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Lourdes Emergency Medicine Expert Offers Tips to Avoid Heat Emergencies

According to U.S. Centers for Disease Control and Prevention, from 1999 to 2010, a total of 7,415 deaths in the United States — an average of 618 per year — were associated with exposure to excessive heat.
The latest data shows that overexposure to summer heat causes up to 170 hospitalizations annually in New Jersey, with countless trips to the emergency room for treatment.
Kenneth Szwak, MHS, PA-C, senior physician’s assistant and EMS director at Our Lady of Lourdes Medical Center, says demanding activity in hot weather can make a person’s internal body temperature rise, and if the body can’t cool itself down, there is risk for a life-threatening heat emergency.
“Children and adolescents, the elderly and obese individuals have the greatest risk for heat-related illnesses, as well as those who have chronic health problems or are taking certain medications,” says Szwak. “However, anyone can fall victim if they participate in vigorous activities during hot weather. Indeed, heat emergencies are the second-most-common cause of death among high school athletes.”
There are three main types of heat emergencies: heat cramps, heat exhaustion and heat stroke. The three conditions are closely related; failure to recognize and treat heat cramps can quickly lead to heat exhaustion and ultimately, heat stroke.

  • Heat cramps: This early phase of heat emergency is characterized by profuse sweating, increased thirst, muscle cramps and fatigue.
  • Heat exhaustion: More severe than heat cramps, heat exhaustion results from a loss of water and salt in the body. Symptoms include headache, generalized weakness, nausea/vomiting, cool/moist skin, dark urine and dizziness. If the body cannot cool itself properly and the condition is left untreated, heat stroke can result.
  • Heat stroke: In this most severe form of heat illness, the individual can develop an elevated body temperature (over 104 degrees Fahrenheit), behavioral changes, confusion, hot/dry/red skin, rapid breathing, rapid and weak pulse, seizures and loss of consciousness. This is a life-threatening emergency and requires immediate medical attention as it can lead to shock, brain damage, organ failure and even death.

Infants, toddlers, and children are especially at risk being exposed to high temperatures or prolonged amounts of heat and humidity. According to Szwak. “Children adjust more slowly than adults, not only to changes in environmental heat, but they also produce more heat with activity and sweat less. They also don’t stop to rest or drink enough fluids, further leading to dehydration and problems maintaining one’s body temperature.”
For adults, other contributing factors come into play with heat-related emergencies. These are heart disease, infections, seizures/convulsions, drug withdrawal, alcohol consumption and sweat gland problems. In addition, medications like diuretics, antihistamines and hypertensive medications (beta blockers and calcium channel blockers) can also contribute to a heat emergency.

Szwak recommends these suggestions below:

To guard against heat-related illnesses:

  • Wear lightweight, light-colored, loose-fitting clothing in hot weather
  • Drink plenty of fluids. Avoid alcohol, caffeine or large quantities of sugar. If your doctor limits your liquids, ask how much you are permitted to drink during hot weather
  • Ask your physician if your medications or health condition make you more vulnerable to heat-related illnesses
  • Rest frequently and in the shade
  • Avoid excessive exercise or activity in hot and/or humid weather. Use your air conditioner or go to air-conditioned places like shopping malls or movie theaters
  • Be careful in hot cars and allow time to cool off, especially with children and pets

In the event of a heat-related emergency:

  • Have the person lie down in a cool place and raise his or her feet
  • Apply cool, wet cloths to skin, especially the neck, armpits, and groin
  • Use a fan to further cool the person
  • If the person is alert, he or she may sip a half cup of an electrolyte beverage such as Gatorade, or cool water (if a electrolyte beverage is not available) every 15 minutes


  • Give medications used to treat fever such as aspirin or Tylenol (acetaminophen); salt tablets; or liquids with alcohol or caffeine
  • Use alcohol rubs
  • Give anything by mouth if the person is vomiting or unconscious

Heat emergencies can quickly change in severity, says Szwak. “Call 911 immediately if someone loses consciousness, becomes confused or experiences another change in their mental status, has a seizure, has a rapid pulse or breathing or the condition worsens or does not improve. In addition, any elderly person or infant should be evaluated promptly. If there is any doubt, err on the side of caution and seek medical attention.”

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