There's an old expression that 'mad dogs and Englishmen go
out in the midday sun.' And I guess this is because they are
so unused to seeing any sun at all. Certainly the English
flood out into the streets and onto the beaches when the
temperature inches over 70 degrees Fahrenheit (24 C), whereas
seasoned Israelis would call that a mild day. The fact is,
though, that lack of experience with high temperatures have
made the English far too disrespectful of the dangers of
prolonged exposure to the sun, and they are less likely to
recognize the symptoms of dehydration or heat stroke.
Those who live in hot climates and visitors who are unused to
hotter temperatures should be well informed of the correct
behavior in the sun and heat, and learn to recognize the
early signs of dehydration or heat stroke, both of which kill
many people every summer.
If you can remember getting out of a swimming pool on a hot
day, even though the air was warm, you felt cool. This is
because when the warm air evaporates the water on your skin
it also takes some of the heat away from the body, causing
the body to cool down. This is how the body keeps cool, as
the sweat hits the skin, the warm air evaporates it, and this
cools the skin.
On a hot day an amazing amount of body fluid is lost through
sweat. The skin may not actually feel at all sweaty, because
the air can evaporate it as fast as it is produced, but under
the arms it should feel a little sticky because the air
cannot circulate very well there. As the body dehydrates, it
tries to conserve water and one of the signs of dehydration
is the cessation of sweating.
If you gently pull up the skin of the hand, it should fall
back into place as soon as you let go (unless you are in the
older bracket, and have lost some elasticity from aging). Try
it on yourself or on a child's hand . . . it shouldn't hurt,
and watch how the skin falls nicely into place. This is
because the skin is somewhat elastic, and this is due to the
water in the skin. When a person dehydrates, the skin loses
its elasticity and will not fall back as quickly, but will
stay pinched up.
Other signs of dehydration are a sunken 'soft spot'
(fontanel) on a baby's head, reduced wet nappies or lack of
going to the toilet, or very concentrated (yellow) urine. The
eyes may have no tears and become dry, the skin may look
grey, and of course, the mouth and tongue will be dry.
However a dehydrating person will often not complain of
thirst.
Summary of symptoms of dehydration:
- Skin under arms NOT sticky/sweaty
- Skin loses elasticity
- Reduced urination or very concentrated urine
- No tears
- Grey skin
- Mouth and tongue dry
- Sunken 'soft spot'
Prevention
Rule Number One has to be stay out of the sun,
especially during the hottest part of the day. Try to find
things to do inside or at least stay in shady places.
Rule Number Two is to drink plenty of fluids. If you
are giving out popsicles, that's very nice, but make it a
rule that the kids have to drink one or two cups of something
else before they can have their popsicle. This is
particularly important when they run in hot from school or
from playing outside, and they may not have had a drink for a
while. Keep reminding them to take more drinks.
Water is definitely the best fluid to give, and it tastes
nicer cold from the fridge, but I know that many children
won't touch it, so don't choose the summer time to wean them
from being spoiled in this regard, and let them drink
whatever fluids go down. If nursing babies need extra fluids,
boiled water can be given by spoon. And don't you
forget to drink, especially if you are nursing; being too
busy is not an excuse.
Rule Number Three is that during hot weather, when a
child complains of headaches, sore throat, or feeling unwell,
then the first thing to do is give more drinks, even if they
say they are not thirsty, and get them to sit out of the
sun.
If you suspect someone is dehydrated, you must seek medical
advice, especially for young children for whom this condition
can be fatal quite quickly. Dehydration can be prevented by
giving fluids, but it should not be treated just by giving
water to drink. The person may need the special re-hydration
solutions which have the right amounts of salts and sugars
that the body needs, or possibly an intravenous infusion of
fluids.
Besides dehydration being caused by heat, it can also be
caused by vomiting and/or diarrhea. In the latter case,
dehydration can be more difficult to treat because any fluids
given will be expelled from the body. In this case, fluids
should be given in small amounts as often as possible rather
than in large amounts less often, and there are advice
guidelines of how much to give depending on the age of the
child. Also the special oral re-hydration solution, which is
more easily absorbed by the body, is particularly good in
cases of vomiting and diarrhoea.
Heat stroke differs from dehydration in that
dehydration is when the body loses body fluids, and heat
stroke is when the body gets overheated. It is very dangerous
if the brain is overheated, and if it not dealt with quickly
(sometimes a matter of minutes) then it can be fatal. When
the air is very humid, evaporation from the skin cannot occur
properly and the body doesn't cool down. So although that
means that the person is less at risk of dehydration, the
risk of heat stroke is much higher. In heat stroke, the
problem is in the brain. It can strike with frightening
speed.
The symptoms of heat stroke:
- Slurred speech
- Dizziness
- Fainting
- Hallucinations
- Seizures
In the case of heat stroke, it is not enough to give fluids.
This is a medical emergency and immediate medical attention
should be sought. Meanwhile remove clothing, use a damp cloth
to wet the body with water and use a fan to cool. If the
person is also dehydrated then they won't be able to lose
heat by sweating, and this will add to the heating up of the
body, so drinking will help.
Please note that the most vulnerable people are those
exercising or trekking, old people in hot humid weather who
do not use an air conditioner and young children left in a
car, even for short periods. Children under two are
particularly at risk because they cannot control their body
temperature as efficiently. Of course someone can suffer from
both these conditions at one time.
Remember that although there are treatments for these
conditions, and people survive them, it is much easier to
prevent them. A spray bottle and a fan are good tools to keep
cool; don't rely on thirst, drink plenty of fluids anyway,
and stay out of the sun during the hottest part of the
day.
