how to manage heat-related illness

It’s heating up! If you work outside or are involved in outdoor sports, it’s important to know how to identify and manage heat related illness. 

Overheating usually occurs due to high external temperatures, high exertion, dehydration and inappropriate acclimation periods. In fact, when the external temperature reaches 95+ degrees, our “sweating mechanism” is not as effective at managing core body temperature. Pair this with the above listed factors and heat exhaustion soon follows. 

First, let’s cover the differences between the main heat related illnesses: Heat exhaustion and heat stroke.

Heat exhaustion occurs first with the following symptoms: 

• Dizziness

• Light-headedness

• Thirst

• Weakness

• Cramping

• Excessive sweating

• Nausea

• Vomiting

What to do: In this phase with proper management, symptoms typically resolve without complications. The key is to recognize when an athlete is experiencing these symptoms and to take action BEFORE symptoms escalade. transport the individual to a cool, shady area. Fluids should be replaced and the feet elevated. NATA recommends that if symptoms do not improve in 5-10 min the individual should be transported to the emergency room for evaluation.

In contrast, heat stroke includes

• Core body temperature over 104 degrees

• Altered Consciousness/ Confusion

• Lack of sweating/dry skin

• Emotional Instability

• Rapid, strong pulse

• Strong, pounding headache

What to Do: This is an extremely serious medical condition, and immediate action must be taken to ensure safety of the athlete. Immediate whole body cooling (preferably cold water immersion), followed by medical treatment in the emergency room or trauma center. If you suspect someone is having heat stroke, call 9-1-1!

Another lesser known form of heat illness is hyponatremia

• This is a potentially fatal condition when the body’s sodium level decreases due to inadequate electrolyte intake or over-hydration with water alone. Symptoms include

  • Excessive fluid intake before

  • Worsening headache

  • Nausea/vomiting

  • Lower extremity swelling

What to Do: If you suspect hyponatremia, it is important to rebalance electrolyte levels, stop activity, and seek medical attention

Here are some steps to avoid these conditions:

• Proper Hydration: Adequate fluids with electrolyte 30 min prior/ during activity 

• Acclimation: Around one week of consecutive days of efforts (between 30 and 90 minutes) in temperatures greater than 86 °F. NATA recommends that with sports involving protective gear only helmets should be worn days 1-2, helmets and shoulder pads days 3-5, and beginning on day 6 all protective gear can be worn.

• Knowing warning signs! 

References:

Wolf, Robb. How to Prevent Heat Exhaustion: A Science Backed Guide. Drink LMNT. 2023.

NATA Offers 10 Tips to Prevent Heat Illness and Dehydration. National Athletic Trainers Association. 5, July, 2018.