Recently I ran a 7 miler race through the streets of downtown Baltimore on a hot and humid morning. During that race, I saw at least one person suffering from what appeared to be heat exhaustion. Luckily for that runner there was race support nearby and EMS on its way. Had there not been race support there to cool the runner down with bottles of water he may not have survived. Running is not the only outdoor summer activity that can result in heat exhaustion or heat stroke. Any outdoor event in this heat can lead to an emergency situation. It is important to know how to prevent such heat-related injury from happening but it’s also imperative to know what to do should someone suffer from heat exhaustion or heat stroke because if not properly treated death can occur.
What is Heat Exhaustion?
Heat Exhaustion usually develops after several days of exposure to high temperatures and inadequate intake of fluids. The elderly and people with high blood pressure are prone to heat exhaustion as well as people working or exercising in the heat. Heat exhaustion symptoms include heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea, vomiting, and/or fainting. With heat exhaustion, a person’s skin may feel cool and moist. Cooling off is the main treatment for heat exhaustion. Drinking cool, non-alcoholic liquids may help as well as taking a cool shower, bath, or sponge bath. Getting into an air-conditioned environment will also help. If the conditions worsen or have not subsided within an hour, seek medical attention. If heat exhaustion is not treated, it may lead to heatstroke which needs immediate emergency medical attention. Call 9-1-1.
What is Heat Stroke?
Heat Stroke is the most severe of the heat-related problems. Like heat exhaustion, it often results from exercise or heavy work in hot environments combined with inadequate fluid intake. Children, older adults, obese people, and people who do not sweat properly are at high risk of heatstroke. Other factors that increase the risk of heat stroke include dehydration, alcohol use, cardiovascular disease and certain medications. Heatstroke is life threatening because the body loses its ability to deal with heat stress. It can’t sweat or control the body’s temperature. Symptoms of heatstroke include rapid heartbeat, rapid and shallow breathing, elevated or lowered blood pressure, lack of sweating, irritability, confusion or unconsciousness, feeling dizzy or lightheaded, headache, nausea, and/or fainting. If you suspect heatstroke, call 9-1-1 immediately. Then try to move the person out of the sun and into a shady or air-conditioned space. Cool the person down by spraying them with cool water or wrapping them in cool damp sheets. Fan the person, and if possible, get the person to drink cool water.
Tips for Prevention
An article on the Active.com website highlights 10 tips to prevent a heat-related injuries:
1. Acclimatize – It takes your body time to adjust hot and humid weather. Just because you can run a 10-miler at an 8-minute pace, doesn’t mean you can do the same when the dog days of summer approach. The same goes for any outdoor exercise! The American Running and Fitness Association recommends that on your first run in the heat, you should cut your intensity by 65 to 75 percent. Then over the next 10 days, slowly build back to your previous level.
2. Check the Index – Before you leave the comfort of your air conditioner, check the heat index and air quality index. The Air Quality Index (AQI) is an index for reporting daily air quality. It tells you how clean or polluted your air is, and what associated health effects might be a concern for you. The Heat Index tells you what the temperature feels like when combining the air temperature and the relative humidity. Both indexes should be checked before heading outdoors. Your health depends on it!
3. Hydrate! Hydrate! Hydrate! – Always remember to rehydrate after outdoor exercise! But it’s even more important to be well-hydrated BEFORE you exercise or spend time outdoors. Hydration during your run depends on the temperature and the length of your run. Don’t wait until you feel thirsty to drink. If you’re thirsty, that means you’re already low on fluids. Also, as you age, your thirst mechanism isn’t as efficient and your body may in the early stages of dehydration and you may not even feel thirsty. After 60 minutes of outdoor exercise, you will need to start using a sports drink or supplementing with a sports gel or a salty food such as pretzels. After 60 minutes, you begin to deplete vital electrolytes (i.e., sodium, potassium, etc.). Sodium is needed in order for your body to absorb the fluids you are ingesting and depleted potassium levels can increase your chances of experiencing muscle cramps. Also, packing an extra bottle of water during outdoor exercise to pour over your head can help increase the evaporation-cooling effect. Lastly, when you finished exercising, you need to replace the water you’ve lost.
4. Know the Warning Signs – Dehydration occurs when your body loses too much fluid. This can happen when you stop drinking water or lose large amounts of fluid through diarrhea, vomiting, sweating, or exercise. Not drinking enough fluids can cause muscle cramps. When you’re dehydrated, you may feel faint, experience nausea and/or vomiting, have heart palpitations, and/or experience lightheadedness. Runners also need to be aware of the signs of severe dehydration such as heat exhaustion and heatstroke, not only for yourself, but so you’ll be able to identify the symptoms if a fellow runner is experiencing heat-related problems.
5. Buddy-Up – In the severe heat, be sure to work-out with a buddy. That way you can keep tabs on each other. Sometimes it’s hard to tell if you’re starting to suffer the effects of the heat, but a buddy may be able to spot the signs before its too late. Plus, working out is always more fun with someone else!
6. Work-Out Early – If at all possible, get your work outs done in the early morning. The hottest part of the day is typically around 5p.m. So, if you can’t work-out until after work, wait until later in the evening.
7. Go Technical – Wearing light-colored tops and shorts made of technical fabrics will keep you cool and allow moisture to evaporate more quickly. Staying dry will also help prevent chafing. Clothing made of Lycra, Nylon, CoolMax and Dry-Fit are some examples of technical fabrics. Be sure to hang dry your technical fabric clothes. The fabric softener in dryer sheets can actually block up the fabric decreasing its moisture0wicking abilities.
8. Change Your Route – If your normal running route or work-out spot is treeless, find one that provides more shade. If this isn’t possible and you have access to a treadmill or gym, head indoors on really hot days.
9. Lather It On – Be sure to wear sunscreen!! Use a sports sunscreen that is waterproof with an SPF of 15 or higher. Also, be sure to wear a hat or visor. This will help keep the sun out of your eyes as well as the sweat out of your eyes.
10. Have a Plan – Let your family and friends know your running route or work-out location. If you’re gone too long, they will know where to look for you. If you are in a rural area or doing a trail work-out, you may even want to pack your cell phone. Don’t change your plans at the last minute without letting someone know. It’s better to be safe then sorry!
For additional information on heat related injury and illness, see the National Weather Services heat advisory information page – Heat Kills