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Health & Exercise Forum

Be cool with summer fun: Part 1 of 2 on heat stroke

Jul 24, 2017

Dr. Mackarey's Health & Exercise ForumBE COOL WITH SUMMER FUN! Part 1 of 2 on Heat Stroke

After a long cold and rainy spring, NEPA is finally experiencing hot summer weather! So, get outdoors and have fun in the sun. However, please be mindful of how your body reacts to high humidity and heat and take appropriate precautions. While football and soccer players will soon be pounding the fields (August 14, 2017 first day of practice for fall sports), it is important to remember that you don’t have to be running a marathon or playing football in full uniform to suffer from heat stroke.

Heat stroke, one of the most serious heat-related illnesses, is the result of long term exposure to the sun to the point which a person cannot sweat enough to lower the body temperature. The elderly and infants are most susceptible and it can be fatal if not managed properly and immediately. Believe it or not, the exact cause of heatstroke is unclear. Prevention is the best treatment because it can strike suddenly and without warning. It can also occur in non athletes at outdoor concerts, outdoor carnivals, or backyard activities.

Hot Temps and Exercise

Some “old school” folks think that wearing extra clothing and “breaking a good sweat” is an optimal goal for exercise. However, it may be potentially very dangerous in hot and humid conditions. When exercising in hot weather, the body is under additional stress.  As the activity and the hot air increases your core temperature your body will to deliver more blood to your skin to cool it down. In doing so, your heart rate is increased and less blood is available for your muscles, which leads to cramping and other more serious problems. In humid conditions, problems are magnified as sweat cannot be evaporated from the skin to assist in cooling the body.

The American Academy of Pediatrics and The American College of Sports Medicine has the following recommendations which are appropriate for both the competitive athlete and weekend warrior:

Signs of Heatstroke:

  • Heat Exhaustion – can be a precursor to heat stroke
    • Signs: cramps, weakness, fatigue, nausa
    • Treatment: rest in shade, cool down with cool (not cold) towels, and drink plenty of fluids.
  • Core Body Temperature above 105 degrees Fahrenheit
  • Hot, dry skin – flushed but not sweaty
  • Lack of sweating (NOTE: athletes often have external heatstroke and they can sweat even with an increase core temperature)
  • Very rapid pulse
  • Mental confusion, disorientation or hallucinations
  • Physical clumsiness, sluggishness or fatigue
  • Seizure
  • Dizziness

Treatment of Heatstroke:

  • CALL 911 – Remember this may be life-threatening
  • Relocate – to a cool shady place or air-conditioned indoors and lie down with slight elevation of feet
  • Undress – Remove outer garments and roll onto side to expose as much skin as possible to the air
  • Cool Down – spray or sponge with cool water (not cold) and fan the skin
  • Ice – place ice packs to the groin, neck and armpits to cool down large blood vessels. No ice bath.
  • Core Temperature – is the only accurate measurement so medical personnel may take rectal temp if necessary. Must get core temp to 102 degrees Fahrenheit ASAP.
  • Begin CPR – if breathing stops
  • No Aspirin or Acetaminophen – to decrease temp
  • Administer Fluids – if person is alert enough to swallow give 32 to 64 oz over 1-2 hours

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Heat Stroke Part 2”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine Geisinger Commonwealth School of Medicine.