Heatstroke: When to Call 911 & How to Prevent It in the First Place

Each year about 700 people die of heatstroke in the U.S.

Heatstroke: When to Call 911 & How to Prevent It in the First Place

We all fantasize about those long summer walks on the beach, the refreshing drinks by the pool, and the delicious outdoor BBQs with family and friends (well, not all family perhaps). However, all that glistens is not gold. Particularly on those hot, sunny days, we must all be vigilant to avoid those painful sunburns (please wear sunblock even on cloudy days) and incur a life-threatening heatstroke.

WHAT IS HEATSTROKE?

Heatstroke (one word, not two) is a condition when your body dangerously overheats to the point where it can cause damage to your brain, kidneys, muscles and your heart. In fact, each year in the United States, about 700 people die from heatstroke. There are two types of heatstroke.


CLASSIC HEATSTROKE

Classic (also called non-exertional) heatstroke tends to occur in older adults with underlying medical conditions and in young children (when horrendously and illegally left alone in a car on very hot days).

EXERTIONAL HEATSTROKE

Exertional heatstroke generally occurs in otherwise healthy people participating in strenuous exercise on those very hot days (please do not use this as an excuse not to exercise all year long). In fact, football players who take dietary supplements (such as creatine) or who are being treated with prescription amphetamines for attention deficit hyperactivity disorder are at a particularly higher risk for developing exertional heatstroke. Therefore, for those of you who are insistent on playing football during a heatwave (yes, this is directed towards your grandpa), taking frequent breaks (preferably in an air-conditioned room) and drinking plenty of fluids are of paramount importance.

HEATSTROKE SYMPTOMS

During heatstroke, one's body temperature rises to 104 F or above, causing confusion, and irritability as well as possible slurred speech, seizures and coma. Many people complain of rapid breathing, rapid heart rate, dizziness, nausea, and, interestingly, dry skin (basically because you are severely dehydrated and can't produce sweat). In fact, having dry skin epitomizes the main danger of heatstroke in that your body becomes ineffective at maintaining your ideal body temperature. Briefly, sweating is your body's ability to keep you cool and maintain your perfect body temperature (around 98.6 F). If you are unable to produce sweat (because you are dehydrated) or your sweat doesn't evaporate (due to high humidity, the other contributing factor to developing heatstroke), you may lose the ability to cool off quickly, thus placing you at risk for developing heatstroke. Accordingly, this is why most people complain of feeling warmer than the actual temperature (as well as miserably clammy) on those very humid days (and correspondingly, feel cooler than the actual temperature during low humidity when one's sweat evaporates easily).

HEATSTROKE TREATMENT

As heatstroke can be rapidly progressive and life-threatening, call 911 if you suspect that someone (including yourself) is experiencing heatstroke. While waiting for emergency services, do everything you can to cool the person down, whether it be dragging him/her into an airconditioned room, immersing him/her into a cold bath, or even hosing him/her down with cold water. If the person is conscious, encourage him or her to drink fluids.


By Dr. Marc Eisenberg

www.doctoroz.com

Dr. Marc Sabin Eisenberg, M.D., F.A.C.C. is an associate professor of medicine at Columbia University Medical Center. He is co-author of the book "Am I Dying?!: A Complete Guide to Your Symptoms and What to Do Next" and co-host of the "Am I Dying?!" podcast, which provides light-hearted advice for the hypochondriac in all of us. He writes the "Rounds With Dr. E" column for DoctorOz.com.

Prone to Clotting? How Blood Thinners Could Help Save Your Life

You've seen all the commercials, but here's what to know about the medications.

Have you ever wondered why there are so many blood thinner commercials on TV? Pradaxa, Xarelto and Eliquis advertisements flood the airwaves promising to protect you from life-threatening clots while also claiming superiority to a medication many of us remember our grandparents taking, called warfarin. Of course, none of us understood why our grandparents may have been taking warfarin (a medication made from rat poison) in the first place. But the newer blood thinners called NOACs (novel oral anticoagulants) are actually great treatment options for many people with specific medical conditions. So should you pay attention the next time one of these commercials pops up? To clot, or not to clot, that is the question perhaps we should all be asking.

What Is Warfarin?

Warfarin, also called coumadin, is in fact derived from rat poison. Being an animal activist and lover of all animals, I will refrain from expounding on how warfarin went from poisoning rats to being used clinically in patients (I'm not sure I would have gone to that doctor), as I find animal persecution too upsetting. However, a well-written article in Nature Reviews Cardiology explains this evolution. In truth, the medical use of warfarin was revolutionary in both treating and preventing leg and lung clots as well as in effectively decreasing the risk of stroke in patients with either an abnormal heart rhythm, called atrial fibrillation, or in people with abnormal heart valves. However, the drawback of warfarin treatment is that patients require frequent blood tests to ensure proper blood levels, as its therapeutic effect and its bleeding risk can be quickly affected by changes in diet (including alcohol) and by multiple medication interactions (including antibiotics).

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