Dangerous heat Exercise common sense, not yourself

Kat Bergeron

Jul. 31, 2008 (McClatchy-Tribune Regional News delivered by Newstex) -- With South Mississippi's high heat and humidity, men, women and children can tax their bodies, sometimes unaware that they tempt hyperthermia -- dehydration, cramps, heat exhaustion and, worst of all, a potentially deadly heat stroke.

The U.S. Centers for Disease Control report about 600 hyperthermia deaths a year, and thousands of emergencies. About 36 of the deaths are from infants left in cars, sometimes by a custodian who simply didn't remember a child was still in the back.

Such losses or near-losses, which have happened on the Coast in recent times, are tragic but hyperthermia is not just a fear for the very young and unattended. Anyone, even those in top physical shape, who experiences our ongoing extreme summer temperatures is susceptible.

Road construction workers sweat in the broiling sun. Senior citizens, to save money, cut back on air conditioning. Warehouse workers load and unload with inadequate ventilation. The military parade in full uniform. Out-of-shape gardeners finish a project, no matter what. Athletes hone endurance.

"The biggest mistake people make is not drinking enough fluids and not taking enough rest breaks in the heat of the day," said Charles Wise, a 16-year paramedic and education specialist with American Medical Response, which serves 13 Mississippi counties.

"Know the signs of the different degrees of hyperthermia, that's the main thing, so that you can recognize them in yourself or someone else."

Those signs, Wise says, begin with heat cramps, often abdominal, from the loss of body salts and electrolytes. Heat exhaustion is next, and signs can include muscle cramps, general weakness, faintness, rapid or shallow breathing and possible loss of consciousness.

"People don't realize it but working outside in the heat, you can lose a liter of perspiration in an hour," Wise said.

Heat stroke, a 911 emergency, is when a person's built-in temperature regulation system fails.

For the thousands working in post-Katrina construction, Wise advises changing work schedules to mornings and evenings, continued hydration with water and sports drinks and breaks.

The same advice applies to students at band, cheerleading and football practice. So far, this summer has caused no young athlete deaths, but last year two Covington County athletes died when heat likely aggravated pre-existing conditions. The Mississippi High School Activities Association quickly sent out school heat guidelines, and is doing so again this year.

The important point, says MHSAA Executive Director Ennis Proctor, is to know student fitness levels. Schools must be aware of the influences of heat on body mass, hydration, as well as temperature, timing of meals, humidity and heat index.

"I think our coaches, band directors, athletic directors and principals are better educated," said Proctor. "It used to be when I was playing years ago we had to be a tough guy and never went to get water. That has changed."

What to look for and do

Two stages of hyperthermia:

--Heat exhaustion symptoms can include headache, light-headedness, nausea, vomiting and irritability. Can be heavy sweating with cool, clammy, sometimes pale skin. Dizziness. Weak pulse and rapid but shallow breathing. Cramping, particularly abdominal. Body temperature is normal.

--Heat stroke symptoms can include hot, dry, sometimes red or mottled skin, deep breathing followed by shallow breathing and large, dilated pupils. Fit people may sweat profusely; others stop sweating. High body temperature and possible loss of consciousness. Can cause death or brain damage.

What to do when things go wrong:

--For heat exhaustion move person to cooler place, lie down and elevate feet 8 to 12 inches. Loosen clothing and fan victim without chilling him. If alert, give sips of water. Call 911 to summon ambulance. Complete recovery usually takes several hours.

--For heat stroke call 911. Remove victim from source of heat and cool him immediately. Apply cool wet cloths over the body, then remove them. Fan vigorously. Can give cool but not cold bath. Don't cool to shivering point. Place ice packs under armpits, on wrists and ankles, groin area and each side of neck. Do not give anything by mouth unless fully alert.

AMERICAN MEDICAL RESPONSE

How to safely face the heat

--Start drinking water before you begin any strenuous efforts. Don't wait until you are thirsty.

--Drink lots of nonalcoholic, non-caffeinated liquids continuously.

--If you have no salt restrictions in diet, mix one teaspoon of salt in each quart of water you drink.

--Avoid strenuous activity if possible.

--Work outside or in unventilated, warm buildings in cooler morning and evening hours.

--Wear loose-fitting, light-colored clothing made of fabric that breathes, such as cotton.

--Wear a broadbrimmed, loose weave hat and take it off from time to time.

--In heat waves, frequently check on the elderly or disabled.

RICK FAYARD,

AMERICAN MEDICAL RESPONSE

School recommendations

The Mississippi High School Activities Association has sent to schools the recommendations of the National Federation of High School Association for avoiding heat-related problems.

Here are the highlights. For a more in-depth look at NFHS guidelines, go to sunherald.com

1. Each athlete should have a physical examination with a medical history when first entering a program and an annual health history update.

2. Coaches should know the physical condition of their athletes and set practice schedules accordingly.

3. Acclimatization to heat is important. It is the process of becoming adjusted to heat.

4. The most important safeguard to the health of the athlete is the replacement of water. Water must be on the field and readily available.

5. Replacement by thirst alone is inadequate. Test the air prior to practice or game using a wet bulb, globe, temperature index.

6. An alternative method for assessing heat and humidity is the weather guide or heat index.

7. Cooling by evaporation is proportional to the area of the skin exposed.

8. Athletes should weigh each day before and after practice and weight charts should be checked. Generally a 3 percent weight loss through sweating is safe.

9. Observe athletes carefully for signs of trouble, particularly athletes who lose significant weight and the eager athlete who constantly competes at his/her capacity.

10. Teams that encounter hot weather during the season through travel or following an unseasonably cool period should be physically fit but will not be environmentally fit.

11. Know what to do in case of an emergency and have your emergency plans written with copies to all your staff.

12. Warn your athletes about the use of any products that contain ephedra.

- NATIONAL FEDERATION OF HIGH SCHOOL ASSOCIATIONS

Heat and cars

--Never leave a child, pet or disabled or elderly person in unattended car. In 10 minutes the ambient temperature of the car can raise 19 degrees. In 30 minutes, 34 degrees.

--Vehicle heating dynamics include the fact that windows and atmosphere are relatively transparent to the sun's shortwave radiation and are barely warmed by it. However, shortwave energy warms objects it strikes. A dark dash board or seat can raise temperatures in excess of 180 degrees.

--Heat stroke occurs when the body core temperature reaches 104 degrees.

--A child's body warms 3 to 5 times faster than an adult's.

--To remember a baby in the back seat, place your purse or briefcase in the back seat, or keep a stuffed animal in the car seat. When child is put in the seat, put animal in the front seat to remind you.

--Teach your children that vehicles are never to be used as a play area. 30 percent of child vehicle hyperthermia deaths are caused by child playing in unattended car.

--At least 18 U.S. children have died because of heat buildup in cars in 2008.

- DEPARTMENT OF GEOSCIENCES, SAN FRANCISCO STATE UNIVERSITY

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