As summer temperatures rise, keeping your cool becomes essential


July 27, 1993|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Contributing Writer

It's not only our lawns that suffer during the summer heat. Each year in the United States, some 4,000 heat-related deaths are reported.

As it is possible that we'll experience another heat wave before summer's end, I asked Julius G. K. Goepp, M.D., assistant director of the Pediatric Emergency Department at the Johns Hopkins Hospital, for his advice about coping with the heat.

Q: What happens to our bodies when it gets very hot?

When the temperature outside is cooler than our body temperature, heat is drawn naturally from the body to the cooler air around it. When outside temperatures are greater than our body temperature, our body heat is dissipated through perspiration. What made the recent heat wave so uncomfortable was the extremely high humidity, which prevented us from cooling through perspiration as efficiently as we normally do. When this happens, we are vulnerable to heat illness.

Q: What is heat illness?

A: There are three main kinds of heat illness.

Most common and least serious is heat cramps. We've all probably experienced these after running or some other strenuous activity in the heat. The cramps are caused by salt loss and excessive sweating.

Heat exhaustion is of greater concern. This is generally caused by dehydration or loss of water. Symptoms include thirst, headache, confusion or disorientation -- especially among the elderly -- and lethargy, which is typical in children.

Heat stroke is a medical emergency. It happens when all the body's mechanisms for reducing heat fail to work properly. Symptoms include hot dry skin, a very high fever and anything from headache/dizziness and confusion to seizures, convulsions and paralysis.

Q: Who is most at risk?

The very young and the very old are particularly vulnerable. People who work outside such as roofers and road workers and people with medical conditions such as cystic fibrosis or heart disease should also be careful in the heat.

Q: What can I do to help someone suffering from heat illness?

AA: Heat cramps can be eased by rest, cooling off, drinking plenty of fluids and eating salty food such as potato chips or pretzels.

If someone is suffering from heat exhaustion, the first thing to do is to get him or her into an air-conditioned room or at least into the shade, loosen the clothing and give lots of water and salty foods. Don't use ice, as this can cause the body temperature to rise even further from shivering. Gradual cooling is what you should aim for.

A victim of heat stroke needs medical treatment immediately. After dialing 911, make the individual as comfortable as possible.

Q: What can I do to prevent my family from suffering heat illness?

AA: Make sure your children drink plenty of fluids and try to keep them out of the worst heat of the day. If they are outside, try to provide some shade. Loose clothing helps to circulate air, and light colors reflect the heat. And never leave a child or a pet in a car without an open window. This is illegal in Maryland and for good reason -- they can rapidly be overcome by the heat.

Q: Should I give my family more salt?

BA: Make sure there are plenty of salt snacks availableThough it is important to watch how much salt and fat we eat, it is important to replace the salt we lose by excessive sweating. If you crave salty foods when it's really hot, the chances are your body is telling you it needs more salt.

Q: What is the best thing to drink?

BA: Water or diluted fruit juices. Sodas make you more thirsty, and the effects of alcohol are more pronounced if you are dehydrated.

Q: What about my baby -- should I give him more water?

Make sure your baby has plenty to drink, but don't give him plain water. Too much water lowers a baby's sodium level and can lead to seizures. Instead, offer Pedialyte or more formula. Never add salt to a baby's bottles, as too much salt can cause salt poisoning.

Q: What about the elderly?

If you know elderly people living alone, check on them once a day. If they seem at all confused or disoriented, the chances are they are suffering from heat illness.

Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Hygiene and Public Health.

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