A. JABBAR DENTAL CLINIC

Sadia Khan

Discover how heatwaves affect your sleep and tips to stay cool at night on Meri Sehat. Sleep better despite the heat.

Tossing and Turning? Blame It On The Heatwave

FAQs About Heat Stroke

Introduction

Extreme temperatures accounted for an estimated 1 to 7 million deaths globally in 2019<a href="#accordion">[1]</a>. 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<a href="#accordion">[2]</a>. Furthermore, the number of people exposed to heat waves increased by 125 million from 2000-2016<a href="#accordion">[2]</a>.

The inevitable climate change has drastically increased global temperatures and the frequency and intensity of heat waves across the world<a href="#accordion">[3]</a>. 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<a href="#accordion">[4]</a>. 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<a href="#accordion">[4]</a>.

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%<a href="#accordion">[5]</a>. The high heat index coupled with high humidity is a common factor in the increased incidence of heat-related illnesses across Karachi and Pakistan.

&nbsp;

Understanding FAQs about heat stroke

<h5>What Are Heat-Related Illnesses?</h5>

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. 
&nbsp;

Heat-related illnesses can range from mild heat cramps to more severe heat stroke. The common types of heat illnesses are:

<ul>
	<li>Heat rash</li>
	<li>Heat cramps</li>
	<li>Heat syncope</li>
	<li>Heat exhaustion</li>
	<li>Heat stroke 
	&nbsp;</li>
</ul>

<h5>Is Heat Illness And Fever The Same?</h5>

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. 
&nbsp;

<h5>What Is A Heat Stroke?</h5>

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.

Heat stroke can be classified into two types - exertional and non-exertional.

<ul>
	<li>Exertional Heat Stroke (EHS) - This type of heat stroke results from prolonged strenuous physical activity in hot and humid conditions. It is more common in young individuals. 
	&nbsp;</li>
	<li>Classic Non-Exertional Heat Stroke (NEHS) - 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. 
	&nbsp;</li>
</ul>

<h5>What Causes A Heat Stroke?</h5>

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.

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. 
&nbsp;

<h5>What Are The Warning Signs Of A Heat Stroke?</h5>

In a heat stroke, the body temperature can rise to 106 &deg;F or higher within a span of 10-15 minutes.

Other signs and symptoms to look out for are:

<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>

Note: Heat stroke is a medical emergency. If you or someone you know experiences any of the above signs and symptoms, seek help immediately. 
&nbsp;

<h5>Can Exercising Lead To A Heat Stroke?</h5>

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. 
&nbsp;

<h5>Is Heat Stroke The Same As Heat Exhaustion?</h5>

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.

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. 
&nbsp;

<h5>What Is The Difference Between A Heat Stroke And A Stroke?</h5>

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. 
&nbsp;

<h5>Can Anyone Get A Heat Stroke?</h5>

Anyone who is exposed to hot, humid conditions can develop a heat stroke. However, certain people are more at risk. These include:

<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 
	&nbsp;</li>
</ul>

<h5>Can I Get A Heat Stroke In A Car?</h5>

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.

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. 
&nbsp;

<h5>Can Certain Medications Increase My Risk Of A Heat Stroke?</h5>

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. 
&nbsp;

<h5>Are Heat Strokes Deadly?</h5>

Yes, if not treated immediately and adequately, heat stroke can be fatal. Delayed therapy can cause mortality rates of 80%<a href="#accordion">[6]</a>. 
&nbsp;

<h5>What Are The First-Aid Measures For A Heat Stroke?</h5>

The following first-aid measures can help treat a heat stroke:

<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. 
	&nbsp;</li>
</ol>

The cooling efforts are continued till the body temperature decreases to 38.3-38.8 &deg;C (101-102 &deg;F).

&nbsp;

<h5>If My Child Has A Heat Stroke, Can I Place Him/Her In A Tub Of Ice Water?</h5>

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. 
&nbsp;

<h5>Can Medications Help Treat A Heat Stroke?</h5>

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.

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. 
&nbsp;

<h5>How Long Does It Take To Recover From A Heat Stroke?</h5>

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.

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. 
&nbsp;

<h5>What Are The Risk Factors Of A Heat Stroke?</h5>

The following factors may contribute to or increase the risk of a heat stroke:

<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 
	&nbsp;</li>
</ul>

<h5>Can A Heat Stroke Have Long-Term Effects?</h5>

If left untreated, people with heat stroke can progress to a coma. The elevated body temperature can also lead to the following complications:

<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 
	&nbsp;</li>
</ul>

<h5>How Can I Protect Myself From A Heat Stroke?</h5>

You can prevent heat stroke by taking the following steps:

<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>

&nbsp;

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

[6] Robert S Helman M. Heat stroke. Practice Essentials, Pathophysiology, Etiology.

Nimrah H. Sattar

FAQs About Heat Syncope

Heat syncope, also known as orthostatic<a href="https://merisehat.pk/disease/dizziness"> dizziness</a>, usually occurs during intense physical activity or prolonged standing in hot environments. This article aims to address frequently asked questions related to heat syncope, providing a comprehensive understanding of its causes, symptoms, and prevention strategies. 
&nbsp;

Understanding FAQs about Heat Syncope

<h5>What Is Heat Syncope?</h5>

Heat syncope is a temporary loss of consciousness or fainting episode caused by exposure to high temperatures. It typically occurs due to a sudden drop in blood pressure and inadequate blood flow to the brain. 
&nbsp;

<h5>What Are The Common Causes Of Heat Syncope?</h5>

Heat syncope is primarily caused by excessive heat, dehydration, and inadequate salt intake. Physical exertion, standing for long periods, and sudden changes in body position can also contribute to its occurrence. 
&nbsp;

<h5>What Are The Symptoms Of Heat Syncope?</h5>

Common symptoms of heat syncope include:

<ul>
	<li>Dizziness</li>
	<li>Lightheadedness</li>
	<li>Feeling faint</li>
	<li>Rapid or weak pulse</li>
	<li>Pale skin</li>
	<li>Sweating</li>
</ul>

Fainting may or may not accompany these symptoms. 
&nbsp;

<h5>Who Is At Risk Of Developing Heat Syncope?</h5>

Individuals engaged in strenuous physical activities, athletes, workers in hot environments, and those with a history of heat-related illnesses or certain chronic illnesses like heart disease are at a higher risk of developing heat syncope<a href="#accordion">[2]</a>. 
&nbsp;

<h5>How Is Heat Syncope Different From Heat Exhaustion And Heatstroke?</h5>

Heat syncope is distinct from heat exhaustion and heatstroke.

While heat syncope involves a temporary loss of consciousness due to inadequate blood flow, heat exhaustion is characterized by excessive sweating, fatigue, nausea, and rapid heartbeat.

Heatstroke, on the other hand, is a life-threatening condition marked by extremely high body temperature, altered mental state, and organ dysfunction. 
&nbsp;

<h5>What Should I Do If I Experience Heat Syncope?</h5>

If you experience heat syncope, you should:

<ul>
	<li>Find a cool and shaded area</li>
	<li>Lie down</li>
	<li>Elevate your legs</li>
	<li>Drink plenty of fluids, preferably water, to rehydrate</li>
</ul>

Note: Seek medical attention if symptoms worsen or persist. 
&nbsp;

<h5>How Can Heat Syncope Be Prevented?</h5>

It is essential to stay hydrated by drinking plenty of fluids, especially before and during physical activities in hot environments to prevent heat syncope. Avoid prolonged standing, take breaks in shaded areas, and wear lightweight, breathable clothing. 
&nbsp;

<h5>Can Certain Medications Increase The Risk Of Heat Syncope?</h5>

Yes, certain medications like diuretics, antihypertensives, and medications that affect blood pressure can increase the risk of heat syncope. Consult with your healthcare provider about potential risks and precautions. 
&nbsp;

<h5>Are There Any Long-Term Complications Associated With Heat Syncope?</h5>

Heat syncope is generally a transient condition without long-term complications. However, recurrent episodes of heat syncope can indicate an underlying health issue and further evaluation may be necessary. 
&nbsp;

<h5>Is Heat Syncope More Common In Certain Climates?</h5>

Heat syncope can occur in any hot climate, but it is more prevalent in regions with high temperatures and humidity levels. It is also more likely to occur during a heatwave or in areas with limited access to cooling facilities. 
&nbsp;

<h5>Can Individuals With Certain Medical Conditions Be More Susceptible To Heat Syncope?</h5>

Yes, individuals with pre-existing medical conditions, such as heart disease, low blood pressure, diabetes, and autonomic nervous system disorders, may be more susceptible to heat syncope. They should take extra precautions and consult with their healthcare provider. 
&nbsp;

<h5>Are There Any Age-Related Factors Influencing Heat Syncope Risk?</h5>

Heat syncope can affect individuals of all ages. However, older adults and children are more vulnerable due to their reduced ability to dissipate heat and regulate body temperature effectively. 
&nbsp;

<h5>Is There Any Specific First-Aid Treatment For Heat Syncope?</h5>

First aid for heat syncope involves moving the affected individual to a cool area, providing fluids for rehydration, elevating their legs, and monitoring their condition. If the person loses consciousness for an extended period or experiences seizures, it is crucial to seek immediate medical assistance<a href="#accordion">[3]</a>. 
&nbsp;

Understanding the causes, symptoms, and preventive measures of heat syncope is crucial especially if you are exposed to high temperatures. By addressing these frequently asked questions, we hope to provide helpful information and empower you to protect yourself and others from the risks associated with heat syncope. Remember, if you have any concerns or experience recurrent symptoms, it is always advisable to seek medical advice from a healthcare professional.

[1] Centers for Disease Control and Prevention. (2021). Extreme Heat and Your Health.

[2] Mayo Clinic. (2021). Heatstroke.

[3] National Institute for Occupational Safety and Health. (2016). Occupational Heat Exposure.

[4]  U.S. Department of Labor. (n.d.). Occupational Safety and Health Administration.

Syeda Qurat-ul-Ain

This article or video has been viewed by many visitors, and is popular.

Combating Extreme Heat? Here’s What You Need To Know!

IMPORTANT!

Heat stroke is a medical emergency. Call paramedics immediately if you or a loved has a heatstroke! 
&nbsp;

With summer ahead, it&rsquo;s about to get pretty hot.

You may not realize it when your body starts heating up, a condition known as <a href="https://merisehat.pk/article/beating-heat-exhaustion-101">heat exhaustion</a>. Especially when you&rsquo;re out playing or sunbathing.

But you can usually cool down from heat exhaustion in 30 minutes or less. The issue arises when you or a loved one don&rsquo;t feel better even after a break. Then, it&rsquo;s considered a heatstroke. 
&nbsp;

There are three types of heat-related illnesses &ndash; heat cramps, heat exhaustion, and heat stroke, with heat cramps being the mildest form and heatstroke being the most severe form of heat illness<a href="#accordion">[2]</a>.

Generally, your body cools down by sweating and radiating heat. However, your body&rsquo;s heat-regulating system may fail sometimes. You become dehydrated and your internal heat rises to dangerous levels. This condition is known as heatstroke.

Heatstroke can occur as a progression from heat cramps or it can occur even if there&rsquo;s no previous heat injury. 
&nbsp;

Causes and Risks

The following factors can cause heatstroke:

<ul>
	<li>Dehydration</li>
	<li>Long exposure to a hot, humid environment (especially between noon and 4 pm, which is the peak sun hour)</li>
	<li>Lack of airflow (e.g., poor ventilation or confined space)</li>
	<li>Crowded places</li>
	<li>Certain drugs like cocaine</li>
	<li>Intense physical activity 
	&nbsp;</li>
</ul>

The following people are vulnerable to getting a heatstroke<a href="#">[3]</a>:

<ul>
	<li>Infants</li>
	<li>Elderly</li>
	<li>People with chronic illnesses like diabetes</li>
	<li>People who are physically unfit, obese, or have a sedentary lifestyle</li>
	<li>People who have infections that cause dehydration</li>
	<li>People who work, train, or participate in events outdoors</li>
	<li>People prescribed certain medicines, including vasoconstrictors, diuretics, beta-blockers, and antidepressants</li>
	<li>Pregnant women</li>
	<li>Breastfeeding mothers</li>
	<li>Homeless people or those living without air conditioning</li>
	<li>People with limited mobility or cognitive impairments so they&rsquo;re unable to identify, communicate their needs, or reach out for water 
	&nbsp;</li>
</ul>

Note: Heatstroke often leads to organ damage and death. Hence, it can be fatal if immediate medical attention is not provided to the patient. 
&nbsp;

Symptoms Of Heatstroke

These include<a href="#accordion">[1]</a>:

<ul>
	<li>Headache</li>
	<li>Hyperthermia (body temperature is suddenly greater than 104&deg;F)</li>
	<li>Rapid heartbeat</li>
	<li>Rapid breathing</li>
	<li>Nausea and vomiting</li>
	<li>Loss of appetite</li>
	<li>Dry, flushed skin that&rsquo;s not sweating</li>
	<li>Lack of sweating despite the heat</li>
	<li>Muscle cramps</li>
	<li>Darker urine</li>
	<li>Fatigue</li>
	<li>Dizziness</li>
	<li>Hallucinations</li>
	<li>Agitation and disorientation</li>
	<li>Slurred speech</li>
	<li>Seizure</li>
	<li>Loss of consciousness</li>
	<li>Coma 
	&nbsp;</li>
</ul>

Untreated heatstroke can be fatal. The longer the treatment is delayed, the greater the risk of developing serious complications or death.

In case of suspected heatstroke, call the local emergency services. While waiting for help, here&rsquo;s what you can do:

<ul>
	<li>Shift the person indoors or lay them in a cool, shady area.</li>
	<li>Remove excess clothing.</li>
	<li>Drench their skin with cool water &ndash; a fan with mist, a spray bottle, or even a cool shower is acceptable.</li>
	<li>Sponge or place ice packs on their head, neck, armpit, and groin.</li>
	<li>Offer them water or sports drink if they are alert and can swallow.</li>
	<li>Monitor their body temperature and continue with your cooling efforts until their temperature drops below 38&deg;C.</li>
	<li>Perform CPR if the patient is not breathing normally.</li>
	<li>DO NOT give paracetamol, aspirin, or ibuprofen to a heatstroke patient. 
	&nbsp;</li>
</ul>

Note: Keep checking up on old and sick people in your neighborhood, family, or friends who may need assistance to beat the heat. 
&nbsp;

Here are some tips to prevent heatstroke: 
&nbsp;

<ol>
	<li>
	<h5>&nbsp;Stay Hydrated</h5>
	</li>
</ol>

<ul>
	<li>Carry a water bottle with you. Drink enough water, fresh juice, or sports drinks even if you don&rsquo;t feel thirsty. This is especially true if you are involved in outdoor or vigorous activities.</li>
	<li>Breastfeeding mothers should drink extra water, too, on hot days.</li>
	<li>However, avoid carbonated drinks, caffeine, and extremely cold fluids.</li>
	<li>Drink oral rehydration solutions if you have painful muscle spasms.</li>
</ul>

&nbsp;

<ol start="2">
	<li>
	<h5>&nbsp;Eat Smaller Meals</h5>
	</li>
</ol>

<ul>
	<li>You can eat more often, just keep your portions small.</li>
	<li>Avoid foods high in protein. 
	&nbsp;</li>
</ul>

<ol start="3">
	<li>
	<h5>&nbsp;Keep Yourself Cool</h5>
	</li>
</ol>

<ul>
	<li>Shower often.</li>
	<li>Pamper your feet with ice baths.</li>
	<li>Use damp towels to sponge when outside.</li>
	<li>Stay in an air-conditioned room if possible. Keep your indoor environment cool even if there&rsquo;s no A.C. Draw your curtains to keep the sun out of your homes and workplaces.</li>
	<li>Visit air-conditioned community spaces like a mall or library for a couple of hours.</li>
</ul>

&nbsp;

<ol start="4">
	<li>
	<h5>&nbsp;Shop Summer Clothing </h5>
	</li>
</ol>

<ul>
	<li>Wear loose-fitting and light-colored clothes made of breathable fabric.</li>
	<li>Take care not to overdress babies in hot weather. 
	&nbsp;</li>
</ul>

<ol start="5">
	<li>
	<h5>&nbsp;Monitor The Urine </h5>
	</li>
</ol>

<ul>
	<li>Dark color or fewer trips to the loo mean dehydration 
	&nbsp;</li>
</ul>

<ol start="6">
	<li>
	<h5>&nbsp;Schedule Your Activities</h5>
	</li>
</ol>

<ul>
	<li>Avoid exercising in this weather. Or plan it for the cooler part of the day.</li>
	<li>Rest and stay indoors.</li>
	<li>If you must be out during the day, make sure there&rsquo;s shade nearby. Also, try and get your body used to the hot weather first before spending time outdoors.</li>
	<li>Apply sunscreen in generous amounts for protection against sunburn.</li>
	<li>Wear a hat and sunglasses or you can use an umbrella to protect yourself from heat exposure. 
	&nbsp;</li>
</ul>

<ol start="7">
	<li>
	<h5>&nbsp;Be Informed&nbsp;&nbsp; </h5>
	</li>
</ol>

<ul>
	<li>Educate your circle on how to identify the signs and symptoms of heatstroke and how to respond to it.</li>
	<li>Make sure you know about medical services in the locality in case of a heat emergency. Act quickly if you notice any symptoms of heatstroke.</li>
	<li>Inform your doctor if certain medications affect your body&rsquo;s ability to dissipate heat. Consult them for further advice on how to manage your medical condition during hot weather.</li>
	<li>Teach children to inform a caregiver when they are tired and need a break. They can cool off by swimming or dousing their wrists and ankles with cold water. 
	&nbsp;</li>
</ul>

Important!

Do not leave a person sitting in a parked car even with the windows open or the air conditioning on. 
&nbsp;

Following the Heat Wave Alert-1 for Karachi issued by the Meteorological Department in 2019, the Government of Sindh took preemptive measures, including the implementation of 24/7 emergency in all hospitals and health facilities and conducting health awareness campaigns among the masses, to address any emergency<a href="#accordion">[7]</a>.

In 2022, the Pak Met Department declared April to be the hottest month on record in 61 years<a href="#accordion">[5]</a>. The National Health Services and Regulations issued an advisory directing all the concerned national and provincial agencies to ensure coordinated measures to avoid casualties due to heatstroke<a href="#accordion">[6]</a>.

Additionally, the National Institute of Health also directed educational institutes to take necessary measures to reduce the effect of extreme heat on students<a href="#accordion">[6]</a>. The School Education Department (SED) of the District Education Authority (DEA), Lahore, has prohibited all public and private schools and academies from conducting summer camps during the summer vacation<a href="#accordion">[8]</a>.

Several heatstroke relief camps have been set up by local governments and NGOs in various parts of the country to provide support. 
&nbsp;

As you take care of yourself and other loved ones to avoid heatstroke, make sure you don&rsquo;t forget your furry friends, too. Make sure they have access to shade and plenty of water. 
&nbsp;

Key Takeaways

<ul>
	<li>Heatstroke is a life-threatening condition.</li>
	<li>Young children, old people, people with chronic medical conditions, and breastfeeding or pregnant women are at greater risk of developing heatstroke.</li>
	<li>Stay indoors or in the shade, drink plenty of water, and reduce activity (e.g., gardening and exercise) during hot weather.</li>
	<li>It&rsquo;s also suggested to schedule outdoor activities either before noon or in the evening to avoid the hottest part of the day.</li>
	<li>The room temperature should be below 32&deg;C during day and 24&deg;C during night.</li>
	<li>Do not leave your pets or kids in a parked car.</li>
	<li>Be attentive to warnings about high temperatures.</li>
	<li>Get medical assistance if you feel confused or weak following an activity in the daytime or if the heat leaves you gasping for breath or increases your pulse.</li>
	<li>Check on loved ones twice a day during a heatwave. Call an ambulance if someone has a high body temperature and shows irrational behavior or altered consciousness. 
	&nbsp;</li>
</ul>

[1] Heatstroke. Mayo Clinic. June 25, 2022. Accessed June 8, 2023.

[2] Heat-Related Illnesses (Heat Cramps, Heat Exhaustion, Heat Stroke) | Johns Hopkins Medicine. February 28, 2020. Accessed June 8, 2023.

[3] Department of Health &amp; Human Services. Heat stress – preventing heatstroke. Better Health Channel. May 17, 2001. Accessed June 8, 2023.

[4] Heatwaves: How to stay cool. World Health Organization. Accessed June 8, 2023.

[5] Heatwave prompts Load Management. The Express Tribune. May 12, 2022. Accessed June 9, 2023.

[6] Azad AR. Amid intense heatwave, Govt Issues Health Advisory. Brecorder. May 15, 2022. Accessed June 9, 2023.

[7] Sindh HD of. Latest News and events. Health Department of Sindh. Accessed June 9, 2023.

[8] Reporter TNS. Ban on summer camps during vacation. DAWN.COM. June 6, 2023. Accessed June 9, 2023.

Shermeen Zuberi

Beating Heat Exhaustion 101!

Summer is all about having fun, lazing around, and for the lucky among us, showing off that bod in the sun. I really feel like a spoilsport (yes, believe me!) reminding you about the heatwave. Far from sharing hot vacation spots, fashion styles, color palettes, or even a list of summer movies, this article advises you to stay safe when the temperature outside soars. 
&nbsp;

Heat exhaustion means your body has become overheated and is unable to cool itself down. While indulging in physical activities, especially exercise, is a common reason for your body to be dehydrated, just being outside in hot, humid weather can also cause heat exhaustion.

Are heat exhaustion and heatstroke the same thing? No. Heat exhaustion precedes heatstroke, which is a life-threatening emergency. That&rsquo;s why it&rsquo;s SO IMPORTANT to know about heat exhaustion. There&rsquo;s a high possibility you don&rsquo;t even realize immediately that your body is losing fluid or heating up until the condition turns critical and needs medical attention! 
&nbsp;

Your Body Needs HELP

DO NOT ignore any of the following symptoms of heat exhaustion as your body signals you to get out of the scorching sun:

<ul>
	<li><a href="https://merisehat.pk/article/types-of-headache">Headache</a></li>
	<li>Extreme thirst</li>
	<li>Dark-colored urine</li>
	<li>Profuse sweating</li>
	<li>Pale skin or heat rash</li>
	<li>Fatigue</li>
	<li>Racing heartbeat</li>
	<li>Rapid breathing</li>
	<li>Dizziness</li>
	<li>Muscle cramps</li>
	<li>Feeling sick or nauseous</li>
	<li>Vomiting</li>
	<li>Diarrhea</li>
	<li>High temperature (over 104 &deg;F)</li>
	<li>Weakness</li>
	<li>Anxiety</li>
	<li>Confusion</li>
	<li>Altered speech 
	&nbsp;</li>
</ul>

The bad news is there&rsquo;s no knowing when these symptoms occur. It may be a sudden onset; it may progress with time. The good news is that heat exhaustion can be prevented and/or treated. 
&nbsp;

Help Those At Risk

Heat exhaustion is a common occurrence. However, some are more inclined to experience it than others. This includes:

<ul>
	<li>Young children</li>
	<li>Elderly</li>
	<li>Those with certain medical conditions, like obesity, heart disease, and diabetes</li>
	<li>Those prescribed certain medications, like diuretics, beta-blockers, and chemo drugs</li>
	<li>Those who live or work in hot conditions, especially if they carry heavy equipment or wear heavy clothing 
	&nbsp;</li>
</ul>

Keep an eye out for them. If someone has heat exhaustion, don&rsquo;t hesitate to move them to a well-aerated place immediately and remove all unnecessary clothing, such as socks, off their body.

Sponge or spray their skin. You can also use a cold pack wrapped in cloth and place it on their neck or under the armpits. Make them drink cool water or a sports drink. Stay with them till they feel better<a href="#accordion">[1]</a>. 
&nbsp;

Note: The body needs to cool down within 30 minutes. If it does NOT, then the person may need emergency medical help. 
&nbsp;

10 Tips To Stay Cool

The following tips can help avoid heat exhaustion<a href="#accordion">[2]</a>: 
&nbsp;

<ol>
	<li>&nbsp;Drink lots of fluids to maintain normal body temperature. Skip the sugary drinks.</li>
	<li>&nbsp;Ditch tight clothes for loose-fitting and breathable clothing to allow for proper cooling.</li>
	<li>&nbsp;A broad-spectrum sunscreen with an SPF of 30 or more, sunglasses, and a wide-brimmed hat? Check, check, check!</li>
	<li>&nbsp;As a thumb rule, it&rsquo;s unsafe to leave anyone in a parked car. Not a loved one and definitely not your pet.</li>
	<li>&nbsp;Inform your doctor if some medication affects your body&rsquo;s ability to dissipate heat or stay hydrated.</li>
	<li>&nbsp;A little management hurt no one. Schedule your outdoor work for another time, like early morning or evening. It shouldn&rsquo;t be too hot then.</li>
	<li>&nbsp;Of course, I couldn&rsquo;t not mention rest now. It&rsquo;s summer, after all. Take your sweet time participating in any activity or sport. Sit in the shade to cool down and rehydrate as often as required. Keep a wet washcloth handy to cool your forehead or the back of your neck. Sit or lie down if necessary.</li>
	<li>&nbsp;Opt to stay indoors. An air-conditioned office or an air-conditioned mall is the place to be. Also, did I remind you how staying at home gives you the perfect opportunity to bathe for as long as you want to cool yourself down?</li>
	<li>&nbsp;Keep your colleagues informed about your condition if you&rsquo;re an increased risk. They can look out for you.</li>
	<li>&nbsp;Staying informed is perhaps the best trick in the book. This includes checking local news for weather updates and passing on that to everyone you know. Moreover, knowing when and where to seek emergency care is crucial. 
	&nbsp;</li>
</ol>

<ul>
	<li>If these strategies don&rsquo;t work, seek medical help immediately! Untreated heat exhaustion can lead to heatstroke.</li>
	<li>If you&rsquo;ve recently recovered from heat exhaustion, avoid hot weather and strenuous exercise until your doctor approves it. 
	&nbsp;</li>
</ul>

Stay safe and enjoy the summer! 
&nbsp;

[1] Heat exhaustion and heatstroke. NHS choices. Accessed June 6, 2023.

[2] Heat exhaustion. Mayo Clinic. April 6, 2023. Accessed June 6, 2023.

First Aid For Heat Stroke

<a href="https://merisehat.pk/disease/heat-stroke">Heat stroke </a>is a severe condition that occurs when the body&#39;s temperature regulation system fails due to prolonged exposure to high temperatures or intense physical activity in hot environments. It is a medical emergency that requires immediate attention. By understanding the signs and symptoms of heat stroke and knowing the appropriate first aid measures, we can potentially save lives and prevent long-term complications. In this article, we will delve into the comprehensive first aid for heat stroke to help you respond effectively in such critical situations<a href="#accordion">[1]</a>. 
&nbsp;

Recognizing Heat Stroke

Heat stroke is characterized by a dangerously high body temperature (usually above 104&deg;F or 40&deg;C) accompanied by a range of symptoms. These symptoms may include:

<ol>
	<li>&nbsp;High body temperature</li>
	<li>&nbsp;Rapid and strong pulse</li>
	<li>&nbsp;Rapid breathing or difficulty breathing</li>
	<li>&nbsp;Headache, dizziness, or confusion</li>
	<li>&nbsp;Nausea or vomiting</li>
	<li>&nbsp;Hot, red, and dry skin (no sweating)</li>
	<li>&nbsp;Altered mental state or loss of consciousness</li>
	<li>&nbsp;Seizures or convulsions<a href="#accordion">[2]</a> 
	&nbsp;</li>
</ol>

First Aid for Heat Stroke

When confronted with a suspected heat stroke victim, it is crucial to take immediate action. Here are the recommended first aid measures: 
&nbsp;

<ol>
	<li>&nbsp;Call for Emergency Assistance: Dial the emergency hotline or ask someone nearby to call for immediate medical help. Heat stroke is a life-threatening condition that requires professional medical attention.</li>
	<li>&nbsp;Move To A&nbsp;Cool Environment: If possible, transfer the person to a shaded or air-conditioned area away from direct sunlight. It is essential to reduce the body&#39;s exposure to heat and provide a cooler environment.</li>
	<li>&nbsp;Lower The Body Temperature: Initiate cooling measures immediately. The following methods can be used:</li>
</ol>

<ul>
	<li>Remove Excess Clothing: Help the person remove any unnecessary clothing to facilitate heat loss.</li>
	<li>Apply Cool Water: Dampen the person&#39;s skin with cool water and use a fan or any available means to promote evaporation and cooling. Focus on areas with large blood vessels, such as the neck, armpits, and groin.</li>
	<li>Use Cold Compresses: Apply cold, wet towels or ice packs to the person&#39;s neck, head, armpits, and groin to aid in cooling. Avoid using ice directly on the skin to prevent frostbite<a href="#accordion">[3]</a>.</li>
</ul>

<ol start="4">
	<li>&nbsp;Hydrate: If the person is conscious and able to swallow, provide cool water or electrolyte-replenishing drinks to help prevent dehydration. However, avoid forcing fluids if the person is unconscious or experiencing seizures.</li>
	<li>&nbsp;Monitor Vital Signs: While waiting for medical professionals to arrive, monitor the person&#39;s vital signs, including their breathing, pulse, and level of consciousness. Be prepared to administer CPR if necessary<a href="#accordion">[4]</a>. 
	&nbsp;</li>
</ol>

Preventing Heat Stroke

Prevention is the key to avoiding heat stroke. Here are some essential tips to prevent heat-related illnesses:

<ul>
	<li>Stay hydrated by drinking plenty of fluids, especially when engaging in physical activities or being exposed to high temperatures.</li>
	<li>Avoid strenuous physical exertion during the hottest parts of the day.</li>
	<li>Wear lightweight, loose-fitting clothing and use sunscreen to protect against sunburn.</li>
	<li>Take regular breaks in shaded or air-conditioned areas when working or exercising outdoors.</li>
	<li>Never leave children or pets unattended in vehicles, as they can quickly succumb to heat stroke<a href="#accordion">[5]</a>. 
	&nbsp;</li>
</ul>

Heat stroke is a life-threatening medical emergency that demands immediate attention. Recognizing the signs and symptoms of heat stroke and knowing how to provide first aid can be the difference between life and death. Remember to call for professional help, move the person to a cool area, initiate cooling measures, and monitor their vital signs. By being aware of preventive measures and promoting heat safety, we can effectively reduce the incidence of heat-related illnesses and protect ourselves and others from the dangers of heat stroke. 
&nbsp;

[1] Mayo Clinic. (2022). Heatstroke: First aid.

[2] Centers for Disease Control and Prevention. (2021). Heat Stress: Heat-Related Illnesses and First Aid.

[3] American Red Cross. (n.d.). Heat Exhaustion and Heat Stroke.

[4] WebMD. (n.d.). Heatstroke: First Aid Treatment.

[5] National Safety Council. (n.d.). Heatstroke Safety.

Heatwaves are becoming increasingly common due to climate change, and their impact extends beyond mere discomfort during the day. They can significantly disrupt your sleep, leading to a cascade of negative effects on your health. 
&nbsp;

Understanding how temperature affects sleep

Our bodies follow a natural circadian rhythm, which regulates our sleep-wake cycles besides other physiological processes. One critical aspect of this rhythm is a drop in body temperature, which signals to your brain that it&#39;s time to sleep. Normally, your body temperature decreases by about 0.5-1&deg;C (1-2&deg;F) at night to facilitate sleep.<a href="#accordion">[1]</a> This decrease in temperature aids in the production of melatonin, the hormone that regulates sleep.

When external temperatures remain high, especially during heatwaves, this natural cooling process is disrupted. As a result, it becomes difficult for you to fall and stay asleep. 
&nbsp;

When your body is unable to reach the ideal temperature for sleep, you may experience: 
&nbsp;

<ul>
	<li>
	<h5>Difficulty Falling Asleep</h5>
	</li>
</ul>

High temperatures make it hard for your body to initiate the cooling process required to fall asleep. The discomfort from excessive heat can keep you tossing and turning for hours. 
&nbsp;

<ul>
	<li>
	<h5>Frequent Awakenings</h5>
	</li>
</ul>

Even if you manage to fall asleep, the heat can cause you to wake up multiple times during the night. These interruptions prevent you from reaching the deeper stages of sleep, which are crucial for restorative rest. 
&nbsp;

<ul>
	<li>
	<h5>Reduced REM Sleep</h5>
	</li>
</ul>

Rapid eye movement (REM) sleep is a crucial stage associated with dreaming and cognitive functions such as memory and learning. Studies have shown that heat can reduce the duration and quality of REM sleep.<a href="#accordion">[2]</a> 
&nbsp;

<ul>
	<li>
	<h5>Increased Risk Of Sleep Disorders</h5>
	</li>
</ul>

Prolonged exposure to high temperatures at night can contribute to the development of sleep disorders such as insomnia. Moreover, people with pre-existing conditions like <a href="https://merisehat.pk/article/i-cant-sleep-is-it-because-of-my-allergies">sleep </a>apnea may find their symptoms worsening during heatwaves. 
&nbsp;

Lack of quality sleep can have several immediate and long-term health consequences, including:<a href="#accordion">[3]</a> 
&nbsp;

<ul>
	<li>
	<h5>Cognitive Impairment</h5>
	</li>
</ul>

Poor sleep affects your ability to think clearly or make decisions. This leads to decreased productivity and a higher risk of accidents. 
&nbsp;

<ul>
	<li>
	<h5>Mood Changes</h5>
	</li>
</ul>

Sleep deprivation is linked to irritability, anxiety, and depression. These effects can be amplified during a heatwave, negatively impacting your overall well-being. 
&nbsp;

<ul>
	<li>
	<h5>Physical Health</h5>
	</li>
</ul>

Chronic sleep deprivation can weaken the immune system, increase the risk of cardiovascular diseases, and exacerbate existing health conditions such as diabetes and hypertension. 
&nbsp;

<ul>
	<li>
	<h5>Dehydration</h5>
	</li>
</ul>

Heatwaves often lead to increased sweating, which can cause dehydration. Dehydration itself can disrupt sleep and create a vicious cycle of poor rest and further dehydration. 
&nbsp;

Here&rsquo;s how you can beat the heat and get better sleep:

<ol>
	<li>Keep your bedroom cool.</li>
	<li>If you&rsquo;re wondering how to sleep in hot weather without AC, then here&rsquo;s one trick &ndash; avoid heavy blankets. Switch to lightweight, breathable bedding made from natural fibers like cotton.</li>
	<li>Drink plenty of water throughout the day, but avoid large amounts right before bed to prevent waking up to use the bathroom.</li>
	<li>Cooling down by taking a shower before bed can help lower your body temperature and make it easier to fall asleep.</li>
	<li>Regularizing your sleep and wake-up times reinforces your circadian rhythm, helping you fall asleep faster and wake up more refreshed.</li>
	<li>Avoid exercise or using electronic devices right before bed. These activities can increase your body temperature, making it more difficult to cool down. 
	&nbsp;</li>
</ol>

Heatwaves are more than just an uncomfortable weather phenomenon &mdash; they pose a real threat to your sleep and overall health. By understanding how heat affects your sleep and taking proactive measures to create a cooler sleep environment, you can get the restful sleep you need. 
&nbsp;

<ul>
	<li>Our body temperature naturally drops by 1-2&deg;F (0.5-1&deg;C) at night to facilitate sleep.</li>
	<li>High external temperatures during heatwaves disrupt this cooling process, making it hard to fall and stay asleep.</li>
	<li>Consequently, poor sleep due to heatwaves leads to cognitive impairment, mood changes, dehydration, and a weak immune system.</li>
	<li>Cooling your sleep environment and maintaining good sleep hygiene can help reinforce your circadian rhythm and ensure restful sleep.</li>
</ul>

[1] Sleep: What happens to body temperature, brain activity, and breathing. WebMD. Accessed July 8, 2024.

[2] Zheng G, Li K, Wang Y. The Effects of High-Temperature Weather on Human Sleep Quality and Appetite. Int J Environ Res Public Health. 2019;16(2):270. Published 2019 Jan 18.