The most important lesson about heat illness applies to most injuries and illnesses in the field – “prevention is better than cure”. This of course seems obvious whilst reading this article, but when out on the trail in trying, hot conditions, this lesson is often out of focus – in the periphery…this is a truly dangerous situation, and heat illness is not the only risk at this time. Add factors such as falls leading to trauma and the exacerbation of existing medical conditions and the concoction in the remote area is extreme.
Prevention of Heat-related Illnesses
• Keep up your fluids – drink water before, during and after physical exertion in the heat.
• Keep up your energy levels – eat regularly, ensuring you take in electrolytes and sodium.
• Protect yourself – wear a hat and lightweight breath-able clothing and use sunscreen.
• Plan physical activity – ensure your trip is planned around the predicted conditions.
• The buddy system – watch out for each other, rest when someone needs to do so.
Special note about fluid intake
Your body absorbs fluids best when you drink frequently and in small amounts. It also helps with fluid absorption if you drink while eating. Don’t depend on feeling thirsty to tell you when to drink – thirst is a late response of the body to fluid depletion. A good indicator of proper fluid levels is urine output and color. Urine should be ‘copious and clear’. Dark urine generally means you are dehydrated.
Signs and Symptoms of Heat-related Illnesses
• Heat rash – this is a skin irritation caused by exces-sive sweating – it looks like a red cluster of pimples or small blisters occurring on the neck, chest, groin and in bodily creases.
• Heat cramps – these include muscle pains or spasms, usually in the abdomen, arms or legs. Com-monly related to strenuous activity in a hot environ-ment resultant from depleted salt and water. These cramps may also be a symptom of heat exhaustion.
• Dizziness and fainting – heat-related dizziness and fainting results from reduced blood flow to the brain. Heat causes an increase in blood flow to the skin
and pooling of blood in the legs, which can lead to a sudden drop in blood pressure.
• Heat exhaustion – this is a serious condition that can develop into heat stroke. It occurs when excessive sweating in a hot environment red-uces the body’s fluid volume. Warning signs may include paleness and sweating, rapid heart rate and breathing, muscle cramps, headache, nausea and vomiting, dizziness or fainting.
• Heat stroke – this is a medical emergency and requires urgent attention. Heat stroke occurs when the core body temperature rises above 40.5C° and the body’s internal systems start to fail. Most people will have profound central nervous system changes such as delirium, coma and seizures. The person may stagger, appear confused, have a fit or collapse and become unconscious. The symptoms of heat stroke may be the same as for heat exhaustion, but the skin may be dry with no sweating and the person’s mental condition worsens.
Treatment Principles for Heat-related Illnesses
• Assist the victim to rest, preferably in a cool, shaded area.
• Remove outer clothing.
• Wet skin with cool water or wet cloths.
• Give frequent, small sips of an oral hydration solution (water, salt, electrolytes).
• Gently stretch any cramped muscles.