Monday, July 5, 2010

Medical Mondays: Some Don't Like It Hot


Happy 4th of July! In honor of our holiday, when we usually celebrate with hot weather, hot fireworks, and hot dogs, I'd like to post about none other than...hot people.

As a response to last week's post on hypothermia, a few questions came up from Terri Tiffany and Jai Joshi.

Terri's question: I've got a scene where a guy goes onto a hot attic in Florida to replace a fuse and becomes disoriented, sweaty, chilled and can't move much--am I close? I know people have died in attics here due to the extreme temps. I have him rescued and given water and cooling cloths.

Jai's question: How long does it generally take for the symptoms of heat stroke to show themselves. I know that in lots of people it's immediate but is it possible for the symptoms to not become obvious for an hour or two hours? Or that someone (another family member) might not notice the symptoms?

Heatstroke occur when the core body temperature exceeds 105°F because the body cannot eliminate excess heat through the usual ways--that is, sweating and dissipation of body heat into a cooler environment.

In heat exhaustion, the core body temp doesn't exceed 104°F.

Overheating occurs if the person is working too hard in hot environment (or also hot and humid--perspiration as a means of cooling off doesn't work if the humidity is >75%). It can also occur if a debilitated person (such as a frail, elderly person) can't remove themselves out of a hot environment. Another possibility is if a lack of hydration makes it harder for a person to sweat.

The initial symptoms of heat exhaustion can be nausea, vomiting, fatigue, muscle cramps, dizziness. The skin may be cool and clammy, sweaty, and they may be very thirsty and feel faint or dizzy.

Symptoms of heat stroke include hot, flushed, dry skin, fast breathing, and a rapid pulse. They might have hallucinations, confusion, agitation, symptoms of stroke, inability to urinate (this is bad--a sign of kidney failure), seizures and coma.

Treatment is to get the person to a cooler environment and decrease the core body temperature. An excellent way (at home or in the hospital) is to mist the person with water and put a fan on them in a cool room. But if the patient appears to have more than just heat exhaustion, the hospital is a better place. Heat stroke holds a mortality rate of 21-63% because at sustained temperatures above 105°F, cellular processes in the body stop working properly and people can have multi-organ failure, including lung, kidney, liver, brain, etc.

So for Terri, the situation for your character sounds perfect for heat exhaustion, but the symptoms wouldn't include shivering (that is a bodily mechanism to increase heat, not decrease it). And they'd more likely be dizzy and weak rather than overtly confused. Using cooling cloths, misting with a fan, or a cool bath would also help, along with giving fluids to drink.

For Jai, if the person just had heat exhaustion, they might be able to get away with other people not noticing so much. But if they had heat stroke it would be very obvious--they'd be quite sick and disoriented. One thought would be if the person can't get to a cooler environment with adequate hydration--and their heat exhaustion turned into heat stroke.

Thanks for the questions guys! Keep it cool, everybody!

Please keep in mind this post is for writing purposes only and is not to be construed as medical advice!

If you've got a medical question, let me know! Post below or email me at


All I ask in return is that you become a follower of my blog and post a link on your blog when I post. Easy peasy.

46 comments:

Aubrie said...

Very interesting! I'll make sure to keep hydrated in the heat.

Terri Tiffany said...

Thank you!! GOing back to revise:))

Stina Lindenblatt said...

This is a huge issue at this time of year for outdoor exericisers. It's why you should run in the morning or evening (not mid day). And for long runs, have water with you. Plus humidity plays a factor. I grow weaker a lot quicker when the humidity is high.

Vicki Rocho said...

I am prone to heat exhaustion. Doesn't take much and I'm feeling woozy in the sun. I now drink lots of water if I'm out in the heat.

Liza said...

Fascinating stuff. Having keeled over a few times in the sun when I was a child, I'm cautious. This is a technical reminder to be careful in the heat.

B.E. Sanderson said...

So, that was heat exhaustion and not heat stroke back in '88. Stacking bales of hay in 98 degree weather inside a metal barn's loft wasn't the best of ideas, but it was part of the job.

Thanks, Lydia. Great post as always. =o)

Lynn said...

Interesting! I was calling heat exhaustation heat stroke. In my climate, heat exhaustion usually only occurs when were on vacation!

Jen said...

Always learning new things over here!!! I loved your title it really made me chuckle!

Joanne said...

Good info to keep in mind always. Here in New England, the temps are predicted to be near 100 every day this week, the perfect time to stay indoors in the a/c!

Tricia J. O'Brien said...

Another fabulous post, Lydia! Have you considered a sidebar with links to each of these? That would help people find topics already discussed. Thank you for doing them. I'm so grateful.

Theresa Milstein said...

Perfect post for this hot weather spell. Thanks for the advice. I never drink enough water, which I have to better about.

Erica Mitchell-Spickard said...

My husband is an air "medic" technically he is a crew chief but they have him help now with medic issues because he has been around it long enough and this time of year in the desert...they pick up a lot of patients with these symptoms. The shivering was one I thought would happen but both of you have said it's not a for sure symptom.
I'm not sure but I heard trying to get them to drink at a certain point in the stage of exhaustion to seizing that letting them have water can become a hazard because the metabolism has to work causing more heat? Ice chips and things are best till the core temp is down? I dunno, but I love learning these things on Mondays :D I know I will have a question for you soon ;) I just have to pick with medical problem comes up in the plot, it's a toss up.

Danyelle said...

Perfect post. :D I'm really enjoying learning more about the body. :)

Palindrome said...

I miss my anatomy and physiology class. Great tip for writers. :)

Carol Kilgore said...

Very good information to know here in San Antonio. Thanks.

Lydia Kang said...

Hey Tricia,
Thanks for the suggestion to put my posts on the sidebar. Done and done!

Hey Erica,
The fluid thing is a good question. Whether drinking water increases the metabolism and core body temperature is less clear to me. I don't think it would be a huge problem. Ultimately it's up deciding whether or not someone needs the fluids or not, because you'd be working on getting their temp down simultaneously anyway.
Hope that helps!

Ed Pilolla said...

i remember when i was dehydrated, i had no idea until someone suggested that maybe i was. doh!

i dig the metaphorical implications of having to 'cool' someone's core, or 'warm' their core, as you said last week.

Talli Roland said...

Interesting!

It never really gets that hot in London; I kind of wish it did! But it was, I'm sure I'd complain loads about it.

Abby said...

Pretty cool!

I am so happy I have an air conditioner right now.

Melissa said...

You fascinate me. I had to say it. Your knowledge and willingness to share it with us and answer our questions is both commendable and invaluable (to people like me :) .)

Thank you.

I do have a question... I know you mentioned that our body starts failing at 105 degrees but if we go higher...is there something worse than organ failure that happens? Can it get worse than that? How hot would someone like that feel to the touch?

Lydia Kang said...

Hi Melissa! I'm so glad you and everyone else appreciate Medical Mondays. Honestly, it's really good for me too. I generally know the answers but I research all the details to make sure my answers are accurate, so I learn with all of you too!

As for your question, someone who was warmer than 105 would feel just plain hot. Burning and dry to the touch. And there isn't much worse than organ failure--if the kidneys, liver, brain, and lungs fail, the person usually will die. When organs are damaged, there is room to improve and recover. When they fail completely, there may be no going back. The lung failure can manifest as fluids filling up the tiny spaces within the lung--like drowning. And if the nervous system fails, you get seizures and comas. Basically--it's all bad. Which is why hyperthermia is so lethal, and why prevention is so important.

Does that answer your question? IF not, keep asking!

Jemi Fraser said...

Great information - thanks again! :)

Laura Eno said...

I found your blog through Carol Kilgore and find it fascinating! Thank you for the follow back as well.

aspiring_x said...

love the illustration! hilarious!

notesfromnadir said...

Lydia,
I've read about people getting so thirsty when stranded in the desert that they drink anything. So this is all good to know and very helpful this time of year. THANKS!

Karen Lange said...

Thanks, Lydia! This is good to know for writing and real life. :)

Saumya said...

I just fainted last week from heat exhaustion :( This post is great advice for characters and all of us in this crazy heat!

Sandy Shin said...

This is such a fascinating post! I'm definitely keeping these info in mind. :)

Deb Salisbury said...

Very timely post! I'm revising a novel where my MC spends tooooo much time in the heat. Now I can double check his reactions. Thanks!

Rachna Chhabria said...

Lydia, I love the title of this post. In India we are quite familiar with the terms heat stroke and heat exhaustion, though we are not aware of all the sypmtoms.
Thanks for this informative post.

Melissa said...

No, that answers my question perfectly. I knew organ failure was bad I just wondered if people were hotter if their organs would like boil or melt or something first.... Weird I know.

Culture Served Raw said...

Wow this was quite an interesting post! I will keep you in mind for future advice. very thorough, good job!

Ocean Girl said...

Hi. I think your blog is so interesting.

Ann said...

Great info! Thanks. I too will keep you in mind for future reference. :)

MT said...

Hey, that's good to know. I've always wondered the difference between the two. I could have googled it, but it's more fun to stumble accross an answer when I'm not even looking. :)

Terri Coop said...

Hi Doc! I'm here from Maria's blog block party!

I work in the family business in our warehouse and heat exhaustion is a constant concern. I keep frozen damp towels on hand to toss around my neck when I start getting that weird feeling. Another rule is that any time I sit down for any reason, I have to drink an 8-ounce glass of water.

I'm joining up as a follower and am really enjoying the blogs in Maria's party.

Terri
www.whyifearclowns.com

Holly Ruggiero, Southpaw said...

I suffered from heat exhaustion once, which caught me completely off guard. I notice that now I’m more sensitive when it’s hot outside. I’m all “hot and bothered” quickly and seek shade and water almost right away. It’s like my body say’s “Hey, now lady. Let’s not do that again.”

Nicole Murray said...

Hi Lydia. I have a thank you over on my blog for you. Thank you!

Julie Musil said...

I just love how you know this stuff! "Cool" post.

Julie Musil said...
This comment has been removed by the author.
Julie Musil said...

Sorry, I posted my comment twice so I deleted one. Oops!

Faith said...

Ooh, this post is perfect for my revisions! I have a character who gets heat stroke, but I haven't yet really "written" the scene -- ie. it's missing detail as I wasn't sure what the real symptoms, etc. were.

Very helpful, thanks! :)

babYpose said...

Your blog is really your oyster. I saw in the news about the hot summer. Hope it wouldnt be that long.

Anonymous said...
This comment has been removed by a blog administrator.
Meadow said...

Stumbled upon your blog today, Lydia, and am loving the Medical Mondays post. I know I'm a little late on this one...but thought I'd throw this tidbit out there because it's a really nice detail. Just before you reach the point of heat exhaustion (or then further to heat stroke) your body stops sweating. I don't know any medical reasons behind this and assume it's probably a last resort, your body realizing it's just not going to cool your body off properly and needs to retain as much water as possible.

I played dutiful girlfriend to a football player in college and he told me that was a huge sign they looked for to sit out of practice for a bit to cool down. It would only take about five minutes after noticing no more sweat that they'd pass out!

Just a small detail I thought could be helpful. Happily following for Medical Mondays!

Jai Joshi said...

Lydia, thanks so much for answering my question! I think my character has heat exhaustion to begin with and it progresses to heatstroke because no one notices or cools him down.

You perfectly dealt with my issue.

I tried to comment on this last week but I had cyber cafe issues and everytime I logged on something went wrong. Just wanted to say thanks.

Jai