Heat Stroke Victims: A Concerning Number

Heat stroke is a life-threatening condition that occurs when the body overheats, reaching an internal temperature of 104°F or higher. It is often caused by high external temperatures and/or physical exertion, and it can lead to serious health complications and even death. In the United States alone, heat stroke claims hundreds of lives each year, with an average of 702 heat-related deaths per year between 2004 and 2018. Globally, an estimated 1.7 million deaths were linked to extreme heat in 2019. The vulnerability to heat stroke varies across different demographics, with certain groups, such as the elderly, young children, and individuals with chronic health conditions, being at a higher risk. Understanding the prevalence and impact of heat stroke is crucial for developing preventive measures and interventions to protect public health during periods of extreme heat.

Heat stroke kills hundreds of people in the US annually

Heat stroke is a severe heat illness that occurs when the body overheats and reaches an internal temperature of 104°F or higher. It is a life-threatening condition that can lead to seizures, organ failure, and even death. In the United States, heat stroke kills hundreds of people every year, with rates increasing between 1995 and 2015. According to the Centers for Disease Control and Prevention, heat stroke claimed 335 lives in the US in 2015, the latest year for which statistics are available.

Heat stroke can affect anyone, from young and active individuals to the elderly and those with underlying health conditions. It can occur during vigorous physical activity or simply from being outdoors in hot weather. The risk factors for heat stroke include obesity, high blood pressure, dehydration, and the use of certain medications. It is important to recognize that even well-conditioned athletes can suffer severe consequences from overexertion in the heat.

To prevent heat stroke, it is recommended to avoid being outdoors during the hottest part of the day, drink plenty of fluids, wear loose-fitting and light-colored clothing, and take frequent breaks in shaded or air-conditioned areas. However, despite these precautions, heat stroke continues to claim hundreds of lives in the United States annually.

Between 1979 and 2022, the death rate as a direct result of heat exposure generally ranged between 0.5 and 2 deaths per million people, with spikes in certain years. Overall, more than 14,000 Americans have died directly from heat-related causes since 1979. When taking into account deaths where heat was a contributing factor, the death rate nearly doubles for some years.

The impact of heat-related deaths is not limited to the United States. During the 2022 European heatwave, which saw the highest temperatures ever recorded in the continent, 61,672 people died from heat-related illnesses.

Heat stroke symptoms and treatment

Heat stroke is a medical emergency that can kill or cause damage to the brain and other internal organs. It is the most serious form of heat injury and can strike even without previous signs of heat injury. Heat stroke results from prolonged exposure to high temperatures, usually in combination with dehydration, which leads to a failure of the body's temperature control system. The medical definition of heat stroke is a core body temperature greater than 104 degrees Fahrenheit, with central nervous system complications that occur after exposure to high temperatures.

The hallmark symptom of heat stroke is a core body temperature above 104 degrees Fahrenheit, but fainting may be the first sign. Other symptoms include:

• Dizziness and light-headedness
• Lack of sweating despite the heat
• Red, hot, and dry skin
• Muscle weakness or cramps
• Rapid heartbeat, which may be either strong or weak
• Rapid, shallow breathing
• Behavioral changes such as confusion, disorientation, or staggering

If you suspect that someone has heat stroke, immediately call emergency services or take the person to a hospital. Do not delay seeking medical help as it can be fatal. While waiting for paramedics to arrive, move the person to a cool, shady area and remove any unnecessary clothing. If possible, take the person's core body temperature and initiate first aid to cool it down to 101 to 102 degrees Fahrenheit. Try cooling strategies such as fanning air over the patient while wetting their skin with water, applying ice packs to the armpits, groin, neck, and back, or immersing them in a cool shower or tub.

Heat-related deaths have been a continuing public health concern. During 2004-2018, an average of 702 heat-related deaths occurred annually in the United States. The risk of heat-related illness dramatically increases when the heat index climbs above 90 degrees. Certain population groups, such as adults over 65 and children, are particularly vulnerable to heat-related illness and death. It is important to take precautions to prevent heat stroke, especially during heat waves.

Risk factors for heat stroke

Heat stroke is a potentially deadly illness that can affect people exposed to extreme heat. While deaths from heat exposure are generally considered preventable, they remain a public health concern. Here are some risk factors for heat stroke:

Intrinsic Factors

• Inadequate heat acclimatization: This refers to an individual's lack of adjustment to hot temperatures, making them more susceptible to heat stroke.
• Inadequate hydration: Dehydration increases the risk of heat stroke as the body cannot effectively regulate its temperature.
• High motivation or ultra-competitiveness: Highly motivated or competitive individuals may ignore warning signs and continue exerting themselves in hot conditions.
• Intense or prolonged exercise with minimal breaks: Strenuous physical activity, especially without adequate rest, can lead to heat stroke.
• Previous exposure to similar conditions: Being exposed to high temperatures, humidity, or sun exposure the day before can increase the risk of heat stroke.
• Wet Bulb Globe Temperature (WBGT): This is a measure of the heat stress an individual experiences, taking into account temperature, humidity, wind speed, and solar radiation. A higher WBGT value indicates more significant heat stress.

Extrinsic Factors

• Peer or organizational pressure: Pressure from peers or organizations to continue exerting oneself despite heat can increase the risk of heat stroke.
• Lack of education and awareness: Coaches, athletes, and medical staff may not recognize the warning signs of heat stroke, delaying appropriate action.
• Inadequate emergency plans or policies: The absence of an emergency action plan or policies to address heat stroke can lead to a delayed response.
• Limited access to fluids or breaks: Not having access to fluids or breaks during practice or work can contribute to dehydration and heat stress.
• Delay in recognition of symptoms: Failing to recognize the signs and symptoms of heat stroke can result in a delay in treatment and potentially worsen the condition.

Heat stroke prevention

Heat stroke is a serious and life-threatening condition that requires immediate medical attention. It occurs when the body reaches a temperature of 104 degrees Fahrenheit or higher, and can be prevented by taking some simple precautions. Here are some essential heat stroke prevention tips:

Stay in a Cool Environment

If possible, stay in an air-conditioned place during hot weather. If your home does not have air conditioning, spend a few hours in a shopping mall or public library to help your body stay cool. You can also call your local health department to find out if there are any heat-relief shelters nearby.

Wear Appropriate Clothing

Choose lightweight, loose-fitting clothing when it's hot outside. Wearing tight or excessive clothing can prevent your body from cooling down properly.

Stay Hydrated

Drink plenty of fluids, even if you don't feel thirsty. Avoid sugary, alcoholic, and very cold drinks, as these can cause you to lose body fluid or lead to stomach cramps. If you're taking medications or have a medical condition, ask your doctor how much fluid you should be drinking.

Protect Yourself from the Sun

Sunburn can affect your body's ability to cool down, so be sure to protect yourself when outdoors. Wear a wide-brimmed hat, sunglasses, and sunscreen with an SPF of at least 15 or higher. Reapply sunscreen every two hours, or more often if you're swimming or sweating.

Avoid Strenuous Activity

Limit your outdoor activity during the hottest parts of the day, usually in the morning and evening hours. If you must engage in strenuous activity, drink fluids and rest frequently in a cool spot.

Be Cautious with Medications

Certain medications can affect your body's ability to stay hydrated and regulate temperature. Talk to your healthcare provider about any medications you're taking and how they may impact your risk of heat stroke.

Never Leave Anyone in a Parked Car

Cars can heat up very quickly, even with the windows cracked open. Never leave children, pets, or anyone else unattended in a parked car, as it can lead to heat stroke or even death.

Know the Signs of Heat Exhaustion

Heat exhaustion often precedes heat stroke. Be aware of the signs, such as cool, moist skin with goose bumps, heavy sweating, faintness, dizziness, fatigue, rapid pulse, headache, and nausea. If you or someone you know exhibits these symptoms, seek prompt treatment to prevent heat stroke.

By following these prevention tips, you can significantly reduce the risk of heat stroke and keep yourself and others safe during hot weather.

Heat stroke in children

Children may exhibit the following signs of heat stroke:

• A body temperature that rises above 104˚ Fahrenheit
• Confusion and disorientation
• Flushed, hot, and dry skin (although the skin may be wet)
• Loss of consciousness
• Nausea, vomiting, and diarrhea
• Rapid heartbeat and breathing
• Weakness and dizziness

If a child displays any of these symptoms after being outdoors or in a hot environment, it is crucial to seek emergency medical treatment immediately. To provide initial care:

• Bring the child indoors or into the shade and remove their clothing.
• Begin rapid cooling by immersing them in a bathtub of cold water. If a bathtub is unavailable, apply cold towels over much of the body, replacing them frequently.
• Avoid forcing fluids unless the child is conscious and alert.

Heat stroke in babies is rare but extremely dangerous. Allowing an infant or young child to remain outside for extended periods in hot weather or leaving them unattended in a car can cause their body temperature to rise rapidly. Since babies cannot communicate discomfort, watch for unusual behaviors or concerning symptoms.

To prevent heat illness in children:

• Encourage fluid intake: Teach children to drink plenty of liquids before and during any activity in hot, sunny weather, even if they don't feel thirsty.
• Appropriate clothing: Ensure they wear light-colored, loose-fitting, lightweight, and moisture-wicking clothing in warm weather.
• Rest and shade: Remind children to seek shaded areas and rest frequently while outdoors.
• Sun protection: Use sunscreen and hats to avoid sunburn.
• Avoid peak hours: Do not let children engage in intense outdoor activities during the hottest hours of the day.
• Recognize overheating: Teach children to come indoors immediately if they feel overheated.
• Never leave children unattended in a car: Do not leave children alone in a parked car, as this can lead to a rapid increase in body temperature.

Frequently asked questions