Heat safety 101: Prevention, warnings and treatment

Children are thrown upward as they are pulled behind a boat on Tuesday, Aug. 1, on the Snake River. (Credit: August Frank / The Lewiston Tribune)



For some, summertime is the peak season for relaxing and spending time outdoors. But those warm, sunny days can turn dangerous without the right precautions.

Richie Lucas is the interim operations chief and deputy fire chief for the Lewiston Fire Department. He said emergency medical technicians often see heat exhaustion and heat stroke in people who’ve been drinking and recreating outdoors.

“A lot of times, excessive alcohol use in the sun […] people don’t realize it, and so it catches up with them,” he said.

An ounce — or 32 — of prevention

Ideally, preventing heat illness is better and safer than treating it later. The Centers for Disease Control and Prevention recommends people working in the heat drink eight ounces of water every 15 to 20 minutes, or 32 ounces every hour.

For most people, regular meals and water intake are sufficient to maintain hydration and electrolyte balance. However, for prolonged sweating lasting several hours, electrolyte drinks can be beneficial.

The CDC also recommends avoiding alcohol in the heat because of its dehydrating effects, and avoiding energy drinks, which can affect the heart because of high caffeine levels and be risky when paired with the bodily strain caused by heat.

Sunscreen is also important, Lucas said — not just to prevent skin cancer, but because sunburns reduce the body’s ability to regulate heat. Sunscreen should be a minimum of SPF 30, and be reapplied every two hours, or more frequently when in the water. 

Sunscreens labeled “water resistant” can remain effective between 40 and 80 minutes in the water before requiring reapplication, depending on the formulation.

Some people are also more susceptible to heat illness than others, and may need to exercise additional caution. People who are elderly, young children and people with medical conditions such as high blood pressure or diabetes are all at higher risk of heat illness. 

People on certain medications such as antihistamines, diuretics and psychiatric medications including antidepressants and antipsychotics are also more susceptible to heat.

People who work certain jobs in hot environments like farming, construction, foundry work or baking are also at an increased risk. 

Even when heat isn’t the direct cause of death, it’s been known to lead to fatigue that results in workplace injury or death, said Dave Kearns, Boise-area director for the Occupational Safety and Health Administration.

Workplaces are responsible for providing appropriate rest, water and climate control for employees. If they do not, employees can file complaints at osha.gov.

Treating heat illness

There are three progressively severe forms of heat illness someone can experience: heat cramps, heat exhaustion and heat illness.

Heat cramps

Heat cramps are the earliest stage, and are characterized by painful cramping, often in the fingers, arms, legs and abdomen. Heat cramps can also include flushed, moist skin and a minor fever, usually under 102.5 degrees. It is treated by moving to a cool location, removing excess clothing, rehydrating with electrolytes, stretching to ease cramps, and using things like a cool, damp towel to reduce body temperature.

It’s also important to not over-cool someone, Lucas said. 

“You don’t want to over-cool someone, because if you induce shivering, shivering is like your body’s mechanism of heating up,” he said. “Shivering will increase their body temperature. So it’s kind of counterproductive to itself.”

Heat exhaustion

Heat exhaustion is more severe, and results from a loss of water and salt. It typically happens in extreme heat when someone isn’t properly hydrating and replacing the salt lost from sweating. 

Symptoms of heat exhaustion include some of the same symptoms as heat cramps  usually a fever of more than 102 degrees. A person may appear pale in addition to having moist skin. It can also include symptoms such as nausea, vomiting, headaches, fatigue, diarrhea, weakness and feeling lightheaded or anxious. The treatment for heat exhaustion is the same as heat cramps. If one’s condition does not improve, or someone is unable to take in fluids, emergency services should be called.

Heat stroke

This is an emergency, and requires immediate intervention and a call to 911. Heat stroke is characterized by symptoms including: a body temperature above 104 degrees; warm, dry skin; a rapid heart rate; confusion; lethargy; loss of consciousness; nausea; and vomiting. In extreme cases, heat stroke can cause seizure, coma or death. Lucas notes a person with heat stroke may still have damp skin, but sweating will have subsided. 

While waiting for emergency services, people with heat stroke should be moved to a cool place to rest and offered cool fluids with electrolytes, without alcohol or caffeine, if they’re alert and able to take them. The Johns Hopkins School of Medicine recommends drenching the skin in cool water, fanning the skin and placing bags of ice in the armpit and groin areas.

Cars, kids and pet safety

Every year, around 38 children, and hundreds of pets, die from heat stroke after being left in a hot car. Even when temperatures outside are comfortable, it doesn’t mean it’s safe to leave children or pets in a car.

A car’s internal temperature can increase by up to 20 degrees in 10 minutes, and 40 degrees within one hour.

Stanford researchers also found that cracking car windows or running the air conditioner prior to leaving a car had an insignificant effect on the rate of heating, and the final temperature. 

The study found that running the air conditioner before leaving the car only delayed a temperature spike by about five minutes.

Dog owners are also recommended to walk dogs before 9 a.m. or after the sun sets in the summer, said veterinarian Jessica Bell, Pet walkers should use their hand to check how hot the pavement is before walking their dog.

Some breeds are more susceptible to heat than others, such as large dogs like mastiffs, or flat-faced dogs like pugs.

Animals that are kept outside need to have access to adequate shade and cool water at all times.