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HEAT WAVE: Know when to seek medical attention for heat-related illness

People gathered on the gravel bar below Wallace Marine Park to cool off in the Willamette River on Thursday, July 30, 2020. (Amanda Loman/Salem Reporter)

Dr. Ralph Yates has spent much of his medical career caring for athletes as a family medicine doctor.

While seniors and young children are especially vulnerable to heat-related illness, he said it’s often healthy adults who end up in his office needing treatment on hot days.

“The patients that often get into trouble are people that go out and perform heavy exercise in the middle of the day. I see men in particular, cyclists in particular, riding without a shirt on,” he said. A shirt that wicks heat away from your body will keep you cooler than going bare, he said.

Yates is the chief medical officer at Salem Health. With Salem expecting triple digit temperatures this weekend, he offered some pointers about what to watch out for, and how to avoid a trip to the emergency room.

Prevent illness by staying well hydrated

Humans rely on our bodies’ natural cooling mechanisms, like sweating, to stay comfortable in warm weather. Hot weather can cause people lose fluids faster than they can replace them – especially when coupled with exercise.

In triple-digit temperatures, people should stay out of the sun and inside as much as possible, he said. If people must exercise or work outside, they should do so early in the morning when temperatures are cooler.

“You have to be acclimated to heat,” Yates said. Salem residents, who rarely experience temperatures above 100, are not used to the conditions expected over the weekend.

Yates said drinking water or other hydrating fluids is key. Though alcohol can feel refreshing on a hot day, it dehydrates people further. The same is true of coffee.

“We see this actually with boaters and others that are out in the direct sunlight drinking alcohol and can really get into a difficult place quickly,” Yates said. His guiding rule for athletes applies to everyone in hot weather: if you go two hours without peeing or find your urine is getting dark in color, you’re not drinking enough water.

Know the signs of heat exhaustion and heat stroke

Heat-related illness includes heat exhaustion, when the body overheats, and heat stroke, when a person becomes so overheated their core body temperature rises and mental function is impaired.

Untreated heat stroke can quickly damage the brain and other major organs before leading to death.

“The body has to compensate, it has to move fluid to compensate, and at some point it loses the ability to compensate,” Yates said. “If it gets to the extreme state, that’s heat stroke.”

In the early stages of heat-related illness, people can generally recover by drinking more fluids, moving to a cooler environment, removing or loosening clothing, and putting ice packs in the armpits and groin.

But Yates said people with more severe symptoms should seek medical attention. Those include pale and clammy skin, an elevated body temperature, high heart and respiratory rate or a general feeling of illness.

People who become confused, display changes in mental status or have a high body temperature are showing symptoms of heat stroke, a life-threatening medical emergency, and should be taken to the emergency room where they can be rapidly re-cooled.

Look out for infants, seniors, and others vulnerable to heat

Babies, young children and seniors are particularly likely to be sickened in hot weather, Yates said. People with some medical conditions, like diabetes, and people who are obese are also at higher risk, he said.

For young children or others who can’t verbally communicate how they’re feeling, irritability and loss of appetite are warning signs of heat-related illness, Yates said. A baby that stops nursing is a cause for concern.

Contact reporter Rachel Alexander: [email protected] or 503-575-1241.

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Rachel Alexander is Salem Reporter’s managing editor. She joined Salem Reporter when it was founded in 2018 and covers city news, education, nonprofits and a little bit of everything else. She’s been a journalist in Oregon and Washington for a decade. Outside of work, she’s a skater and board member with Salem’s Cherry City Roller Derby and can often be found with her nose buried in a book.

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