Boston Area Liberation Medic (BALM) Squad
Providing Medical Coverage for Progressive Actions in Boston and Beyond
BALM Squad Home
What Do Street Medics Do?
The BALM Library
Street Medic Links
Medics in the News
IT'S HOT! IT'S HUMID! IT'S SUNNY!
Information on heat and sun-related illnesses brought to you by your friendly Street Medics
A note on replacing fluids: If a person has been sweating, they have lost both fluids and electrolytes (chemicals in the blood, with sweat mainly salt). The problem may be even worse if they drink water without replacing salt. To correct this imbalance give water with salt, in gatorade or another a commercial sports drink, or water with 1 teaspoon of salt per 32 ounces of water. Do not give fluids with high sugar content (check the labelmore than 5% of daily carbohydrate needs is too much) since the sugar interferes with water absorption in the intestines.
Risk factors for heat-related illness
Dehydration: When the body loses fluid and salt that are not replaced adequately. Symptoms include thirst, weakness, fatigue, dizziness, headache. Treat by replacing fluids and salt. Start with frequent sips as more liquid may cause vomiting.
Sunburn: When the skin is burned because of excessive solar radiation. Risk of sunburn is higher from 10 am to 3 pm, at higher elevations, on windy days, when a person has fair skin, and when the person is wet. Some foods and medications (especially antibiotics, ibuprofen, aspirin, vitamin A) increase risk of sunburn. Frequent sunburns increase your risk for skin cancer. Prevent sunburn with sun-screen (oil-free if there's a risk of chemical weapons), a hat, loose clothing that covers exposed skin, and avoidance of prolonged sun exposure. Sunburn does not begin to appear until 2 - 8 hours after exposure, and usually peaks 24 - 36 hours later. Symptoms include red, itchy, painful skin, and may include nausea, vomiting, low grade fever, loss of appetite and weakness. Severe sunburn can blister. Treatment includes cooling the skin with water or wet clothes, fluid and salt replacement, aloe vera and vitamin E creams, steroid creams (no steroids to blistering skin) and anti-inflammatory medication (aspirin, ibuprofen). Don't use anesthetic sprays or creams because they can cause allergic reactions. For blistering burns, consider seeing a health care practitioner who can give stronger anti-inflammatory medications.
Heat cramps: Muscle cramps, usually in the calf or abdomen, caused by loss of salt through sweating and replacement of water without salt. Prevent by replacing fluids lost with water and salt, and by getting enough calcium before exposure to heat. Treated with gentle massage, stretching, and fluid and salt replacement.
Heat syncope, or fainting: When a person diverts blood to extremities in order to get rid of heat, resulting in less blood flow to the brain. More common when someone is also dehydrated and/or standing for a long period of time. If someone who faints has hit their head or has any other problem (including stroke, abnormal heart rhythm, diabetes), treat that problem first. If the person wakes up shortly after fainting and is not confused, then they have probably fainted from the heat. Treat heat syncope the same way as mild heat exhaustion (see below). Make sure the person remains laying down for 15 - 30 minutes, then sits for 5 minutes. Be careful when standing for the first time, as fainting may occur again.
Heat exhaustion: caused by loss or water and/or salt and exposure to high temperatures (although with heavy exertion this can occur at temperatures as low as 70 degrees F), leading to heavy sweating, pale clammy skin, fast heart rate, weakness, fatigue, headache, anxiety, poor coordination, vomiting and confusion. Mild heat exhaustion (someone with no confusion, vomiting or other medical problems) is treated by getting person to a cool shady place, resting with feet elevated 8 - 12 inches (unless there is a concern about a head injury, broken neck, leg or pelvis), loosening restrictive clothing if it is okay with the person, placing cloths with cool water or ice on the neck, chest and groin (again, with permission), fanning the person, misting with water, and replacing fluid and salt. Do not sponge with alcohol or give aspirin. If the person does not get better in 1 hour they should seek medical attention. Anyone with heat exhaustion should rest for at least 12 hours before further activity. Anyone with more serious symptoms, such as confusion or vomiting, should be seen by a health care professional immediately. While waiting for formal medical attention treat the same as for mild heat exhaustion, but do not give anything by mouth to someone who is confused or unconscious. Untreated heat exhaustion can lead to heat stroke, especially in older and younger people or anyone with other medical problems.
HEAT STROKE: CAN BE FATAL. AN EMERGENCY caused by severe dehydration and heat exposure, when the body loses the ability to control body temperature. Symptoms include hot, flushed or dry skin; confusion; shortness of breath; seizures; abnormal heart rhythms. This is a medical emergency. Treated with immediate transport to a hospital. While waiting for transport, treat the same as mild heat exhaustion, but do not give anything by mouth to someone who is confused or unconscious.
This page last updated: 10/19/2003