How to Identify & Avoid a Heat Stroke

As temperatures & humidity continue to increase, the risk of heat related illnesses and the negative effects on riding & performance continue to be a daily issue.  As defined by the Mayo Clinic, “Heatstroke is caused by prolonged exposure to high temperatures or by doing physical activity in hot weather. You are considered to have heatstroke when your body temperature reaches 104 F (40 C) or higher.  Heatstroke occurs if your body temperature continues to rise beyond the point of heat exhaustion. At this point, emergency treatment is needed. In a period of hours, untreated heatstroke can cause damage to your brain, heart, kidneys and muscles. These injuries get worse the longer treatment is delayed, increasing your risk of serious complications or death.”

Heatstroke follows two less serious heat-related conditions:
Heat Cramps. Heat cramps are caused by initial exposure to high temperatures and/or high intensity exercise. Signs and symptoms of heat cramps usually include excess sweating, fatigue, thirst and cramps, usually in the stomach, arms or legs. This condition is common in very hot weather or with moderate to heavy physical activity. You can usually treat heat cramps by drinking water or fluids containing electrolytes (Energy Fuel or other sports drinks), resting and getting to a cool spot, like a shaded or air-conditioned area.

Heat Exhaustion. Heat exhaustion occurs when you don’t act on the initial signs and symptoms of heat cramps and your condition worsens. Signs and symptoms of heat exhaustion include a headache, dizziness or lightheadedness, nausea, skin that feels cool and moist, and muscle cramps. Often with heat exhaustion, you can treat the condition yourself by following the same measures used to treat heat cramps, such as drinking cool, nonalcoholic beverages, getting into an air-conditioned area or taking a cool shower. If your symptoms persist, seek medical attention immediately.

Heatstroke can occur in these ways:
Exposure to a hot environment. In a type of heatstroke called nonexertional heatstroke, your condition is caused by a hot environment that leads to a rise in body temperature, without strenuous physical activity. This type of heatstroke typically occurs in hot, humid weather, especially for prolonged periods. It occurs most often in older adults and in people with chronic illness.

Strenuous activity. In a type of heatstroke called exertional heatstroke, your condition is caused by an increase in body temperature brought on by physical activity in hot weather. Anyone exercising or working in hot weather can get exertional heatstroke, but it’s most likely to occur if you’re not accustomed to high temperatures.

Potential for heatstroke can be brought on or worsened by:
Wearing excess clothing that prevents your sweat from evaporating easily and cooling your body

Wearing clothing that is made of cotton.  The saying that “cotton kills” is associated with the fact that cotton doesn’t allow heat out in hot conditions and it retains cool in cold conditions.

Sudden exposure to hot weather. If you’re not used to high temperatures or high humidity, you may be more susceptible to heat-related illness if you’re exposed to a sudden increase in temperature, as might happen with a heat wave that occurs during late spring. Limit your physical activity for at least several days until you’ve gotten used to the higher temperatures and humidity. However, you may still have an increased risk of heatstroke until you’ve experienced several weeks of higher temperatures.

Becoming dehydrated, because you’re not drinking enough water to replenish fluids you lose through perspiration

Drinking alcohol, which can affect your body’s ability to regulate your temperature

The Heatstroke Sequence Includes:
Phase 1: High body temperature. 104 F (40 C) or higher is the main sign of heatstroke.
Phase 2: A lack of sweating. Pay close attention to your forearms (between your elbow & wrist).
Phase 3: Cold chills.  Though you are in hot conditions your body becomes chilled. Watch for goose bumps on your forearms.
Phase 4: Blurry vision and/or feeling of nausea vomiting.
Phase 5: Headache. You may experience a throbbing headache. The top of your head feels like someone put a hot plate on it.
Phase 6: Confusion. You may have seizures, hallucinate, or have difficulty speaking or understanding what others are saying.
Phase 7: Unconsciousness. You may pass out or fall into a state of deep unconsciousness (coma).

If you think a person may be experiencing heatstroke, seek immediate medical help. Call 911 or your local emergency services number.

Immediate action to cool the overheated person while waiting for emergency treatment: 
If you notice signs of heat-related illness before any noticeable signs or symptoms of heatstroke appear, take action to lower your body temperature and prevent your condition from progressing to heatstroke. In a lesser heat emergency, such as heat cramps or heat exhaustion, the following steps may be sufficient to lower your body temperature:

Get to a shady or air-conditioned place. Remaining in the heat will worsen your condition. If you don’t have air conditioning at home, go someplace that is air-conditioned, such as the mall, movie theatre or public library.

Once moved to the shade, remove excessive clothing.  The skin’s surface is where your body rids itself of internal heat (endothermic process) through sweat.  The more surface area of skin you can expose, the quicker the body’s core body temperature will drop to safe levels.

Cool off with damp sheets and a fan. If you’re with someone who is experiencing heat-related symptoms, cool the person by covering him or her with damp sheets or by spraying with cool water. Direct air onto the person with a fan.

Place ice packs on major arteries. Place ice packs or cold, wet towels on the person’s head, neck, armpits and groin (all sites of major arteries which carries blood away from your heart).

Take a cool shower or bath. If you’re outdoors and nowhere near shelter, soaking in a cool pond or stream also can help bring your temperature down.

Rehydrate. Keep in mind that the symptoms of heat-related illnesses are caused not only when you become dehydrated but also when you lose salt through sweating. Sports drinks mixed at a 4% carbohydrate concentration rate with added electrolytes (Energy Fuel) will replenish both water and salt. The amount you’ll need to drink to rehydrate varies from person to person, so download my Sweat Rate Calculator off of our Coach Robb Resource page to determine your sweat and replenishment rate.  sip slowly and call your doctor if you’re concerned. Note, if you’re on a low-sodium diet, be sure to check with your doctor before having drinks with a high salt content.

Don’t drink beverages with alcohol to rehydrate. These drinks may interfere with your body’s ability to control your temperature.

Heat Stroke Prevention
The good news is that heatstroke is preventable. Take these steps to prevent heat related issues during hot weather training & racing:

Wear loose fitting, lightweight clothing. Wearing excess clothing or clothing that fits tightly won’t allow your body to cool properly.

Wear light-colored clothing if you’re in the sun. Dark clothing absorbs heat. Light-colored clothing can help keep you cool by reflecting the sun’s rays.

Drink plenty of fluids that contain electrolytes. Properly hydrating (and absorbing) will help your body sweat and maintain a normal body temperature.  Energy Fuel was designed to enhance your fluid absorption and maintain proper electrolyte levels in your body.

Take extra precautions with certain medications. Be on the lookout for heat-related problems if you take medications that can affect your body’s ability to stay hydrated and dissipate heat.

Take it easy during the hottest parts of the day. If you can’t avoid strenuous activity in hot weather, follow the same precautions and rest frequently in a cool spot. Try to schedule exercise or physical labor for cooler parts of the day, such as early morning or evening. Taking breaks and replenishing your fluids during that time will help your body regulate your temperature.

Get acclimatized. Limit the amount you spend working or exercising in the heat until you’re conditioned to it. People who are not used to hot weather are especially susceptible to heat-related illness, including heatstroke. It can take several weeks for your body to adjust to hot weather.

Be cautious if you’re at increased risk. If you take medications or have a physical condition that increases your risk of heat-related problems, avoid the heat and act quickly if you notice symptoms of overheating.