Get answers to frequently asked questions about heat stroke with Meri Sehat. Stay informed for prevention and timely intervention.

FAQs About Heat Stroke

The lack of greenery and increased urbanization in cities around the world have led to an increased risk of heat-related emergencies.

Introduction

<p>Extreme temperatures accounted for an estimated 1 to 7 million deaths globally in 2019<sup><a href="#accordion">[1]</a></sup>. The severity, duration, and frequency of extreme temperature events, such as heatwaves, floods, and storms, have been increasing over the past few years. According to the World Health Organization (WHO), more than 166,000 people died due to heat waves between 1998 and 2017<sup><a href="#accordion">[2]</a></sup>. Furthermore, the number of people exposed to heat waves increased by 125 million from 2000-2016<sup><a href="#accordion">[2]</a></sup>.</p>

<p>The inevitable climate change has drastically increased global temperatures and the frequency and intensity of heat waves across the world<sup><a href="#accordion">[3]</a></sup>. Extreme heat exposure affects the body&rsquo;s temperature regulations, leading to heat-related illnesses and an exacerbation of existing conditions, such as <a href="https://merisehat.pk/disease/hypertension-57">hypertension </a>and diabetes<sup><a href="#accordion">[4]</a></sup>. However, these effects of extreme heat are often exaggerated among city dwellers due to the urban heat island effect. Cities in both high- and low-income countries can have temperatures 3.5-12 &deg;C higher than the surrounding areas<sup><a href="#accordion">[4]</a></sup>.</p>

<p>From 2006-2015, the temperature in Karachi (Pakistan) reached a high of 45 &deg;C during May-July, and the daily average humidity ranged between 30-95%<sup><a href="#accordion">[5]</a></sup>. The high heat index coupled with high humidity is a common factor in the increased incidence of heat-related illnesses across Karachi and Pakistan.</p>

<p>&nbsp;</p>

Understanding FAQs about heat stroke

<h5><strong>What Are Heat-Related Illnesses?</strong></h5>

<p>Prolonged exposure to extreme heat and humidity coupled with dehydration can lead to heat-related illness. Working or exercising in hot and humid conditions can also cause heat illness. A high temperature and increased humidity disrupt the body&rsquo;s temperature regulation and cause normal core temperature to rise.<br />
&nbsp;</p>

<p>Heat-related illnesses can range from mild heat cramps to more severe heat stroke. The common types of heat illnesses are:</p>

<ul>
	<li>Heat rash</li>
	<li>Heat cramps</li>
	<li>Heat syncope</li>
	<li>Heat exhaustion</li>
	<li>Heat stroke<br />
	&nbsp;</li>
</ul>

<h5><strong>Is Heat Illness And Fever The Same?</strong></h5>

<p>Although the body temperature is raised above the normal level in a heat illness, it is not due to an infection, as is the case in a fever. Instead, high heat and humidity are the cause of hyperthermia.<br />
&nbsp;</p>

<h5><strong>What Is A Heat Stroke?</strong></h5>

<p>Heat stroke is a severe type of heat-related illness characterized by an elevated core body temperature (&gt;40 &deg;C) and neurologic dysfunction. It is a life-threatening condition and needs emergency medical attention.</p>

<p>Heat stroke can be classified into two types - exertional and non-exertional.</p>

<ul>
	<li><strong>Exertional Heat Stroke (EHS) -</strong> This type of heat stroke results from prolonged strenuous physical activity in hot and humid conditions. It is more common in young individuals.<br />
	&nbsp;</li>
	<li><strong>Classic Non-Exertional Heat Stroke (NEHS) -</strong> Unlike exertional heat stroke, this type occurs due to heat waves and is more likely to occur in regions that do not typically experience prolonged hot conditions. It is common in the elderly, chronically ill individuals, and infants.<br />
	&nbsp;</li>
</ul>

<h5><strong>What Causes A Heat Stroke?</strong></h5>

<p>Sweating is a normal body response to excessive heat. The evaporation of this sweat helps the body cool down. However, during periods of high heat index (&gt;90 degrees Fahrenheit) and humidity (&gt;60%), sweat evaporation is disrupted. As a result, the body absorbs more heat than releasing it, causing the internal body temperature to rise.</p>

<p>A depletion of salt and water in the body, likely due to dehydration, also contributes to a heat stroke as the body is unable to sweat fast enough to release heat.<br />
&nbsp;</p>

<h5><strong>What Are The Warning Signs Of A Heat Stroke?</strong></h5>

<p>In a heat stroke, the body temperature can rise to 106 &deg;F or higher within a span of 10-15 minutes.</p>

<p>Other signs and symptoms to look out for are:</p>

<ul>
	<li>Lack of sweating</li>
	<li>Hot, red, and dry skin</li>
	<li>Confusion or altered mental status</li>
	<li>Dizziness, light-headedness, and weakness</li>
	<li>Headache</li>
	<li>Nausea</li>
	<li>Fast pulse</li>
	<li>Seizure</li>
	<li>Loss of consciousness</li>
</ul>

<p><strong>Note:</strong> Heat stroke is a medical emergency. If you or someone you know experiences any of the above signs and symptoms, seek help immediately.<br />
&nbsp;</p>

<h5><strong>Can Exercising Lead To A Heat Stroke?</strong></h5>

<p>Exercising in direct sunlight or in hot and humid environments can lead to excessive sweating, resulting in the loss of water and salts. If these are not replaced adequately, it can result in dehydration. Dehydration reduces the body&rsquo;s ability to sweat, raising the internal body temperature and causing a heat stroke.<br />
&nbsp;</p>

<h5><strong>Is Heat Stroke The Same As Heat Exhaustion?</strong></h5>

<p>Heat exhaustion is a milder form of heat illness. Although both heat exhaustion and heat stroke can elevate the body temperature, in heat exhaustion, the body temperature does not go above 40 &deg;C (104 &deg;F). However, it is a precursor to heat stroke.</p>

<p>Moreover, heat exhaustion is characterized by heavy sweating, cool, clammy skin, muscle cramps, and weakness. Whereas heat stroke has symptoms that include a lack of sweat, dizziness, and neurological dysfunction.<br />
&nbsp;</p>

<h5><strong>What Is The Difference Between A Heat Stroke And A Stroke?</strong></h5>

<p>Both stroke and heat stroke cause damage to brain cells. However, a heat stroke results from extreme heat exposure, while a stroke occurs due to a clot or aneurysm disrupting blood flow to the brain cells.<br />
&nbsp;</p>

<h5><strong>Can Anyone Get A Heat Stroke?</strong></h5>

<p>Anyone who is exposed to hot, humid conditions can develop a heat stroke. However, certain people are more at risk. These include:</p>

<ul>
	<li>Elderly</li>
	<li>Infants</li>
	<li>Athletes</li>
	<li>People who work outdoors (e.g., laborers, firefighters, farmers)</li>
	<li>People unacclimatized to high temperatures<br />
	&nbsp;</li>
</ul>

<h5><strong>Can I Get A Heat Stroke In A Car?</strong></h5>

<p>Cars can heat up quite rapidly in the sun, even on a mild day. Therefore, children and pets left in a locked car can die from a heat stroke in less than an hour.</p>

<p>Similarly, older adults in nursing homes or those shut inside their rooms during the summer can also get a heat stroke. Although the room may not seem hot, their frail bodies can slowly get overloaded by the heat.<br />
&nbsp;</p>

<h5><strong>Can Certain Medications Increase My Risk Of A Heat Stroke?</strong></h5>

<p>Yes, certain medications can increase the risk of heat stroke and other heat-related illnesses. They include antidepressants, diuretics, antihistamines, antipsychotics, antibiotics, anti-hypertensives, and stimulants. These medications can interfere with the body&rsquo;s normal thermoregulatory function by decreasing the sweat rate.<br />
&nbsp;</p>

<h5><strong>Are Heat Strokes Deadly?</strong></h5>

<p>Yes, if not treated immediately and adequately, heat stroke can be fatal. Delayed therapy can cause mortality rates of 80%<sup><a href="#accordion">[6]</a></sup>.<br />
&nbsp;</p>

<h5><strong>What Are The First-Aid Measures For A Heat Stroke?</strong></h5>

<p>The following first-aid measures can help treat a heat stroke:</p>

<ol>
	<li>Call emergency medical services immediately.</li>
	<li>Follow the ABCs. Ensure the airways are open, and the person&rsquo;s breathing and circulation are intact.</li>
	<li>Move the person to a cool, shady area or an air-conditioned environment.</li>
	<li>Remove any unnecessary or tight clothing.</li>
	<li>Spray the person with cool water.</li>
	<li>Sponge the person with a wet cloth.</li>
	<li>Fan the person to help them sweat and promote evaporation.</li>
	<li>Place ice packs under the person&rsquo;s neck, groin, and armpits.</li>
	<li>Immerse the person in cold water.</li>
	<li>If the person can drink, offer them cool liquids, like sports drinks.</li>
	<li>Monitor body temperature with a thermometer.</li>
	<li>In cases of seizures, the patient should be moved away from injury-causing objects and not given anything by mouth.</li>
	<li>Unconscious patients should be moved to their side to avoid choking.<br />
	&nbsp;</li>
</ol>

<p>The cooling efforts are continued till the body temperature decreases to 38.3-38.8 &deg;C (101-102 &deg;F).</p>

<p>&nbsp;</p>

<h5><strong>If My Child Has A Heat Stroke, Can I Place Him/Her In A Tub Of Ice Water?</strong></h5>

<p>Ice or cold water immersion should not be used in children and older adults. Evaporative cooling is preferred as it does not interfere with monitoring or resuscitation measures and achieves rapid cooling.<br />
&nbsp;</p>

<h5><strong>Can Medications Help Treat A Heat Stroke?</strong></h5>

<p>Medications usually have no role in the treatment of heat stroke. Antipyretics, such as acetaminophen, are strictly contraindicated as they can cause liver or kidney injury.</p>

<p>In the past, doctors have used dantrolene in the treatment of heat stroke, but research has shown it to be ineffective. Furthermore, benzodiazepines are often used to control the shivering associated with cooling methods. However, there are no universal recommendations outlining its use in heat stroke patients.<br />
&nbsp;</p>

<h5><strong>How Long Does It Take To Recover From A Heat Stroke?</strong></h5>

<p>Recovery typically depends on the severity of the heat stroke and whether any organ damage has taken place. Initial recovery takes 1-2 days in the hospital, while complete recovery can take anywhere from 2 months to a year. During recovery, it is advised to avoid physical activity and any heat exposure for at least a week. The doctor should be consulted before returning to normal activities.</p>

<p>Moreover, people who have had a heat stroke are at risk of developing it again. Therefore, it is important to take precautionary measures, especially during heatwaves.<br />
&nbsp;</p>

<h5><strong>What Are The Risk Factors Of A Heat Stroke?</strong></h5>

<p>The following factors may contribute to or increase the risk of a heat stroke:</p>

<ul>
	<li>Dehydration</li>
	<li>Male gender</li>
	<li>Age (Infants and the elderly are most at risk)</li>
	<li>Wearing heavy clothing in hot weather</li>
	<li>Obesity</li>
	<li>Deprived sleep</li>
	<li>History of a heat stroke</li>
	<li>Certain medications, e.g., diuretics, antidiarrheals, calcium channel blockers, antihistamines, or laxatives</li>
	<li>Existing health conditions, such as diabetes</li>
	<li>Drinking alcohol</li>
	<li>Illicit drug use<br />
	&nbsp;</li>
</ul>

<h5><strong>Can A Heat Stroke Have Long-Term Effects?</strong></h5>

<p>If left untreated, people with heat stroke can progress to a coma. The elevated body temperature can also lead to the following complications:</p>

<ul>
	<li>Rhabdomyolysis</li>
	<li>Kidney failure</li>
	<li>Brain swelling</li>
	<li>Acute respiratory distress syndrome (ARDS)</li>
	<li>Liver failure</li>
	<li>Metabolic dysfunction</li>
	<li>Nerve damage</li>
	<li>Circulatory problems<br />
	&nbsp;</li>
</ul>

<h5><strong>How Can I Protect Myself From A Heat Stroke?</strong></h5>

<p>You can prevent heat stroke by taking the following steps:</p>

<ul>
	<li>When going outdoors, wear loose, light-colored clothing, and a hat.</li>
	<li>Ensure proper hydration by drinking eight glasses of fluids (e.g., water, fruit juice, vegetable juice) or more per day.</li>
	<li>Increase fluid intake when exercising or working outdoors in hot conditions.</li>
	<li>Exercise or work during the cooler hours of the day.</li>
	<li>Use sunscreen when going out in the sun.</li>
	<li>Avoid drinks containing caffeine or alcohol, as they can cause dehydration.</li>
	<li>Try to stay indoors during a heatwave.</li>
	<li>Close windows and draw curtains during the afternoon or hotter parts of the day.</li>
	<li>Keep cool by staying in an air-conditioned room or under a fan. In case there is no electricity, place a wet cloth or an ice pack around the neck or wrists to stay cool.</li>
</ul>

<p>&nbsp;</p>

Conclusion

[1] The Lancet. Health in a world of extreme heat. The Lancet. 2021;398(10301):641. doi:10.1016/s0140-6736(21)01860-2

[2] Heatwaves. World Health Organization.

[3] Heat and Health. World Health Organization.

[4] Razzak JA, Agrawal P, Chand Z, Quraishy S, Ghaffar A, Hyder AA. Impact of community education on heat-related health outcomes and heat literacy among low-income communities in Karachi, Pakistan: randomized controlled trial. BMJ Glob Health. 2022;7(1):e006845. doi:10.1136/bmjgh-2021-006845

[5] Khan UR, Ahmed N, Naeem R, et al. Heat Emergencies: Perceptions and Practices of Community Members and Emergency Department Healthcare Providers in Karachi, Pakistan: A Qualitative Study. Int J Environ Res Public Health. 2021;18(9):4736. Published 2021 Apr 29. doi:10.3390/ijerph18094736

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