As we progress through a relatively cool Mid-South summer, the topic of heat injuries may seem a bit off this year. However, with fall sports beginning to practice, heat injuries and illness become important
The types of heat injuries can be broken down into heat cramps, heat exhaustion, rhabdomyolysis, and heatstroke. Heat cramps consist of skeletal muscle cramping, usually in the abdomen or the extremities. The contractions are involuntary and painful. The cramps typically last one to three minutes, but can repeat for up to 8 hours.
Heat exhaustion is the inability to continue exercise, with or without collapse. This is characterized by rapid heart rate with low blood pressure. Someone with heat exhaustion also may be irritable, appear pale, and display decreased coordination, weakness, and dizziness. An important distinction is that the body temperature is less than 104 degrees.
Rhabdomyolysis, or muscle breakdown, is damage to the muscle tissue with possible resultant injury to the kidneys. A person experiencing rhabdomyolysis experiences muscle pain, but not cramping, and possible sweating. The breakdown may cause the urine to have a characteristic Coke-colored appearance.
Finally, heatstroke consists of mental-status changes ranging from delirium to seizure, coma, and even death. All of the signs of heatstroke may be present, along with a body temperature over 104 degrees. Clotting disorders, disorientation, irrational behavior, seizures, or coma can also be present.
Treatment for heat injury depends on the severity. The initial step is to remove the person from the sun and place them in the shade to allow cooling. Additional methods of cooling include mist spray and fans, applying ice to the armpits, groin and neck, and an ice water bath. Once in the shade, removing excess clothing and equipment is the next step. Finally, fluid and electrolyte replacement needs to occur. If anything other than heat cramps is suspected, emergency care needs to be sought.
Prevention of heat injuries has multiple steps. The first is to perform heat acclimatization. Exercising should be performed in the heat, which improves response to the heat in just a few days, with a maximum response time of 10 days. This will lead to sweating sooner during exercise with less salt loss in the sweat.
Rest periods should be planned while avoiding direct sun if possible. Sleeping at least six hours per day improves response to heat. Drinking cool water is an additional way to help decrease core temperature. Finally, increasing salt intake and taking two full weeks to slowly acclimatize to heat can help prevent heat injuries.
Dr. Kevin Coates is an Orthopaedic Surgeon with Memphis Orthopaedic Group. To schedule an appointment, call (901) 381-4664 or visit MemphisOrthoGroup.com.