are developing a heat stroke commonly complain about feeling nauseous, a bad headache and dizziness. These symptoms tire the person out and they find it difficult to remain standing. The muscles of the body start aching and one gets muscle cramps. As the temperature of the body continues to increase, the person will start having neurological symptoms, such as confusion, disorientation and starting to behave strangely. If not treated immediately, the person can lose consciousness, have convulsions, and even go into a coma! Unresponsiveness and convulsions are a bad sign as these symptoms suggest that the heat has started affecting the person's brain.

What can I do to help a person who is having a heat stroke?
If you suspect that a person is having a heat stroke, you must help the person immediately to prevent his/her condition getting worse and to prevent organ damage. The very first thing you should do is to cool the person. First, take the person indoors or under a cool, shaded area immediately. Quickly loosen the person's clothing to let the heat out and start applying cool water over the person's body. If you are outdoors, you can spray the person's body with a water pipe at low speed. Start fanning the person to evaporate the water away; this will help the body cool down as the water will take a lot of heat away from the body as it evaporates. Put ice cubes underneath the armpits and in the groin. If you have a thermometer at hand, regularly measure the body temperature. You need to continue to follow the above steps until the affected person's body temperature has come down to normal (37.5 degree Celsius). Make sure you ask somebody to call a doctor while you are looking after the affected individual.

Note : A common mistake when treating a person suffering from a heat stroke is immersing the person's body under ice cold water. This is dangerous! This is because if you immerse a person under ice cold water, it causes the person's blood vessels to constrict and slows down the rate at which the heat is lost from the body. As mentioned above, the best way to treat a heat stroke is by wetting the affected person's body with cool water and then fanning the person until the temperature comes back to normal.

What if I carry out all the aforementioned steps but the person still does not improve?
The best thing to do is to take the person to the nearest Emergency department at a good hospital. The doctors at the hospital will give the patient some medications to reduce the body temperature and cold saline to cool the person's body to normal temperatures.

How can I prevent a heat stroke from affecting me?
Prevention is always better than cure and hence it is always wise to follow a few simple steps that will ensure that you do not get a heat stroke. First, drink plenty of water throughout the day (>10 glasses on a hot day; you may substitute water with lemonade or other soft drinks). Avoid working directly under the sun for long hours. If you are an outdoors person or a keen sportsman, it is best to limit your exposure to the sun for not more than 20 minutes at a stretch. Avoid drinks that contain caffeine (e.g., coffee and tea) and alcohol, as these cause dehydration even though they are liquids. You also lose a lot of salt and electrolytes with your sweat, so drinking lemonade with sugar and salt is a good replacement for the lost solutes. Wear clothes that are loose (to help with air circulation inside your clothes), lightweight (to keep you comfortable during sticky, humid days) and are light coloured (to help reflect sunlight away, thus keeping you cool). Finally, locate the nearest water dispenser at your office so that you can refill yourself regularly, or take a water flask with you to work. Please make sure that the water you drink has been purified appropriately as unpurified water can give you diarrhoea and other water borne diseases.

Summer is a time for long holidays, afternoon siestas and eating plenty of nutritious, sweet fruits. So make sure you get the best out of the summer by looking after your own health, and keep those nasty heat strokes, sun burns and other summer health problems at bay by restricting your exposure to sun for short periods. Drink plenty of water to keep yourself hydrated. Summer is the time to have fun, so go ahead and enjoy yourself… just don't forget to take your water bottle with you!

Dr. Mehtab Ghazi Rahman is a doctor currently working for the National Health Service of the United Kingdom. He is a Graduate of Medicine & Surgery (MBBS) and Human Bio-Medical Sciences BSc(Hons)* from the University of London.

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