1. Preventing Heat Illness Carol Kennedy, RN, BSN, MS Health Promotion Lafene Health Center

2. Session Outline Hydration Hydration Perspiration (a.k.a. Sweat) Perspiration (a.k.a. Sweat) Dehydration Dehydration Heat Illness Heat Illness –Cramps –Exhaustion –Stroke Treatment of Illness Treatment of Illness Prevention Tips Prevention Tips

3. Hydration Consuming adequate amounts of fluids Consuming adequate amounts of fluids –adults 8-12 ozs. every hour during active periods. Water or sports drinks replace fluids lost through perspiration. Water or sports drinks replace fluids lost through perspiration. Drink more than you think you will need. Drink more than you think you will need. Cool drinks tend to be more palatable, may be easier to drink  ’d volume. Cool drinks tend to be more palatable, may be easier to drink  ’d volume. Urine check: Urine check: –Normal volume and pale yellow. –Normal frequency - at least once every four hours.

4. Sweat 4 The Importance of SWEAT 6Normal body function. 6Salt = sweat leftovers. 6Sweat facts: 62 - 4 million sweat glands (100 grams). 6Highest concentration - bottom of feet. 6Lowest concentration - back. 6Women have more sweat glands than men. 6Male sweat glands are more active. 6Men can become dehydrated more quickly.

5. Sweat = Perspiration 4 The SWEAT Process. 6Evaporation causes cooling of the skin. 6Blood is diverted to the skin surface. 6Circulating blood volume is reduced. 6Water and electrolytes (salts) are lost. 6Above 95° F the body relies on sweating to control internal body temperature. 6High humidity ”gums up” the sweating cooling system (sweat evaporation is affected).

6. Heat Illness Dehydration Cramps Cramps Exhaustion Exhaustion Stroke

7. Dehydration 4 Dehydration - loss exceeds replacement. 4 Thirst is not a reliable indicator of dehydration. 4 Evaporation cannot occur in high humidity. 4 Normal body cooling prevented  body temperature increases. 4 Decreased blood to the brain  pass out.

8. Dehydration Symptoms Dry Mouth Dry Mouth Thirst Thirst Irritability Irritability Headache Headache Seeming bored or Disinterested Seeming bored or Disinterested Dizziness Dizziness Cramps Cramps Excessive Fatigue Excessive Fatigue

9. Dehydration - Treatment Move to shaded or air conditioned area. Move to shaded or air conditioned area. Give fluids to drink. Give fluids to drink. Watch for further signs of continuing dehydration. Watch for further signs of continuing dehydration.

10. Muscle Cramps - Treatment Occurs in voluntary muscles (i.e. legs). Occurs in voluntary muscles (i.e. legs). Stop exercising/activity. Stop exercising/activity. Get out of the sun/heat. Get out of the sun/heat. Massage extremity. Massage extremity. Drink water or sports drink. Drink water or sports drink. your shirt 

11. Heat Exhaustion Caused by fluid loss. Caused by fluid loss. Blood supply is sent to the skin. Blood supply is sent to the skin. Reduces blood to the brain. Reduces blood to the brain. Confusion and/or unconsciousness. Confusion and/or unconsciousness. Wet skin – perspiration present. Wet skin – perspiration present.

12. Heat Exhaustion - Treatment Stop activity. Stop activity. Get out of heat (not in the sun). Get out of heat (not in the sun). Lie down. Lie down. Raise your feet. Raise your feet. COOL OFF!!!! (AC) COOL OFF!!!! (AC) Get fluids ASAP!

13. Heat Stroke LIFE THREATENING! LIFE THREATENING! Body temperature increases. Body temperature increases. Skin is usually hot and dry (no sweat). Skin is usually hot and dry (no sweat). Symptoms: Symptoms: –Dizziness –Vomiting –Diarrhea –Confusion

14. Heat Stroke - Treatment Get immediate medical attention. Get immediate medical attention. Call “911.” Call “911.” Reduce body temperature with cool water. Reduce body temperature with cool water. Get in tub of cold water. Get in tub of cold water. Drink cool liquids if person is conscious. Drink cool liquids if person is conscious. Call 911

15. PreventionTips Listen to your body. Listen to your body. Wear loose-fitting clothing. Wear loose-fitting clothing. Stop activity when you start to feel overheated. Stop activity when you start to feel overheated. Avoid overheating -- pour water over your head. Avoid overheating -- pour water over your head. Get out of the heat -- avoid hot places. Get out of the heat -- avoid hot places. Drink plenty of fluids: Drink plenty of fluids: –Before, during and after entering heat facility –Schedule water breaks to drink at least 8 ozs. of water/hour. –Avoid caffeine and alcohol which add to dehydration. Obese and/or older adults at > risk. Obese and/or older adults at > risk.

16. Prevention Tips (cont.) Medications, prescription and over-the-counter, may interfere with you body's ability to regulate temperature. Medications, prescription and over-the-counter, may interfere with you body's ability to regulate temperature. –Gastrointestinal drugs containing atropine (Donnatal); antidepressants or antipsychotics (Thorazine, Haldol, Prozac); –Antihistamines (Benadryl); –Certain cardiovascular medications including betablockers (Blocadren) and diuretics (Diuril); –Parkinson's disease medications. If you use any of these medications, be especially careful to limit your exertion and drink plenty of water during hot, humid weather. If you use any of these medications, be especially careful to limit your exertion and drink plenty of water during hot, humid weather.

17. Wallet Card Place this card in your wallet so that you have it handy should you need to refer to it. Place this card in your wallet so that you have it handy should you need to refer to it. Look out for each other, if your neighbor is becoming confused or acting “funny,” get him to a cool area and HYDRATE! Look out for each other, if your neighbor is becoming confused or acting “funny,” get him to a cool area and HYDRATE! Sources: Sources: –The Merck Manual, 16 th Edition, R. Berkow, M.D., Editor, 1992. –University of Michigan Health System (web resource) http://www.med.umich.edu/1libr/primry/life18.htm –drkoop.com (web resource) http://www.drkoop.com/template.asp?page=newsdetail&ap=93&id=510008 http://www.drkoop.com/template.asp?page=newsdetail&ap=93&id=510008