Let’s talk about the dangers of the heat

Dr. Carla Fry, administrator and health officer for the Department of Health in Monroe County, joined Good Morning Keys on KeysTalk 96.9/102.5FM yesterday morning to talk about the heat.

Heat causes more deaths than any other extreme weather event.

Dr. Fry said, “Oftentimes that kind of flies under the radar, I think it’s not as sexy a headline necessarily as the hurricanes and tornadoes and things that we experience across the country. But it is there. It’s kind of an insidious thing. Last year, we saw more heat related illnesses here in the Keys than I think we’ve had in some time. So we’re gearing up for what looks like it may be more of the same and we want to make sure we get that education and awareness out there.”

What’s the difference between heat exhaustion and heatstroke?

Dr. Fry said, “I think the thing that’s so cool is the body just has amazing compensatory mechanisms. It’ll do all that it can to cool us. So with heat exhaustion, what you have is an excess of loss of water, and of salt, of sodium, because of sweating, that sweating is the body’s attempt to cool itself and it does an amazing job up to a certain point. So with heat exhaustion, what you’re going to see is people are losing water and salts, so they’re going to get muscle cramps, that’s one of the very first things that you might experience as kind of crampy, and just not feeling that great. Headache, some dizziness, weakness and fatigue, just a general feeling of being unwell and even to the point of sometimes feeling nauseous. So those are your warning signs, that’s the time to say I better get out of the heat get hydrated, get into a cooler location. Up and to a point, the body can continue to do that and that excessive sweating will really help do the trick. So if you run across somebody who has heat exhaustion, they’re going to feel kind of cool and clammy, wet, sweaty, that’s what you’re going to feel on their skin, if you touch their skin, it’s a bit of a telltale sign that you’re looking still at heat exhaustion. They’re going to have a rapid pulse, because their heart rate is trying to go a little bit faster to pump that blood and keep those compensatory mechanisms working. So, a really quick feel of the wrist, rapid pulse, sometimes it’s a little bit weak, and then that cool, clammy skin, but still kind of wet is really that’s your heat exhaustion.”

At that point is hydration the most important thing?

Dr. Fry said, “It is, getting to a cooler place, hydration, making sure you take a cool shower, if a cool shower is not available, ice is always great. You don’t want to make a person freezing, because then that’s kind of counterproductive. But anything we can do to get a person cool and get them into shade, out of the direct sunlight for sure.”

Is Gatorade okay?

Dr. Fry said, “There’s nothing wrong with good old fashioned water and Gatorade is okay, as well. What we don’t want is for people to mix their own concoctions or take salt pills, the kinds of things that can really upset the delicate electrolyte balance. We see that sometimes and the body will go quickly in the other direction and too much sodium is every bit as bad as not enough sodium. So avoiding anything like that. But water, Gatorade, are certainly fine. Alcohol is not good, because alcohol is going to cause a person to be even more dehydrated.”

What is heat stroke?

Dr. Fry said, “Heat stroke is life threatening, and sometimes, can lead to long term disability. So when we’re moving into heat stroke, now what you’re talking about is the body has gotten to the point where compensatory mechanisms have failed, there’s no longer the ability for the body to cool itself. That excessive sweating goes away. So there is no sweating and in fact, the skin, when you touch a person’s skin is going to feel hot, and dry, and maybe red. That is a distinct warning sign and an absolute medical emergency, time to call 911. They’ll probably have a throbbing headache, they may already be vomiting, they’ll definitely be nauseous. At this point, the heart is pounding. So where before, you might have had a rapid kind of a weaker feeling pulse, now the heart is pounding and people can mistake that say, well, that’s a good sign. They’ve got a nice strong heartbeat. But that’s the body’s saying I’m getting into real trouble here. So at that juncture, again, it’s a 911 call. A person can easily and quickly become unconscious and slip into a coma because now the sodium levels are probably dangerously low. When that occurs at its worst, well before that, seizures can happen, but at its worst, a cardiac arrest, the heart will stop. So those things, they’re the extremes. You don’t see it as often. But I would say that the more at risk are people who are quite elderly, or already have those underlying heart conditions, medical conditions, things like that.”

Does heat exhaustion precede heat stroke?

Dr. Fry said, “Most of the time, they’re going to experience heat exhaustion to some varying degree first. Again, the body is really good at giving you those warning signs. The problem can be if you’ve got somebody who’s very young, if you have somebody who’s very old, or if you have somebody who’s cognitively impaired, they may miss those warning signs. If they don’t miss the warning signs, maybe they can’t communicate effectively what’s going on. So we just need to really be careful of our vulnerable population who may not recognize that they moved quickly from a heat exhaustion to heat stroke. There’s no specific timeline to say, this is going to happen in five minutes or 10 minutes. It’s kind of heat over time, so it’s cumulative.”

Exertional heat stroke can affect younger, healthier individuals.

Dr. Fry said, “A couple of different populations come to mind for me for the Keys. First of all, we want to be so careful with the people that we trust to work outside all summer long. I don’t know how they do it, bless them for doing it. It’s so difficult, whether linemen or people who are out there keeping our grass mowed, anything like that. So they’re young, they’re healthy, and most likely they’ve lived here for a long time. But that does not mean that they’re completely totally, impenetrable. They still can suffer from that. So if you’re working with crews that work outside, we need to have a plan in place to make sure that there are frequent breaks, there is the ability to get out of the heat, and that we’re not just having a person out there all day long. So that’s one and then the other really, that comes to mind too, is tourists or people that don’t live here, there is a big component to becoming kind of acclimatized you get used to it after a little bit of time. But if you haven’t, if you don’t live here, and you’ve not spent at least a good couple of weeks or a month, and maybe that’s not even long enough, it’s a lot to get used to. So they’re really particularly vulnerable as well and a lot of times just completely unaware, coming here from Ohio, or something like that, you’ve never experienced the kind of heat that we have here.”

Pregnant women also can have an increased risk for issues with heat.

Dr. Fry said, “Their compensatory mechanisms, the mechanisms may not be quite as solid. They’re trying to raise a baby inside. So it’s already a stressor on the body. So definitely that would be considered a situation where exertional heat exhaustion, or heat stroke could happen a little more quickly.”

What are some precautions to take?

Dr. Fry said, “Staying hydrated, kind of staying on top of that fluid intake is key and crucial. Don’t drink a lot of caffeine, don’t drink a lot of alcohol. Again, , the tourists come to mind. You come down here and it’s a bit of, sometimes it’s a party, and so I can see people walking around with their fruity alcohol drinks with the umbrellas. It’s going to add up and so we want to make sure that those things, alcohol and caffeine do cause more dehydration. So we use good old fashioned water and getting into the air conditioned places or getting in the pool, staying out of the heat. During the hottest part of the day, that’s the time to go inside and take a siesta, have a little nap and stay away from that hottest part of the day. Something really kind of poignant to that I just was talking to John Rizzo in our local meteorology team over NOAA, he was discussing how the angle of the sun really matters too. At a certain point of the day, you just can’t get out of the heat. We think about that as being noon, when the sun is high overhead, but high overhead gives you opportunities to get away but when it gets to be around five, six o’clock here, there’s just no escaping it. So it seems like that danger zone really is a little bit little later in the day than we expect it to be. So getting to shade, getting into the AC, those are really a big part of it. Making sure that our clothing that is loose fitting, it’s not tight. Lighter colors, more reflective, a big wide brimmed hat, some sunscreen for sure. Then checking on anybody who’s young, who’s elderly, people with health conditions already making sure that we’re checking in to see that they’re okay. If the broken air conditioning unit is a problem, it needs to be fixed. We don’t have time for that to sit and wait. So that’s going to require some vigilance and then never leaving kids or pets unattended, especially in a vehicle. But even in those kind of wide open places, out in the parks or things like that.”

Hurricane season is upon us and the Department of Health is ready to help.

Dr. Fry said, “Our piece of that puzzle is that we run the special needs shelter, along with Emergency Management here in Monroe County. So people who have limited mobility, people who cannot be without electricity or need oxygen, really need to be looking ahead to the special needs registry to get registered, get signed up, to make sure that they have a place to go. The hurricane comes and goes and there may be devastating effects, we may have damage to property, things like that. But after the fact the heat is just oppressive. So we want to make sure that people are, if they’ve got those special needs, if they feel like they need to be away from that heat and those dangers, they need to sign up sooner rather than later. They can do that on the Monroe County website. We’re working on that, getting the awareness out there, getting people prepped and ready to go and and hoping for the best, preparing for the worst, but hoping for the best.”

The time after a storm can be incredibly tough.

Dr. Fry said, “That’s what keeps me up at night is the after storm, the impacts afterwards. People I think don’t really think about that piece. They say oh, I’ll be okay with the winds. I’ll be okay with the water. But the aftermath can really be absolutely devastating. Again, some of those long term injuries, illnesses and even deaths, they go unnoticed. Cardiac events spike after a hurricane. So we want to get people up and out of here, have them have them prepared to have a plan. So that’s our big mission right now and our big push and it will be for the next couple of months.”

For more information, click here:   https://monroe.floridahealth.gov/