Burning Up: Staying Safe in the Heat

8 August 2020 By Aileen Mack

With record-breaking heat occurring in areas all over the world, there’s more to worry about than just trying to stay cool and avoid getting a sunburn. This extreme heat is potentially very dangerous and everyone must take precautions to protect themselves from heat-related illnesses, especially those in hot and humid environments. The Centers for Disease Control and Prevention states that despite the fact that heat-related illnesses are preventable, around 618 people in the U.S. are killed by extreme heat every year.

The Occupational Safety and Health Administration in the U.S. focuses on preventing heat illness in outdoor workers. If the heat index is 103F (39.4C), employers must take proactive steps to protect employees. These steps include educating employees about heat illness signs and symptoms, ensuring they drink plenty of water, enforcing frequent breaks and rest in cool places. The organization also requires clear and enforced work and rest schedules to control heat exposure. Kevin Sullivan, SVP Operations of Patronus Medical, suggests following these guidelines, even for captains and crew outside the U.S.

Heat-related illnesses range in severity from skin irritation to potentially fatal heat stroke, says the MedAire medical team. Heat cramps come first, followed by heat exhaustion, and then heat stroke, which is a medical emergency requiring an immediate response.

Heat cramps symptoms include heavily sweating, cramps, and experiencing muscle pain. The person experiencing this should take a long break in a cool area and drink lots of water. “The best rule of thumb here is to hydrate until your urinary output is light yellow,” Sullivan says. “If you pay attention at this stage, you can prevent something serious from happening.”

Heat exhaustion is often treated like the first stage but at this stage, someone should be considered seriously ill. A person with heat exhaustion needs medical care and medical supervision. In addition to heavy sweating and muscle pain, they will develop pale and clammy skin, a fast pulse, nausea and/or vomiting, and dizziness, headache, and possibly fainting. They should immediately be moved to a cool place, replace most clothing with cool, wet compresses, and slowly rehydrate. They shouldn’t return to work until the symptoms have been resolved for six to eight hours, and close consultation with a physician is strongly recommended.

The last stage is heat stroke in which your body shuts down. This is obviously life threatening and without medical intervention, this person will die because their body is already in a form of decompensated shock. The symptoms include headaches and dizziness, hot red skin (that’s often dry), high body temperature (above 103F), confusion and mental status changes, and loss of consciousness. The person should be moved to a cool place and all clothing should be removed to cover the body with cool, wet cloths. Very close medical monitoring is necessary for prolonged periods of time, and hospitalization may be required.

The symptoms of heat-related illnesses run on a spectrum and are progressive, such as the overlapping symptoms between heat exhaustion and heat stroke. “It is best to use the symptoms as a guide, rather than an absolute,” Dr. Andy Desjardins of Patronus Medical says. “If someone isn’t looking or feeling good, take action even if they don’t exhibit all the worst symptoms. The goal is to never get to the wrong end of the spectrum.”

The temperatures we’re seeing this summer are exceptionally high, Sullivan says, and our bodies need time to adjust to these higher temperatures when they first occur. So slow down your work and physical activities if you must keep working outside in a period of high heat, especially during the first few days, to give your body time to adjust.

To help reduce high heat exposure, change your schedule. Desjardins points out, “The military and others have been dealing with exceptionally high temperatures for years. One of the strategies they use is to change work schedules so that the most strenuous activities are performed during cooler early morning and nighttime periods.”

The heat causes your body to flow more blood to your skin to vent the internal heat through sweat. However, this causes a volume problem because your heart and brain are competing for blood, along with your muscles if you’re working outside. Due to perspiration, you’re losing a lot of water and reducing your blood volume, so your heart speeds up and operates at max speed until the problem is solved, but if your body stays too hot for too long, your heart runs out of steam and doesn’t perform its work effectively. “When you look at it this way, it makes it easier to understand why you need to drink so much more water and move your body into cooler spots to take breaks,” Desjardins says.

To help prevent heat-related illnesses, the MedAire medical team suggests drinking water every 15 minutes, taking frequent rest breakfast in a shady place or cool indoor area, using spray or water mist as a cooling device, and applying ice and wet cloths to your skin. Also, wear a broad-brimmed hat, light-colored loose clothing, neck covering, and sun screen when outside. They recommend, “Information about heat-related illness and how to respond should be posted in crew areas so that crew can follow them in an emergency situation, when it can be difficult to remember proper treatment steps.” They also note that it’s safer and easier to avoid heat-related illnesses than it is to treat them.

Desjardins mentions that the crewmembers Patronus works with all pride themselves on being hard workers and having fun at work. “It’s really important that people in supervisory positions lead by example. Call for breaks. Enforce breaks. Drink water. And eat; your blood sugar is important here, too,” he says. “An ounce of prevention is worth a pound of cure. There is nothing worse than seeing a friend and crewmember come close to death from too much heat, but it happens quite frequently.”