"THE HEART OF THE MATTER"
a special program of the National Emergency Medicine Association (NEMA)


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Week: 583.6 Pt. 2 

Guest: Amanda Niscar, Nurse Epidemiologist, Centers for Disease Control 

Topic: Heat related problems & dangers 

Host/Producer: Steve Girard

NEMA: We're into the hottest part of the year for most of the country. Even those of us in the traditionally sticky Southeast need to remember what extreme heat can do to, know the signs of heat injury, and how to prevent it. We're talking with Amanda Niscar, a nurse epidemiologist at the Centers for Disease Control in Atlanta - talk about an area known for summer heat and humidity! Amanda, what is the biggest tool in preventing heat related injury?  

NISCAR: If I had to pick one thing that people forget to do when it's hot out...is that they don't drink enough water. It's very important that people take in non-alcoholic beverages...and then also, if it is during the very sunny part of the day to wear sun lotion...wear a hat - a wide brimmed hat, so that it covers their ears...wear lightweight, cotton clothing that's a light color. Things like that really help.  

NEMA: There are subsets of the population we worry about more than others... like the elderly, who may not have made air conditioning a staple of their lives, and who may not take the steps needed to stay safe...  

NISCAR: For the elderly, it's very important for the community to get involved...so that they have a buddy, or maybe a grandchild...somebody who checks in on them twice a day...and make sure that they are consuming enough fluids. And if they don't have air conditioning, to have the windows open so that air can circulate, and have a ceiling fan on them to circulate the air. Cool sponge baths are very helpful, or giving them ice to help keep them cool.  

NEMA: What about people who need to exercise, or work in the heat?  

NISCAR: For people who exercise regularly when it is really hot outside...they should really try to reschedule so that they exercise in the morning or in the evening... and that also includes outdoor work. So, if you're a construction worker, or just any sort of outdoor activity...whether its recreational or work, you should try to reschedule if possible. And if it's not possible, then try to rest as often as possible...sit in the shade, continue to drink fluids and wear a hat.  

NEMA: Now, when we don't take the proper precautions, there are several things that could happen...the most dangerous being heatstroke...  

NISCAR: What happens with heatstroke is that the body's unable to control its temperature, and so the body's temperature rises rapidly and is unable to sweat appropriately....and so the body can't cool down, and that's when heatstroke occurs. And heatstroke is a medical emergency...it can be fatal, and you should definitely seek medical attention immediately. If you see a person who's feeling dizzy and nauseous, or possibly unconscious... heatstroke symptoms can also be confusion, a rapid heart rate, dizziness, and of course an extreme high body temperature. And actually, people experiencing heatstroke will not be sweating...there'll be no sweating - they'll just have hot, red, dry skin - because that mechanism has failed.  

NEMA: Heat exhaustion, on the other hand, has different symptoms, and is a body's different response to extreme heat. Give me an idea of what that's like....  

NISCAR: A person with heat exhaustion is going to have heavy sweating, paleness... they may feel muscle spasms, or cramps...they're going to feel tired and weak...maybe dizzy or nauseous...they may even faint. Heat exhaustion can progress to heatstroke, if not taken care of. Heat exhaustion is not necessarily a medical emergency...if you can stop whatever you're doing, rest...get some fluids...get into an air conditioned area, or at least get into the shade. But heat exhaustion should be considered an emergency if the symptoms are really severe, or if the person has other problems, such as heart conditions.  

NEMA: So, anything that brings the body temperature down is good in these situations...?  

NISCAR: Get them some cool fluids...anything nonalcoholic is fine...and get the person into an air conditioned environment. If that's not possible, maybe you can get a garden hose and spray them with cool water, or a cool sponge bath...anything that can help cool the body temperature...that's helpful for both heat exhaustion and heatstroke.  

NEMA: Why does the body cramp up when you're outside in the heat?  

NISCAR: In that situation, the person has been sweating so much that their body has run out of salt and water... and then the person starts to get muscle spasms and cramps. That can be in their abdomen or their arms or their legs...and it's associated with overexertion, exercise...or work-related... and it usually occurs after the strenuous activity.  

NEMA: And this is one of the stepping stones to heat exhaustion or heatstroke...  

NISCAR: Yes...if you ignore the symptoms of heat cramps, it can lead to heat exhaustion or heat stroke. So, it's important that the person stop and rest, and drink fluids or some clear juice is good also at this point to replenish the natural minerals you're losing.  

NEMA: This next heat related area has to do with something most of us do at least a few times in our lives. We forget to put on the sunscreen and get burned. How do we treat it properly...? And is there a line over which we should seek a doctors help in treating sunburn?  

NISCAR: Well, to prevent the sunburn, first of all...you should wear at least a sun protection factor 15, and you should apply that 30 minutes before you go out in the sun, and then follow the directions for reapplication if you're out all day long. You should consult a doctor for the sunburn if you have a fever, or blisters forming, or severe pain. And any infant, under one year of age, gets sunburned....they should also see a physician. When treating the sunburn, you should remember to apply cold compresses, or take a cool water bath. And don't use any ointments or butter...you want to apply a moisturizing lotion to the affected area to keep it more moist...because it's dry. And if you have blisters, don't break them. And of course, avoid repeated sun exposure if you have sunburn.  

NEMA: We love the sun, but we have to respect it for the dangers it can pose. Prevention is the key in protecting your skin, your system and your health. Thanks to Amanda Niscar, a nurse epidemiologist with the Centers for Disease Control.  

Thanks for joining us for today's program. If you have any comments or suggestions, contact this station. Or visit our home page at:

www.nemahealth.org 

...for a look at transcripts of this or past programs, or to find out more about the National Emergency Medicine Association. I'm Steve Girard at The Heart of the Matter.