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Heat Disorders

Heat disorders are a group of illnesses caused
by prolonged exposure to hot temperatures,
restricted fluid intake, or failure of the body's
ability to regulate its temperature.
The general term used for heat disorders
is hyperthermia. The three most common forms of
hyperthermia are heat cramps, heat exhaustion,
and heat stroke.

Hyperthermia can cause harm to people of all
ages. But its effects are more serious
with increasing age.

The human body functions normally only within a very narrow range of temperatures close to 98.6°F (37°C). If the body gets much warmer or much colder than 98.6°F, health problems develop. Raising or lowering the body temperature by only a few degrees can cause death in a short period of time.

One method the body uses to cool down is perspiring (sweating). Perspiration is the loss of water from the skin. Body heat provides the energy needed to evaporate water from the skin. The more a person perspires, the cooler the body becomes.

However, excessive perspiration can cause problems. The body may lose too much water. It may become dehydrated. Dehydration can cause a variety of medical problems.

Heat Cramps
Heat cramps are the least serious form of hyperthermia. They are the first sign that the body is having difficulty with increased temperature. Heat cramps are a warning sign that more serious problems may soon develop.

Heat Exhaustion
Heat exhaustion is more serious than heat cramps. The condition may be caused when a person is exposed to high temperatures for a long period of time. Or the body may become dehydrated, or its temperature regulation system may begin to fail. Heat exhaustion is a common problem among athletes, firefighters, construction and factory workers, and anyone who wears heavy clothing in hot weather.

Heat Stroke
Heat stroke is the most serious form of hyperthermia. The condition can cause death in a short period of time. Heat stroke often results in death. The conditions that lead to heat stroke are the same as those that cause heat exhaustion. However, those conditions cause more serious symptoms in the case of heat stroke.

Causes
The primary cause of all types of hyperthermia is prolonged exposure to hot temperatures, restricted fluid intake, or failure of the body's ability to regulate its temperature. The three forms of hyperthermia are caused by progressively greater exposure to heat.

Symptoms
Symptoms for the different types of hyperthermia vary. The longer one is exposed to heat, the more serious the symptoms of hyperthermia become.

Heat Cramps
At relatively warm temperatures, the body begins to perspire. Perspiration results in the loss of water. The body slowly becomes dehydrated. Dehydration leads to heat cramps.
As heat cramps develop, muscle tissue becomes less flexible. It becomes more difficult and more painful to move. Muscles in the legs are most frequently affected. A person may find it difficult to walk or maintain his or her balance. Young children, the elderly, and people with circulation problems are more likely to be affected by heat cramps.

Heat Exhaustion
After hours in a hot environment, perspiration increases and body temperature rises. The skin may appear cool, moist, and pale. Other symptoms of heat exhaustion include headache, nausea, exhaustion, and a general sense of weakness. Before long, dizziness, wooziness, and mental confusion develop.

Breathing becomes rapid and shallow. The urine of a person with heat exhaustion is likely to be dark yellow or orange.

Heat Stroke
Under the most extreme conditions, the body's temperature regulation system may begin to fail. The brain is no longer able to send messages to the rest of the body telling it how to cool off. Heat stroke may occur after the body temperature has reached 104°F (40°C). At this point, the patient may become mentally confused and aggressive. He or she may begin to stagger and feel weak.

During heat stroke, a patient's pulse rate may reach 160 to 180 beats per minute. The skin appears to be dry and flushed. There is very little perspiration. At this point, the patient needs immediate medical attention. Without care, he or she may die in a matter of hours.

Diagnosis
Most cases of hyperthermia can be diagnosed easily. The two key factors are the patient's visible symptoms and recent personal history. Testing the person's temperature, heart rate, and other vital factors may confirm the diagnosis quickly.

Blood and urine tests can also be used to confirm a diagnosis of hyperthermia. In any form of hyperthermia, the imbalance of chemicals in blood and urine occur. Laboratory tests can detect these changes and confirm the presence of hyperthermia.

Treatment
The first steps in treating any form of hyperthermia include:

Moving the patient to a cooler location.
Providing the patient with cool water.
Giving the patient liquids that contain electrolytes.

Electrolytes are chemicals that occur naturally in the body and that maintain the proper balance of fluids in the body. The usual liquids given to the patient are salt water that contains a low concentration of salt or a sports drink.

The patient should not be given salt tablets. The concentration of salt in tablets is too high for the body to absorb. Salt tablets can make a case of hyperthermia more serious, rather than improving it.
The above steps are often sufficient to treat most cases of heat cramps and heat exhaustion. Massage of leg muscles can also offer relief from the pain and soreness of heat cramps. Patients with heat exhaustion should be made to lie down with their feet elevated.

Cases of heat stroke require emergency treatment by trained medical personnel. While waiting for this help, some first aid measures can be taken. Ice packs should be placed around the neck, under the arms and knees, and in the groin. Medical treatment may involve intravenous feeding of fluids and electrolytes. Bed rest is often necessary for many days.

Prognosis
Prompt treatment of heat cramps and heat exhaustion is usually successful. Patients recover in a matter of hours or, at most, a day or two. Heat stroke poses more serious problems. Prognosis depends on the patient's age and general health. In the most serious cases, heat stroke can lead to permanent damage to internal organs, and even death.

Prevention
The general rules for avoiding any form of hyperthermia are the same. One should avoid strenuous exercise when it is very hot. Wearing light, loose-fitting clothing can also help. An important factor in preventing hyperthermia is consumption of sufficient amounts of liquids. The warmer it becomes and the more active a person is, the greater the body's need for liquids. Caffeine and alcohol should be avoided in hot conditions because they can contribute to dehydration, increasing the risk of hyperthermia. Eating lightly salted foods can also help replace electrolytes lost during perspiration.