Don’t take heat danger lightly

People take it too lightly.

That’s the reply from Capt. Paula Carter of Columbus Fire & Emergency Medical Services when asked the most common misconception of heat-related illness.

“I think people take it too lightly, if anything,” said Carter, who trains firefighters and medics. She has nearly three decades’ experience, having joined the department as an emergency medical technician 29 years ago, when she was 22.

“I think they don’t realize that it can happen to them,” she continued. “They think, ‘Well, I’m healthy, and I’m going to get out here and I’m going to cut grass,’ or do some type of high-intensity work, and not take the breaks they need to. And then before you know it, they’re starting to have the cramping and the nausea and the vomiting, and then they realize, ‘Oh man, I’d better go get shelter and drink something cool.’”

They’d better get fluids and shelter before they vomit, to avoid an emergency. Nausea and vomiting complicate the recovery, Carter noted, because they limit the victim’s fluid intake and risk obstructing airways. That’s why rescuers are advised to give an overheated person sips of water, to begin with, and not let the patient lie flat, lest vomit cause choking.

They’re also to give the victim tepid fluids, if available, as ice water takes more energy to metabolize. Sports drinks such as Gatoraid can help restore depleted electrolytes, but the sugar in them can make the patient sick. A half-and-half mix of Gatorade and water works better, Carter said.

Lowering the victim’s core body temperature is crucial. Typically taking them into an air-conditioned room is the first step, but if stuck outdoors, they must be moved to shade, their clothing loosened or removed, and their bodies swathed in cool, wet cloth. Applying cold compresses to their neck, armpits and groin works most effectively, Carter said.

Of course it’s best to see the affliction coming and head it off before such emergency measures are needed. Thirst is among the first symptoms, and ignoring that — continuing exertion instead of stopping to drink and rest — is a dangerous gamble when the heat index surpasses 100 degrees.

“Once you get thirsty, that already means you’re dehydrated,” Carter said.

Another sign of dehydration is infrequent and dark urination. “If you notice that your urine is really dark, that means you’re not properly hydrated,” she said. “It should be clear and copious. You should be going to the bathroom a lot, and it should be basically clear.”

Weakness and dizziness also are warning signs, and any disorientation indicates the illness is getting to your head. Without treatment, your body temperature can spike, producing stroke-like symptoms that can lead to loss of consciousness.

“That’s where it’s very dangerous, because now your core temp has already exceeded normal body temp,” she said, likening it to your brain “boiling in your skull.”

“If your body temp hits 106 or 107 degrees, that’s irreparable damage,” Carter said.

Typically people are advised to seek medical care for a temperature topping 103 degrees.

Extreme heat is a danger firefighters know intimately, and not just from battling flames head-on. The heavy suits they wear are designed to withstand temperatures up to 1,400 degrees, and while the outfits keep heat out, they also trap it in.

The risk of dehydration requires frequent breaks, usually every 20 to 30 minutes, to strip off the heavy gear and cool down, Carter said.

A homeowner working in the yard on a hot summer day needs a similar routine, she said: about 15 minutes of rest for 30 minutes of intense exertion.

“A lot of people say, ‘Well, I just want to finish doing this, or I want to finish cutting the grass, and then I’m going to go in.’ Well, by then it may be too late,” she said.

Recreation can be more dangerous than labor, because of alcohol. A common scenario among beachgoers is spending all day in the sun, playing in the sand, getting sunburned, and drinking nothing but beer or another alcoholic beverage.

Alcohol facilitates dehydration, and sunburn reduces the body’s ability to cool down through sweating. For the young and the reckless, a trip to the beach sometimes includes a visit to the emergency room.

So, folks here in the super-hot South are warned to anticipate such dangers, and prepare — to drink plenty of nonalcoholic fluids, take frequent breaks to cool off during exertion, to wear sunscreen or take other measures to avoid sunburn, to know and recognize the symptoms of heat-related illness, and to be equipped to treat it.

In other words, don’t take it lightly.

This story was originally published July 27, 2016 at 7:34 PM with the headline "Don’t take heat danger lightly."