by Sally Plomley, ISB Health Coordinator
sallyp@isb.ac.th
Rick Nelson, ISB Safety Manager
According to the NOAA National Centers for Environmental Information, 2015 was the planet’s hottest for average temperature since records began in 1880. January has started equally hot and just set another record. In a report of 3,116 cities, put out by AccuWeather, in 2015 Bangkok registered on average 1.6 C. (2.9 F. ) degrees warmer than average. These facts and trends compel the school and community to better understand the real dangers and consequences of heat and heat illness, especially as we enter the “Hot Season” for Thailand. Last year ISB ramped up its efforts to educate and promote prevention steps to avoid the consequences of heat illness. The following message includes information shared last year by Sonja Roback (ISB Nurse Consultant 2015-16).
Heat related illnesses include a range of conditions including heat rash, heat cramps, heat exhaustion, and most serious, heat stroke, which can be a life-threatening condition. These conditions are caused by a combination of high temperatures, fluid loss and a loss of salts in the body. In Thailand, we have ample exposure to high temperatures and humidity but this acclimatization does not equal immunity to heat illness.
We want to give you information on early warning signs, which indicate that the body is having difficulty cooling itself. Preparation and planning for high temperatures and humidity, paired with early recognition of symptoms, are important steps in keeping you and your family safe.
In Bangkok we participate in many activities held outside. These activities occur year round, and temperatures and humidity at this time of year begin to climb into high risk zones. According to the American National Federation of High School Associations, “exertional heat stroke is the leading cause of preventable death in high school athletics.” This highlights the importance for people to be aware of prevention strategies, and know how to respond when someone exhibits signs of the body having difficulty cooling itself.
Normal Heat Response Versus Heat Illness
The body’s normal response to heat and humidity is sweating. As temperatures and humidity increase, and if activity is strenuous such as in exercise or athletic events, sweating alone may not be adequate to sufficiently cool the body. In addition, the Centers for Disease Control and Prevention (CDC) highlights certain groups of people who are at higher risk of developing heat illness including the elderly, infants and children younger than 4, people with chronic or recent illness or on certain medications. Become familiar with the symptoms of heat illness below.
Signs and symptoms of heat-related illness:
- Heat Rash: small, red bumps on skin, itching, discomfort, “prickly” type of pain
- Heat Cramps: earliest sign of heat illness, painful, involuntary spasm of muscles
- Heat Exhaustion: heavy sweating, rapid pulse, fatigue, weakness, cold, clammy skin, pale appearance, nausea or vomiting
- Heat Stroke: confusion, high body temperature, skin is hot, red, moist or dry, strong and rapid pulse, loss of consciousness
Treatment
Heat Cramps:
- Move to cool place and rest.
- Give sips of fluids, ideally fluids containing electrolytes and carbohydrates.
- Lightly stretch and massage the muscle.
- If the cramps stop, you can recommence the activity as long as there are no other symptoms of heat related illness.
- Encourage the person to continue drinking fluids.
Heat Exhaustion:
- Move to cool environment with circulating air (ideally into air conditioning).
- Loosen or remove clothing if possible.
- Apply cool, wet cloths to skin.
- Fan the person.
- If responsive and able to swallow give cool electrolyte and carbohydrate containing fluids in sips.
- If no improvement or there is a change in conscious state or iis unable to take fluids or vomits, call for an ambulance whilst continuing to cool.
- Person should wait several hours after recovering before resuming activity.
Heat Stroke:
- This is a medical emergency! Call for an ambulance immediately.
- If possible, move to cool environment with circulating air (ideally into air conditioning).
- Rapidly cool the person by placing ice water soaked towels over the person and rotating them frequently.
- Do not give fluids.
Prevention
Prevention is important in preventing this potentially life threatening condition.
The CDC recommends the following:
- Wear sun protection
- Wear clothing that is light in color and fits loosely
- Drink plenty of fluids. It is important to be adequately hydrated before starting any activities where you are exposed to heat and humidity. For most exercising athletes, water is appropriate and sufficient though electrolyte drinks may be advisable for some, especially with increased exertion and duration. Avoid caffeine, energy drinks and alcohol.
- Time activities to avoid intense heat and direct sun
- Break up time in the heat with time in cool, air-conditioned buildings
- Pay attention to the weather forecast and heat advisory warnings
Remember: The most important action in staying safe in the heat is prevention followed by early recognition of heat illness symptoms
NOAA National Centers for Environmental Information, State of the Climate: Global Analysis for Annual 2015, published online January 2016, retrieved on February 25, 2016 from https://www.ncdc.noaa.gov/sotc/global/201513.
