NEVER leave pets & children in hot cars

NEVER leave pets or children in a closed, parked vehicle; even for "a few minutes." Children, elderly adults, or disabled individuals left alone in a vehicle are at particular risk of succumbing to heat stroke. When the outside temperature is 70 degrees Fahrenheit, the temperature inside the car can exceed 120 degrees in minutes, even with the windows slightly open. Pets are even more susceptible than humans to heat stroke in cars, as dogs, cats and many other animals cannot produce whole body sweat.

Heat stroke can be fatal and occurs when the body gives up on trying to cool down. As temperatures climb, your heart beats faster to whisk away internal body heat via the blood stream to keep your insides and your brain at 98 F. Your skin sweats (dogs pant) to aid the removal of heat from the blood just beneath the skin.

If you've ever had a fever with a cold (or raised an infant) then you'll know that our body has very little tolerance for internal temperate change. Heat stroke is defined as an internal temperature of 104 F; that just 5.4 degrees above normal. At that temperature the brain can become confused and internal organs can become damaged. The body will work very hard to keep you below that limit but it's a losing battle when the air itself is hotter than 104 or when exposed to heat for a long time and you run out of sweat (dehydrated) or the heart becomes exhausted and just flutters rapidly instead of rapid pumping. One sign of heat stroke is the LACK of sweat.

For heat stroke call 911 and get help. Shade and water will help with heat exhaustion but with heat stroke the body is in serious trouble. The Mayo Clinic says,

Heatstroke treatment centers on cooling your body to a normal temperature to prevent or reduce damage to your brain and vital organs. To do this, your doctor may take these steps:

• Immerse you in cold water. Your doctor may put your body in a bath of cold water or ice water to quickly lower your temperature.
• Use evaporation cooling techniques. Some doctors prefer to use evaporation instead of immersion to lower your body temperature. In this technique, cool water is misted on your skin while warm air fanned over your body causes the water to evaporate, cooling the skin.
• Pack you with ice and cooling blankets. Another method is to wrap you in a special cooling blanket and apply ice packs to your groin, neck, back and armpits to lower your temperature.
• Give you medications to stop your shivering. If any treatments to lower your body temperature make you shiver, your doctor may give you a muscle relaxant, such as a benzodiazepine. Shivering increases your body temperature, making treatment less effective.

Special precautions in hot weather

A message from the CDC,

The Centers for Disease Control and Prevention encourages coaches, athletes, and those exercising outside in hot weather to know the warning signs for heat-related illness and take action when needed. 
“Any athlete dying from heat is a tragedy that can be prevented,” said CDC’s Robin Ikeda, M.D., M.P.H., Deputy Director for Noncommunicable Diseases, Injury and Environmental Health.  “Coaches, parents, teachers, and athletes should educate themselves on how to recognize and prevent heat-related illness.”
CDC estimates that, each year, there are almost 6,000 emergency department visits for sports and recreation heat illnesses. CDC says the most common activities leading to the hospital visits are football, and exercises such as walking, jogging, running, and calisthenics.  People who exercise in extreme heat are more likely to become dehydrated and get heat-related illness.
Extremely hot weather can cause illness or death, but all heat-related illnesses and deaths are preventable.
Here are some ways to act against heat-related illness:

• Stop all activity and get to a cool environment if you feel faint or weak.
• Limit outdoor activity, especially midday when the sun is hottest.
• Schedule workouts and practices earlier or later in the day when the temperature is cooler.
• Pace activity. Start activities slow and pick up the pace gradually.
• Drink more water than usual and don’t wait until you′re thirsty to drink more.
• Have a workout partner. Monitor each other’s condition.
• Wear loose, lightweight, light-colored clothing.
• Seek medical care immediately if you or a teammate has symptoms of heat-related illness.

Coaches can learn more about how to protect the athletes in their care by taking CDC′s accredited Web–based course on how to recognize, treat, and prevent heat–related illness. School nurses and athletic trainers may also find the course useful for sharing information with others who work with athletes.

CDC has also published a toolkit to educate readers, especially caregivers for vulnerable groups such as athletes, as well as older adults and small children, about how to recognize warning signs of heat illness.  Materials such as posters for locker rooms and water bottle labels are targeted for use with school athletic programs.  

More information about heat illness in high school athletes can be found at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5932a1.htm.

For more information on extreme heat and heat safety, call 1-800-CDC-INFO (1-800-232-4636) or visit http://www.cdc.gov/.

Stay Cool to Stay Healthy As Temperatures Soar

Here is a message from the US Center for Disease Control (CDC) regarding the summer heat:
The Centers for Disease Control and Prevention officials are warning people to stay cool, hydrated and informed to prevent illnesses and injuries as cities across the Midwest, South and East Coast continue to issue heat warnings and watches. Extreme heat can lead to very high body temperatures, brain and organ damage, and even death. On average, 675 people die from complications related to extreme heat each year in the United States – more than tornadoes, hurricanes, floods, lightning or any other weather event combined.
"Extreme heat affects all of us but the most vulnerable are the elderly, those who work or exercise outdoors, infants and children, the homeless or poor, and people with a chronic medical condition," said Christopher Portier, PhD, director of CDC's National Center for Environmental Health. "Taking precautions to stay cool, hydrated and informed helps to prevent serious health effects such as heat exhaustion or heat stroke during this massive heat wave."
Heat related deaths and illness are completely preventable yet every year many people succumb to the effects of extreme heat. People suffer heat-related illness when their bodies are unable to compensate and properly cool themselves. Common sense practices will keep you safe and healthy during the scorching days of summer.

Stay cool

Air-conditioning is the number one protective factor against heat-related illness and death. If a home is not air-conditioned, people can reduce their risk for heat-related illness by spending time in public facilities that are air-conditioned like shopping malls and libraries. (http://www.cdc.gov/nceh/extremeheat/)

Stay hydrated

Drink cool non-alcoholic beverages and increase your fluid intake regardless of your activity level; increase your intake hourly if you are outdoors working or exercising. Drink more water than usual and don't wait until you're thirsty to drink. Make sure your family, friends and neighbors are drinking enough water. (http://www.cdc.gov/nceh/extremeheat/)

Stay active

Doing too much on a hot day, spending too much time in the sun or staying too long in an overheated place can cause heat-related illnesses especially during sports and recreational activities.
"Take breaks; stay hydrated and move physical activities to the cooler parts of the day if they can't be moved indoors," said Linda Degutis, Dr. PH, M.S.N., director of CDC's National Center for Injury Prevention and Control. "We encourage people to continue sports and recreational activities as much as possible during this heat wave, but take the necessary steps to prevent heat-related illness and injury."
Be sure to gradually increase exercise frequency, duration and intensity to allow your body to adjust to the heat if you are just getting started or returning to practices (e.g. football or band rehearsals). It's also a good idea to have an exercise partner or practice partner and watch for signs and symptoms of heat illness in each other. If leading organized activities, follow established guidelines from schools, sports organizations or medical organizations regarding changing or canceling activities to prevent heat illness, and alter practices to remove the need for heavy safety gear (e.g., football pads) on hot or humid days.

Stay safe

Even short periods of high temperatures can cause serious health problems, debilitating injury or death, never leave infants, children or pets in parked cars; check on people who are overweight they may be prone to heat sickness because of their tendency to retain more body heat. People who suffer from chronic conditions such as heart disease or high blood pressure, or who take certain medications, such as for depression, insomnia, or poor circulation, may be affected by extreme heat. Know the symptoms of heat disorders, overexposure to the sun, and be ready to give first aid treatment. http://www.cdc.gov/Features/ExtremeHeat/

Bottom Line

Check your local news for extreme heat warnings and safety tips, or sign up for free weather alerts to your phone or e-mail from websites such as www.weather.com/mobile. Visit http://www.cdc.gov/ for tips for preventing heat sickness, keep an eye on your friends, family and neighbors and be aware of weather and heat safety information.
For more information on extreme heat and heat safety, call 1-800-CDC-INFO (1-800-232-4636) or visit http://www.cdc.gov/.

It's Hot, Hot, Hot

“Some people change their ways when they see the light;
others when they feel the heat”

- Caroline Schoeder

What is the deadliest type of natural disaster? A supernova as pictured yesterday would top the list by frying the entire planet but we should be safe from that for several billion years. Other obvious candidates include hurricanes, massive earthquakes, and tidal waves. Hurricane Katrina may have killed 1700 people directly with a total of 4000 deaths if you include secondary causes. And yet according to a new book called "Hot Time in the Old Town" by professor Edward P. Kohn, the deadliest type of natural disaster in America is heat waves.

"We all enjoyed pictures of children playing in fountains and eating ice cream.  To the media, a heat wave means a holiday.  This obscures the sinister fact that heat waves are this country’s number one natural disaster killer. On average, heat kills more Americans than floods, hurricanes, and tornadoes combined. "

This summer Russian had a terrible heat wave that caused forest fires and burned wheat fields. American TV showed pictures of a smoke-choked Moscow but news agencies failed to mention the death count. The Moscow city government reported a doubling of deaths during the heat wave; every day three hundred additional people died over a period of  several weeks. This quickly adds up to a catastrophe.

The 1896 heat wave in New York City killed as many as thirteen hundred people who literally roasted to death in brick buildings. The media and the government basically ignored the emergency. The one person who took action was a young Theodore Roosevelt, President of the Board of Police Commissioners, who distributed free ice to the poor. No one learned anything from this and history continued to repeat itself. In 1972 as many as nine hundred people died during a New York heat wave.  The 1995 Chicago heat wave killed seven hundred, while a 2003 European heat wave killed over 50,000.

Bottom Line

Perhaps it was the 2003 European disaster that finally convinced cities to take heat waves seriously.

Today, most cities have heat wave response plans in place even before summer arrives.  Emergency cooling centers are set up in local community centers, and officials check on the elderly and chronically ill through phone calls and home visits. 

For more information on the risks of extreme heat check out these prior blog posts:

2009/07/greenhouse-effect-in-cars
2009/07/exercising-on-hot-days
2009/07/extreme-heat
2008/08/heat-exhaustion
2008/08/hyperthermia   (note: hyper not hypo)

The Greenhouse Effect in Cars

"Every dog has his day - but the nights are reserved for the cats" - unknown

Have you ever visited a green house and been amazed at how warm it was inside? Light waves, in particular short-wave infrared, penetrate the glass, get absorbed by objects inside and radiated back as heat (long-wave infrared). The heat waves can not penetrate the glass, so the temperature goes up inside.

Have you ever considered that your car is also a greenhouse? Each year about 40 children in the US die inside hot cars. Hundreds of dogs are literally cooked to death.

The typical excuse of parents is, “I only ran in for a second, I wasn't going to be long.” On a 78 degree day, a car parked in the shade can quickly exceed 90 degrees. A car parked in the sun can hit a scorching 160 degrees. It only about 10-15 minutes, for a child or pet left inside a hot car to suffer from heat exhaustion, heat stroke or death.

Rolling down a window doesn't guarantee protection since temperatures can still climb into the danger zone. And if the window is rolled down sufficiently, your pet may escape from the car. If your window is open and a passer-by claims he or she was bitten through the car window, you will be liable for a lawsuit. [Paw-rescue.org]

Some people leave the car running with the A/C blowing to keep pets cool while they’re away. Overlooking the chance of car jacking, this is still dangerous. In 2003, a police dog in Texas died after the air-conditioning in the patrol car shut down because the engine got too hot. The car automatically switched to blowing hot air to save the engine.

Bottom Line

Leaving children and pets unattended inside a car is a crime in most states. Don’t do it.

Sometimes children become trapped inside cars when playing or decide to sleep in the car. Always lock car doors and trunks and keep keys out of children's reach.

If your pet show signs of heat exhaustion - restlessness, excessive thirst, heavy panting, lethargy, dark tongue, rapid pulse, fever, vomiting, glazed eyes, dizziness, or lack of coordination - move the pet into the shade, an air conditioned area, or to the vet. Lower body temperature gradually by giving the animal water to drink. Place a cold towel or ice pack on the head, neck and chest, and/or immerse dogs in cool (not cold) water.
www.paw-rescue.org/PAW/PETTIPS/DogTip_HotCars.php

Exercising on Hot Days

“Laughter is as good as jogging for our heart, lungs, and brain” - unknown

Exercising in hot weather can be dangerous for your and your dog.

Pets need exercise, but on very hot days it is best to limit walks or exercise to early morning or evening hours when it’s cooler. Hot asphalt and beach sand can burn pet paws. Pets can get sunburned too, and may require sunscreen on their nose and ear tips.

With people, heat exhaustion, heat stroke, and dehydration are real possibilities when the temperature is greater than 70 degrees with humidity of 70% and above. High humidity means sweat doesn't evaporate very well because the air is already saturated with moisture. So you're losing fluids but not cooling down.

1. Stay hydrated. Take a drink every 15 minutes when exercising and consider a sports drink like Gatorade to replace lost salts and electrolytes.

2. Avoid the peak heat between 10am and 3pm.

3. Dress in light, comfortable clothes in light colors

4. Know the symptoms of heat illness: headache, nausea, dizziness, and light-headedness. Stop your fitness workout routine immediately, start replacing fluid, and find shade or spray your body with cool water.
Signs of heat stroke include confusion, rapid pulse, difficultly breathing, and dry skin with no sweat. If you suspect heat stroke, it's important to seek medical attention immediately as this can be a life threatening.

5. Wear sunscreen.

6. Cut yourself a little slack on extra hot days. This is NOT the time to maximize your workout. The good news is that you’ll be burning extra calories just coping with the heat.

7. When the temperature hits 80 with humidity consider moving your workout to an air-conditioned mall or gym. An increase in your body’s core temperature reduces the endurance capacity of your muscles.

8. If you insist on working out outdoors, build up to it slowly with short workouts in the heat for two weeks before your body is ready for the full routine.

9. Train with other people when it’s extra hot. Remember confusion is a symptom of heat stroke so a friend may notice if you’re in trouble, even if you don’t.

Bottom Line

If you live in a city, high heat can also mean poor air quality with ozone or smog. Long term exposure to smog can reduce the immune system's ability to fight off respiratory infections and can damage lung cells.

See Also
http://www.hss.edu/conditions_14593.asp/
www.50plus.com/Health/Fitness/index.cfm?documentID=21577
www.bukisa.com/articles/84831_how-to-exercise-in-hot-weather

Hyperthermia (Heat Stroke)

"I will have nought to do with a man who can blow hot and cold with the same breath" - Aesop (620 BC - 560 BC), The Man and the Satyr

Hyperthermia (too much internal body heat) is the opposite of Hypothermia. The early stage is more commonly called Heat Exhaustion (up to 104°F), the advanced, life threatening, stage is Heat Stroke (105°F and above). Heat Stroke can permanently damage the brain and internal organs.

Under normal conditions the body can sweat away and radiate away the heat we produce inside. When the air temperature is higher than your body temperature (98.6 degrees) heat radiation is greatly impacted. You can also be affected by lower air temperature if you're exercising or exerting yourself vigorously and generating heat faster than the body can shed it. Both high humidity and dehydration can reduce the ability to sweat effectively. (Hence the importance of drinking fluids.) Antihistamines and certain types of medication for high blood pressure or depression can increase the risk of over heating. Tea, coffee, soda and alcohol can lead to dehydration and should be avoided when heat illness is likely.

Symptoms of Heat Stroke

• hot, DRY skin that is flushed but NOT sweaty
• a high body temperature
• rapid heart beat (flutter)
• headache or dizziness
• disorientation, agitation or confusion
• hallucinations
• sluggishness or fatigue
• seizure
• loss of consciousness or coma
• death

Note: some individuals can develop symptoms of heat stroke suddenly and rapidly without warning. Symptoms may differ per individual.

The symptoms for Heat Exhaustion are quite similar to Heat Stroke with one vital exception: with Heat Exhaustion the body is sweating profusely. If sweating stops, it's Heat Stroke - seek medical care immediately. If a person with Heat Exhaustion is unable to drink or vomiting back the fluids, call for medical help.

How to treat Heat Stroke
Heat stroke can cause permanent damage or death. Call 911 and apply these first aid measures while waiting for help to arrive:

• Get the person indoors
• Have the person lie down in a cool area with their feet slightly elevated (to prevent shock)
• Remove clothing and gently apply cool water to the skin followed by fanning to stimulate sweating. Do NOT use an alcohol rub.
• Apply ice packs to the groin and armpits
• If the person is able to drink without vomiting or choking, give cool fluids such as water or sports drinks (but not anything caffeinated)

Intravenous fluids are often necessary to compensate for fluid or electrolyte loss. Bed rest is generally advised and body temperature may fluctuate abnormally for weeks after heat stroke.

Bottom Line

Take precautions when exposed to prolonged hot and/or humid conditions.

1. Drink plenty of non-caffeinated, non-alcoholic, fluids
2. Wear loose, lightly-colored clothing
3. Wear a hat or use an umbrella
4. Take frequent breaks to cool down and drink
5. Mist yourself with a water spray or wear a wet hat or wet shirt
6. If sweating heavily you'll want to refresh your electrolytes (such as sodium). Eat a cracker or consume a sports drink
7. Have a shelter you can retreat to for shade

The Importance of Shelter

All architecture is shelter, all great architecture is the design of space that contains, cuddles, exalts, or stimulates the persons in that space. -Philip Johnson

Unless you're an expert breath holder, most people have no problem accepting the 1st Survival Rule of Three - find air within 3 minutes. However I've seen lots of misunderstanding over the second Rule of Three - find shelter within 3 hours. One commenter on a different blog pointed out that he frequently spends more than 3 hours at the beach with no difficulty.

However, the beach goer did have shelter - if the sun became too hot he could retire to his car or his house. When far from civilization, you should establish a shelter within the first few hours to keep dry or become dry, to stay out of the wind, and to find warmth or shade BEFORE weather conditions turn fatal. For hikers, shelter may be a tent they carry on their backs. It could be your car, a cave, a cabin, etc. Here are some links on creating your own emergency shelter:

http://www.abc-of-hiking.com/hiking-tents/outdoor-shelters.asp
http://en.wikibooks.org/wiki/Outdoor_Survival/Shelter
http://www.essortment.com/all/howdoyoumake_rkdt.htm
http://outdoorsurvival.org/quick-emergency-shelter

Bottom Line

Provide a shelter BEFORE you need it. While a shelter may be a place to keep "your stuff" (George Carlin) its real value is to maintain your body temperature under adverse conditions - too much heat leads to heat stroke, too little heat causes hypothermia.

Tomorrow's topic will cover hypothermia.