Internists and house call doctors like LA’s Dr. Michael Farzam must be ready to treat any acute illness or minor injury – and that includes issues with minor and major heat illnesses. As we write this, a searing heatwave has had California and much of the West in its grip. Even without a heat wave, heat illnesses are becoming more common as temperatures rise more generally and people continue going about their lives.
Many of us have lost relatives and friends to heat illnesses. People who have died prematurely from heat exhaustion include award-winning film editor Sally Menke*, mixed-martial artist Dave Legano (Fenrir Greyback in the Harry Potter films), and an unfortunate fan at a recent Taylor Swift concert. It can happen to anyone, anywhere, any time.
It’s more important than ever to watch out for heat illnesses and to take any signs of overheating seriously so that easily treatable minor problems do not escalate into life-or-death emergencies. To do that, it’s important to understand what causes these illnesses, how to prevent them, and how to stop minor issues from turning into life-or-death situations.
Heat Exhaustion and Heat Stroke
These two conditions are often confused. Heat exhaustion is a dangerous but easily treatable heat-related illness that must be treated promptly. Heat stroke is the most severe form of heat illness and is a life-threatening medical emergency. The cause of both is easy to understand: spending too much time in hot conditions, excessive exertion, and not taking in enough water while losing electrolytes. We’ll go into more detail below.
Heat Exhaustion
Heat exhaustion is when the body is no longer able to cool itself as more heat enters the body. Symptoms may include a pallid complexion, cold skin, sweating, dry mouth, and a temperature over 100 degrees. Nausea, vomiting, diarrhea, faintness, headaches, fatigue, and extreme anxiety are other symptoms that should arouse concern. Low blood pressure is another potential threat.
The treatment is largely common sense. Remove yourself or the ill individual from heat, go to a cool area where the patient can rest, such as an air-conditioned room, and remove any heavy or extra clothing that may be trapping heat. At this point, the patient must drink fluids, preferably with some sugar and electrolytes; an electrolyte imbalance can be life-threatening.
Sports drinks like Gatorade or Powerade are a standard treatment – but do not confuse them with sports-oriented energy drinks. Regular sports drinks are rich in electrolytes and contain some sugar, though less than you’ll find in a standard soda or fruit juice. Coconut water is also high in potassium and other nutrients without being excessively high in sugar. If electrolyte-rich drinks are unavailable, use water. Fruit that is high in potassium can also be helpful, particularly fruits with high liquid contents such as watermelon and juicy oranges, apples, berries, etc.
Avoid any beverages that may contain caffeine such as colas, iced tea, Mountain Dew, and especially energy drinks and iced coffee. Caffeine causes the body to speed up and is a diuretic and that’s exactly the opposite of what someone with heat exhaustion needs. Alcoholic beverages are also diuretics and obviously must be avoided. Alcohol could also cause an ill person to become careless and not seek necessary attention.
If there’s no improvement after about an hour, immediate medical attention is required.
Heat Stroke
Heat stroke is always a life-threatening emergency. The symptoms are like heat exhaustion but likely to be more severe. If confusion, fainting, unconsciousness, seizures, and a temperature of 104 or over occur, the situation is an emergency, and calling 911 will typically be necessary.
First aid should be administered immediately while you’re waiting for help. Get the patient to a cool place where they can rest. If the patient is conscious, try to have them drink an electrolyte beverage or cold water. You should also fan the skin and place ice packs against the neck, under the arms, and in the lap and groin area. These locations may sound odd, but it turns out that there are large blood vessels in these areas; strategically placed ice packs can help the individual cool down more quickly.
Less Serious Heat Illnesses
These conditions are extremely uncomfortable but less dangerous. If they recur or persist, however, it’s important to see a medical professional.
Heat Rash (Prickly Heat)
This condition involving small, itchy bumps on the skin may be more common in infants but people at any age can get it.
It is easily treated in most cases. Patients should stay in an air-conditioned area, if possible, drink a lot of fluids without caffeine or alcohol, and cool down the skin with a tepid or cold shower or bath. Somewhat more severe rashes may involve larger bumps that can, in the most gross cases, break open and expel pus. Regardless, cooling the skin and hydration should bring an adult or child back to normal.
Heat Cramps
Heat cramps are more than just painful, they are a possible warning sign that further heat exposure may be dangerous. They happen when excessive sweating causes us to lose vital electrolytes such as potassium and muscles are unable to function properly. Along with some degree of pain, you may feel your muscles tighten and harden and you may even be able to see extremities like fingers and toes curl up. Muscle spasms are also likely.
If you act promptly and get out of the sun, remove any extra layers of clothing, go to the coolest area available, drink liquids, and take in electrolytes, relief should come quickly. While Gatorade and coconut water-type beverages may be the quickest route out, water and whatever fruits may be on hand may also be sufficient.
If the situation improves but you find yourself experiencing heat cramps repeatedly, first make sure you are staying well hydrated, consuming electrolytes, and not spending a lot of time in excessive heat. If heat cramps recur after that, you should speak to a doctor.
Prevention
A little basic knowledge and common sense go a long way. The most important thing is to make a habit of staying well hydrated by drinking plenty of fluids, preferably water. This might sound self-evident but simply drinking when you’re thirsty may not be sufficient for several reasons. We don’t always realize we are dehydrated or, in some cases, may not feel thirsty after we are already at risk of an illness. Babies, young children, and more aged people may have a reduced thirst response.
As for the rest of us, there is little reason not to drink a little more water than we feel like. Not only does it effectively prevent heat illnesses, but drinking a lot of water also appears to have many long-term health benefits. While it’s possible to overdo anything, drinking more water is nearly always an excellent idea.
Handling Potentially Dangerous Situations
If you will be exerting yourself for a significant time on a hot day or even just a warm one, make sure you will have beverages handy – preferably with little or no caffeine.
Hiking and running alone can be especially dangerous and have resulted in countless deaths. Drink fluids, get to the coolest area nearby, and rest. If you don’t feel better within an hour and symptoms persist — despite getting hydrated, resting, and cooling off — seek medical attention. If you’re someplace remote calling a friend, relative, or emergency medical care may be a lifesaving decision.
Who Gets Heat-Related Illnesses?
Anyone who spends long periods in excessive heat is at risk but some people are in greater danger. Children, seniors, and obese people may be more suspectable. Pets are also vulnerable. Every year far too many children and pets, more often dogs, pass away from excessive heat after being left in cars, even with windows partially opened. Leaving kids or pets alone in cars for more than a few minutes is abuse and neglect; don’t do it.
Of course, athletes and other people who exert themselves outdoors are more likely to suffer from heat illnesses. People who exert themselves while wearing heavy clothes either for protective purposes, like construction workers and football players, or for ceremonial reasons like marching band members, are also more likely to suffer heat illnesses for obvious reasons.
People who use recreational drugs like amphetamines, crystal meth, and cocaine are especially vulnerable as well. Unhoused people also run a special risk for obvious reasons.
What House Call Doctor Los Angeles Can Do
While heat stroke is a very urgent condition that must be treated on an immediate basis and it’s important to apply first aid very quickly, board-certified internist Dr. Michal Farzam and his team are here to help you deal with ongoing or acute dehydration issues that can get even worse during a long-running heatwave. We can also help with issues such as asthma, diabetes, and cardiovascular problems that can all be made worse by hot weather.
In addition to routine checkups and tests to rule out more serious problems, we can also provide specialized IV drips that combine speedy hydration with an array of nutrients and supplements in a special mixture (“cocktail”) designed for a patient’s health and wellness. Many of our patients swear by our IV hydration and Meyers cocktail services. IVs provide instant hydration that goes directly into the bloodstream with a special blend of nutrients. Many patients find it invigorating and a boost to their overall well-being.
Stay Cool, Hydrated, and Healthy with House Call Doctor Los Angeles
Whether you’re feeling seriously run-down after a hard day of outdoor exertion or suffering from a chronic or acute illness or minor injury, driving through LA traffic on a hot day – or any day – to get to a crowded traditional urgent care center is never ideal. Dr. Michael Farzam and House Call Doctor Los Angeles can dispatch a top mobile doctor who can provide personalized care at your home, office, or hotel. For those who’d like to take advantage of this kind of care all the time, we also offer concierge services for those who’d like personalized mobile care regularly.
To learn more about what Dr. Michael Farzam and the House Call Doctor Los Angeles Team can do for you, call the number on your screen or visit our contact page.
* Menke was best known for her career-long association with Quentin Tarantino. She died after going on a hike with her dog, who was not in danger; the pooch apparently got much better care from the beloved filmmaker than she gave to herself.
