• Ronnie Shalev, MD

Summer Safety: Preventing Heat Exhaustion

Working in the ER over the summer months in Texas, I see many patients with some variant of heat exhaustion.

Most people associate heat exhaustion with young people working or exercising in the sun, heat, or unventilated areas.

However, I frequently see it with the elderly who get overheated in their houses or at a family picnic . Our body's cooling system is designed for us to sweat, which dissipates the heat and cools us. In heat exhaustion, despite profuse sweating, the body cannot compensate for the heat generated and starts to break down.

People with heat exhaustion come to the ER with a variety of complaints, including weakness, headaches, dizziness, muscle cramping, and nausea.

Oftentimes, heat exhaustion can progress to heat stroke which is a life threatening condition where the body's cooling system fails, causing the body temperature to spiral out of control.

Temperatures have been known to reach 107F. This is dangerous and can kill you!

While exercising, always try to prevent heat exhaustion by taking several actions:

1) Wear loose-fitting, lightweight clothing

2) Avoid getting sunburned

3) Seek shade or a cool environment

4) If you are feeling dizzy or weak, take a short break

5) Hydrate! Hydrate! Hydrate! Drink plenty of fluids (water, gatorade)

How much should I drink?

A general recommendation for those doing moderate- to high-intensity exercise is to drink 17 to 20 oz of fluid two hours before exercise. Consider adding another 8 oz of water or sports drink right before exercise. During exercise, you should consume another 7 to 10 oz of water every 20 minutes, even if you don't feel thirsty. Also, drink another 8 oz within a half hour after exercise. So the old recommendation of 8 glasses of water a day does not apply in the summer or when working in the heat!

An easy way to remember is to drink half of your body weight in ounces of water. For example, if you weigh 150 lbs, then consider drinking at least 75 oz of water a day.

If you start feeling dizzy, confused, nauseated, or even pass out, immediately start cooling measures such as a cool shower, cool towels, fans, or air conditioning.

Heat exhaustion is strongly related to the heat index, a measurement of how hot you feel relative to the humidity and air temperature. A relative humidity of 60% or more hinders sweat evaporation, which obstructs your body's ability to cool itself. The risk of heat-related illness dramatically increases when the heat index climbs, which is common in Texas! Pay attention to the heat index, and remember that the heat index is even higher when you are standing in full sunshine.

Stay safe this summer and stay hydrated and cool!

-Dr. Ronnie Shalev is a board certified emergency medicine physician and is the Chief Medical Officer of MediBookr