Prevention and recognition of exertional heat illnesses can make summer days happy days Published May 24, 2007 By John Martin Exercise physiologist SHEPPARD AIR FORCE BASE, Texas -- As many of you know, North Texas summers can bring about extreme weather conditions, varying from mild to high humidity with mild to high temperatures. As we approach the 101 Critical Days of Summer, it's important to start applying operational risk management practices to prevent exertional heat illnesses, when exercising outdoors. Make sure you are prepared! You're saying, "Alright, John, what are exertional heat illnesses?" Well, dehydration, heat cramps, heat exhaustion and heat stroke are all considered exertional heat illnesses. As you read on you will find a definition of each, how to prevent, how to recognize, and how to treat an exertional heat illness. Dehydration Definition: Excessive loss of fluids from the body, often caused by inadequate fluid intake before, during, or after strenuous exercise. Prevention: Drink 16-24 ounces of cold water two hours before exercise time, and 4-8 ounces of cold water for every 15 to 20 minutes during exercise. Recognition: Dry mouth, thirst, irritability, general discomfort, headache, apathy, weakness, dizziness, cramps, chills, vomiting, nausea, head or neck heat sensations, excessive fatigue and/or decreased performance. Treatment: Move to a cool environment and re-hydrate. Drink 16-24 ounces of cold water after exercise. If exercise was at a high intensity and a long duration re-hydrating with a sports drink might be appropriate to replenish the carbohydrates and electrolytes that were lost. If you experience any nausea or vomiting, you should seek medical help. Heat cramps Definition: Intense pain from persistent muscle contractions. Prevention: Ensure adequate exercise conditioning, acclimization, rehydration during and after exercise, electrolyte replacement and appropriate dietary practices which includes adequate intake of minerals. Recognition: Intense pain not associated with acute muscle strain, and persistent muscle contractions in working muscles during prolonged exercise and most often associated with exercise in heat. Treatment: Re-establish normal hydration and replace some of the sodium losses with sports drinks or other sodium sources. Light stretching, relaxation and massage of the involved muscle may help alleviate acute pain associated with muscle cramps. Heat exhaustion Definition: A condition caused by prolonged exposure to heat, resulting in the depletion of body fluids and causing weakness, dizziness, nausea and often making the body shut down. Prevention: Drink 16-24 ounces of cold water two hours before exercise time, and 4-8 ounces of cold water for every 15 to 20 minutes during exercise. Ensure adequate exercise conditioning, acclimization, rehydration during and after exercise, electrolyte replacement and appropriate dietary practices which includes adequate intake of minerals. If the humidity is very high and the temperature is between 75 degrees and 102 degrees, the exercise/rest ratio recommendation is 15 to 20 minutes of activity followed by five to 10 minutes of rest and fluid breaks. With moderate to low humidity, the exercise/rest ratio recommendation is 20 to 30 minutes of activity followed by five to 10 minutes of rest and fluid breaks. Recognition: Having difficulty in continuing to exercise in the heat, physical fatigue, weakness, coordination problems, dizziness, profuse sweating, headache, nausea, stomach/intestinal cramps or vomiting. Treatment: Move to a cool dry environment and replace fluid losses. If more serious symptoms persist seek immediate medical attention. Heat stroke Definition: A severe, life threatening condition resulting from a derangement of the bodies internal heat control system, often brought on by strenuous physical activity and increased environmental heat stress. Prevention: Drink 16-24 ounces of cold water two hours before exercise time, and 4-8 ounces of cold water for every 15 to 20 minutes during exercise. Ensure adequate exercise conditioning, acclimization, rehydration during and after exercise, electrolyte replacement and appropriate dietary practices which includes adequate intake of minerals. If the humidity is very high and the temperature is between 74 degrees and 102 degrees, (same note as above) the exercise/rest ratio recommendation is 15 to 20 minutes of activity followed by five to 10 minutes of rest and fluid breaks. With moderate to low humidity, the exercise/rest ratio recommendation is 20 to 30 minutes of activity followed by five to 10 minutes of rest and fluid breaks (same note as above). Recognition: Central nervous system dysfunction i.e....altered consciousness, coma, convulsions, disorientation, irrational behavior, decreased mental acuity, irritability, emotional instability, confusion, hysteria and apathy. Also other signs of heat stroke are nausea, vomiting, diarrhea, headache, dizziness, weakness, hot and wet or dry skin. Treatment: Call 911 for immediate medical emergency attention. While waiting for help to arrive, move the patient out of the sun to a cool area if possible. Begin whole body cooling using ice packs under the arms or in the groin area, even spraying the body with cold water or immersing them in ice water if available. Even if the patient's status improves get the patient to a hospital to monitor for organ damage. Additional questions about exertional heat illnesses can be addressed by calling/contacting exercise physiologist John Martin at the Health and Wellness Center, 676-4292.