Heat Related Illness & Dehydration

The risk of heat related illness increases as the summer gets hotter and kids start participating in sports tryouts. The combination of bulky, heat-trapping athletic equipment, hot and humid weather, and inadequate fluid intake combine to put our athletes at risk. It is crucial that we educate ourselves and our family members in recognizing the early warning signs of heat related illness.

One of the earliest warning signs is muscle cramping. Further increases in temperature can lead to heat exhaustion which can be accompanied by heavy sweating, weakness, clammy skin, nausea, and vomiting. If the body core temperature continues to rise, heath stroke, which is characterized by confusion, agitation, fainting, bizarre behavior, warm/hot skin, and rapid heart rate, can occur which can rapidly lead to death.

The best way to avoid heat related illness is prevention. Recognize the days which put you or your loved ones at the most risk – hot, humid, sunny days (though sometimes a cloudy day can give one a false sense of security). Proper hydration, in sufficient quantity to account for sweating and fluid loss, allows for proper perspiration which cools the body. Ideally it is a cold, electrolyte containing sports beverage, but water is preferable to nothing. Avoidance of excessive caffeine and alcohol is also important. Removing oneself from the humidity and heat, getting into an air-conditioned environment can help greatly. Certain medications, such as ADHD medications, should put us on high alert as these can make us more susceptible to heat related illness.

Symptoms of heat related illness or heat stroke should warrant immediate medical evaluation. If you or a loved one are concerned about heat related illness, please seek evaluation from your Primary Care Physician, the Emergency Department, or your local Piedmont Urgent Care by Wellstreet.

Dehydration

Many of us know the dizziness, fatigue, and cramping that come with being dehydrated or volume depleted. Understanding why dehydration occurs and how to recognize it in our family members is more difficult.

The most common cause of dehydration in both adults and children is increased loss via the gastrointestinal tract via vomiting or diarrhea. The human body secretes 4000ml (equal to 2 2 liter soda bottles) of fluid in the intestines daily, though most of this is reabsorbed. Anything that can cause diarrhea, vomiting, or interfere with this reabsorption can rapidly lead to much fluid loss. Other less common causes of fluid loss include burns, bleeding, excessive sweating, kidney issues, and diuretics (water pills).

One of the most common symptoms of dehydration is dizziness (more a feeling that you may faint or pass out than the room spinning) that initially may only occur when going from a sitting to standing position but when more severe, may occur all the time. Other early symptoms include low energy, thirst, decreased urination, and cramping. More severe dehydration can also lead to chest pain, abdominal pain, and confusion as the dehydration begins to impair blood flow to the heart, abdominal organs, and brain. For babies and children unable to vocalize, initial symptoms will be crankiness, decreased wet diapers, inability to make tears when crying, and dry mouth and lips. Older individuals may present with more vague symptoms and may, at baseline, have some of the more common symptoms of dehydration including dry mouth, speech difficulty, muscle weakness.

There are tests for dehydration including serial blood pressure and heart rate evaluation (Orthostatics), evaluation of the urine which may show a large amount of ketones or high specific gravity, and checking a complete metabolic panel which may show abnormal kidney function tests which can be common in dehydration.

The primary treatment of dehydration is fluid replacement – ideally orally but if one is unable to keep the fluids down, via an IV or intravenous line. Some fluids are better than others for rehydrating. For babies or young children, oral rehydration solution such as Pedialyte would work well. Breastfeeding should continue. For older children or adults, sports drinks such as Gatorade or Powerade work better than water, tea, or ginger ale.

If you feel that you need to be evaluated for possible dehydration, please seek medical attention which may include your local Piedmont Urgent Care by WellStreet location. We have the ability to evaluate dehydration, offer intravenous rehydration therapy, as well as attempt to identify and treat the source of the dehydration.