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July 24, 2007 > Beat the Heat This Summer

Beat the Heat This Summer

Learn Tips to Avoid the Most Serious Form of Heat Injury

Take it from Dr. Frank Zeidan, an emergency medical physician who has been treating patients in Washington Hospital's emergency room for almost 30 years: you don't want to suffer heat stroke this summer. Especially given the recent rise in the mercury, it's important to take preventive measures to ensure you and your loved ones beat the summer heat and not the other way around.
"Heat stroke is the most extreme form of heat-related illness," says Dr. Zeidan, who serves as medical director of Washington Clinic/Fremont, the hospital's urgent care clinic located at 2500 Mowry Avenue. "It is often very serious, and it can be fatal. It's the consequence of an imbalance between the body's ability to produce and dissipate heat in order to maintain a normal temperature. Heat-related illnesses can range from minor complications to the most critical form, which is heat stroke."
In most cases, Dr. Zeidan says, patients suffering from heat stroke arrive at the emergency room by ambulance because of the serious nature of the illness, and it's important to recognize signs of less serious forms of heat-related illness before the situation progresses into heat stroke.
Lesser forms of heat illness can include heat edema, a mild swelling of hands and feet; heat rash, an inflammation of the sweat glands and blockage of sweat pores that results in a rash; heat syncope, a combination of dehydration and vasodilatation that can cause sufferers to faint; heat cramps, including painful spasms or contractions in the lower extremities that often afflicts athletes in particular; and heat exhaustion, symptoms of which include high fever (equal to or greater than 104 degrees), fatigue, headache, exhaustion, vomiting, and possible syncope.
Symptoms of heat stroke may include fever above 104 degrees, dizziness, headaches, vomiting, nausea and cramps, but the critical component of heat stroke diagnosis, according to Dr. Zeidan, is the occurrence of altered mental status, as exhibited by a disturbance of mental function or an abnormal neurological exam. Those affected by heat stroke may suffer seizures, confusion, severe disorientation or even coma.
To illustrate the serious and potentially deadly risk posed by extended periods of hot weather, Dr. Zeidan cites the example of the heat wave that struck Europe in 2003, killing more than 14,000 people in France alone.
"Heat stroke is really a critical form of illness that constitutes a severe medical emergency," he states, noting, "By definition, a heat wave is three or more consecutive days of outside temperature of more than 90 degrees."
Those at greatest risk for heat stroke or injury are members of vulnerable populations that include the elderly, young children and those with chronic illnesses. Oftentimes, the heat-related injuries or even fatalities that occur during hot weather affect those without access to air conditioning or other methods of cooling down, Dr. Zeidan says.
"During heat waves or hot summers, people who don't have access to air conditioning are well advised to seek shelter in places such as senior facilities, churches, schools, public libraries, or even the mall," he suggests. "One option is going to a movie if the theater is air conditioned."
Even for those in good physical shape, especially athletes intent on performing exercise or sports training during hot weather, there are inherent risks to heat exposure, Dr. Zeidan says.
For athletes or people performing exercise routines outdoors during hot weather, he recommends using the technique of "acclimation," in which one slowly increases the duration of activity in the heat over time, as well as continuous hydration before, during and after physical exertion. An athlete can lose up to 1,000 ml of liquid - which is equivalent to 2.2 pounds body weight - per hour when exercising strenuously in a hot environment. Dr. Zeidan says the amount of water needed to replenish fluids lost during strenuous exercise is more than one would imagine - as much as 500 ml for every pound of weight lost, according to athletic organizations, such as The National Athletic Trainers' Association.
"As a community, we really need to raise people's awareness in general of the danger posed by heat-related illness and injury through education and prevention," he says.
If you believe you or someone else may be approaching heat stroke, call 9-1-1 immediately.
To see a list of services and programs available at Washington Hospital, visit and click on "Services & Programs." To learn more about Washington Hospital's primary and urgent care clinics located throughout the community, visit the homepage and click on "Our Facilities."

Stay Cool, Stay Safe

To stay safe during the hot weather, Dr. Frank Zeidan, emergency medicine physician and medical director of Washington Clinic/Fremont, has several tips:
* Seek a cool environment when possible
* Dress in cool fabrics and light colors; avoid multiple layers
* Avoid exercising during the hottest points in the day
* Avoid alcoholic beverages, which can speed dehydration
* Hydrate often with fluids containing electrolytes and carbohydrates, such as sports drinks, to aid in fluid replacement
* During the hot weather, if you or someone you know is experiencing symptoms including elevated body temperature, headache, nausea, vomiting or abnormal sweating, call 9-1-1 or seek medical assistance immediately

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