The Heat is On

Summertime is fun time for many of us. However, the risks of undue heat exposure should not be taken lightly. Heat related illness can and does effect diverse populations, from young to old, ill to athletic, and rich to poor.

An estimated 6 million workers are exposed to heat stress via their occupation. Fatalities are common in the following industries: construction, agricultural and manufacturing1. Heatstroke has cost the lives of more than two dozen athletes over the last decade2. The elderly and those with chronic illness are at risk, especially those with poor access to air conditioning. Also affected are those with pre-existing conditions including heart disease, lung disease, mental illness and social isolation.

Children are at a unique risk because they have a core temperature that rises faster when they are dehydrated. A fatal event can occur with a child within twenty minutes if their normal heat mechanisms are overwhelmed3. More than that, children are usually unaware of the warning signs that they have succumb to heat related illness. Even seemingly healthy adults who are not prepared for excessive heat conditions and do not keep themselves properly hydrated may fall victim to health related illness.

Heat related illness is the body’s inability to deal with heat produced by metabolic activity. Heat related illness can be broken into three categories: heat cramps, heat exhaustion, and heat stroke1. Heat stroke can further be broken down into classic and exertional1.

Heat cramps often occur in athletes and otherwise physically fit people. The main reason it occurs is because the activity for which they are engaged in is not balanced by proper fluid intake. Painful spasms occur usually in the calf or abdominal wall muscles and are most often the result of sodium depletion1.

Heat exhaustion occurs either because of water depletion or sodium depletion. Usually the elderly experience heat exhaustion as a result of water depletion. Heat exhaustion from sodium depletion occurs most often in un-acclimated persons who drink plenty of water but neglect to replace lost sodium levels1. Symptoms of heat exhaustion are milder than heatstroke and include dizziness, thirst, weakness, headache, and fatigue. With proper hydration and cooling they can recover quickly3.

Heatstroke is the deadliest of all of the health related illnesses and again can occur in two forms; classic and exertional1. In either form, it is defined by a core body temperature above 104 degrees Fahrenheit. Survival is based on immediate treatment, and if noted and treated promptly the survival rate can be as high as 90 percent1. Classic heat stroke occurs during the summer months and mostly affects the elderly or persons with chronic medical conditions. Exertional heatstroke occurs most often in the summer months, and is primarily seen in athletes and laborers. The difference of most importance is that those with exertional heatstroke continue to sweat. This major difference often leads to a delay in treatment.

Those who have heatstroke can present rapid breathing, rapid pulse, seizures and hot dry skin. Delay in treatment can lead to multi-system organ failure or death. Treatment includes removal from participation, removal of clothing, ice pack application to the neck, armpit, and groin. In the emergency room rapid cooling is done by cool emersion as well as monitoring blood chemistries.

This article is just a glimpse at the seriousness of health related illness. If you are interested in learning more about this topic please contact our offices to set up an in office presentation. Our services related to health related illness can be applied in many ways. Below is a list of services we offer related to this topic.

Education: Modules designed for your clients that will decrease the risk that they are taking by exposing the populations they serve to heat. Examples of these modules can be customized for schools to understand how to prevent heat related illness, how to recognize signs of heat related illness and initial treatment.

Medical Chart Review: Review of a patient’s history to determine if heat related illness could have been prevented and was the treatment appropriate.

Timeline Analysis: To determine the timeline of the incident in question.

Standard of Care Research: To identify applicable standard of care and determine any breach of care.

Expert Witness Identification and Location

Medical Research: Research on this topic as it applies to your client.

References
1.Wexler, Randall K. Evaluation and Treatment of Heat-Related Illness. American Family Physician. 2002; 65:11.

2. Heat Stroke Prevention Strategies. Retrieved June 2006 from http://www.insurevents.com/Articles/Heatstroke.htm.

3. Glazer, James L. Management of Heatstroke and Heat Exhaustion. American Family Physician. 2005; 71:11.

For more information on this issue please see Contact Us and see how our services can work for you.