Summer is the season of freedom. The kids are out of school, the sun is bright and many people take vacations. The sunny weather is not without its dangers, though. The increase in temperature, coupled with the high levels of humidity in Florida, significantly increases the risk of heat-related illness.
The most serious heat-related illness is heatstroke. Exertional heatstroke (EHS) is when the body overheats because of exposure to high temperatures and humidity, especially during intense physical exertion. Typically, the evaporation of sweat allows the body to cool. Unfortunately, in Florida’s hot and humid weather, sweat does not evaporate and people do not cool off.
EHS is diagnosed as a temperature over 104 F (40 C) combined with central nervous system dysfunction. Symptoms to watch for include nausea, vomiting, disorientation, confusion, dizziness, erratic behavior, irritability, headache, loss of coordination, delirium, collapse and seizures.
Athletes are at a higher risk for EHS by nature of their intense physical activity. However, other individuals at increased risk include adults over the age of 65 and young infants; both groups have a weakened central nervous system due to age.
Additional risk factors have also been recognized. External risk factors include excessive clothing, pads and equipment. Individual risk factors include a previous heat injury, obesity, poor physical conditioning, dehydration, poor sleep, illness or fever. Alcohol, some medications and some nutritional supplements also increase the risk.
Fortunately, EHS is a preventable condition if the known risk factors are addressed, and some individuals are able to acclimate to their environments. The principle of acclimation is to slowly introduce the body to incrementally increasing physiological stressors. Acclimation can be achieved by progressively increasing the amount and intensity of exercise in the heat over a period of at least two weeks. This allows the body to progressively adapt by increasing its heat tolerance and exercise performance.
Other important preventative measures include getting the necessary amount of sleep and avoiding exercise in the heat when sick. Finally, proper hydration is vital. Beginning exercise while improperly hydrated places the body at an increased risk for heatstroke. Sufficient hydration during exercise is also important, and individuals should, at minimum, drink when thirsty during physical activity.
EHS is a medical emergency. If you see someone suffering the symptoms of EHS, contact 911 or a team physician at a sporting event. Take immediate action to get the individual into air conditioning or into the shade. Remove excess clothing, and cool the person with whatever means are available. Ideally, you should immerse the individual in a tub of ice water. If ice water is not available, alternatives are a cold shower, garden hose, sponges saturated with cold water, a blowing fan combined with cool water mist or ice packs. Cool until the body temperature decreases to 100 F and the symptoms are resolved. After, transport the individual to a medical facility for full evaluation. Complications from EHS vary and may involve organ damage or even death if not recognized and treated early.
Football, especially in high school and college, is a sport with a particularly high risk for EHS. The body disposition of the athletes, summer training camps in August, the use of pads and the rigorous demands placed on the athletes significantly increase their risk of EHS. An estimated 9,000 cases of exercise heat illness occur annually from high school sports. However, EHS occurs 11 times more often in football than all other high school sports combined. Education of athletes, parents and coaches remains paramount to prevent such catastrophic events. Fortunately, all major high schools in Alachua County have athletic trainers present during practices and games who are trained to recognize and manage EHS.
Though EHS is a risk in the hot and humid swamp we call home, Floridians can still enjoy the many benefits of exercise as long as they take precautions. Be sure to hydrate before, during and after physical activity. Wear clothing that allows your body to breathe and sweat so heat may evaporate off your skin. Exercise in shady areas or during early morning and late evening. Make sure to rest when necessary. Know how to recognize the signs of overheating in yourself and others before EHS occurs. If EHS does occur, seek medical assistance and quickly cool the victim.