We talked to Prof. Matteo Piattoli, Lecturer in Anaesthesiology at UniCamillus University
During the hottest time of the year, between July and August, temperatures above 35 degrees Celsius and often extremely high humidity can cause so-called ‘heat illnesses’. These are conditions that occur when the body, subjected to excessive heat, can no longer regulate its temperature effectively. Symptoms may be mild, such as simple muscle cramps, or more serious, such as heat exhaustion and heatstroke: the latter, in particular, can be fatal, as the body temperature can rise above 41°C causing damage to the brain and vital organs.
While at high temperatures the risk of experiencing heatstroke can happen to anyone, there are certainly more vulnerable people, such as children or the elderly. But that’s not all: those who do sport (such as athletes) and those who work in the heat (such as farmers and construction workers) are also particularly at risk.
Types of heat illnesses
Heat cramps. They are short and painful muscle contractions, which mainly affect the quadriceps femoris and the twin muscles (the muscles of the thigh and calf), occur most often during or after intense physical activity in extreme heat and are caused by hydrosaline losses due to excessive sweating. Although they do not represent an emergency, it is nevertheless important to stop exercising, rest, rehydrate and stretch, as they represent an alarm bell: they are an early sign of dysfunction in the body, and alert us to an initial difficulty in regulating internal temperature.
Heat exhaustion. This is a more serious situation than cramps, with symptoms such as intense thirst, weakness, dizziness, nausea, irritability, headache, excessive sweating and high body temperature (39-40°C). The affected individual should be taken to a cool place, wrapped with wet towels and encouraged to drink liquids containing salts and sugars. The aim is to prevent the condition from evolving into the more serious heatstroke.
Heatstroke. It is the most severe form of heat illness and represents a life-threatening medical emergency. The body can no longer regulate the temperature, which can exceed 41°C causing brain damage or death if not treated promptly. Children and the elderly are particularly vulnerable, especially if they wear heavy clothing or engage in strenuous physical activity without adequate hydration. Even staying in a closed car on a hot day can cause heatstroke.
Vulnerability and Prevention
Fortunately, heat illnesses are largely preventable, which is why it is important to know how to behave on high risk days. In order to find out more, we asked a few questions to Prof. Matteo Piattoli, Lecturer in Anaesthesiology at UniCamillus University.
What are the symptoms to look out for?
“First of all, it is necessary to make a small distinction between ‘heatstroke’ and ‘sunstroke’: the former occurs as a result of prolonged standing in very hot and poorly ventilated environments and is often more sudden, as the body temperature can rise very quickly. The latter is associated with prolonged sun exposure and does not necessarily require excessively high temperatures.
The main symptomatology is very similar between the two conditions and consists of headache, dizziness, muscle or abdominal cramps, vomiting, as well as sunburn in the case of prolonged exposure. In more serious cases, loss of consciousness, nuchal rigidity (stiffening of the posterior muscles of the head/neck axis) and convulsions may be associated. These are very serious manifestations and, if they do occur, it is important to provide immediate assistance and call 112 or other local emergency numbers.”
What should you do in case of heatstroke?
“In the event of sickness, the affected person should be taken to a cool, ventilated room, preferably in the shade and away from bright lights, freed from particularly tight clothing and bathed with cool water, especially on the extremities, i.e. the head and limbs. If the person has not lost consciousness and is able to swallow well, it is advisable to give them room-temperature or at most slightly cool water to drink in small sips (avoid cold water because of the excessive temperature change) to promote rehydration. If the victim is unconscious, this should be avoided at all costs as it could cause inhalation and suffocation, and help should be called immediately to provide intravenous therapy.”
How tcan you prevent heatstroke?
“As always, prevention is our best weapon. It is important to avoid going out during peak heat, to wet your head frequently and to wear sunglasses if you need to go outside. Keep an eye on environmental conditions inside the house as well, turning on fans/air conditioners, if necessary, especially if the room is poorly ventilated. It is also important to remember to drink more frequently than usual, even if we do not feel particularly thirsty: an adult of average build should always drink at least 2-2.5 litres of water a day, which can increase even more if they are active in sports or are subject to intense sweating for any reason.”
Who is most at risk and why?
“Individuals at higher risk are those who work outdoors (as they are exposed to the sun and heat throughout most or all of the day); children as they have a reduced perception of symptoms and tend to do a lot of physical activity at all hours; and vulnerable people as well as the elderly. The latter, in particular, physiologically have a reduced perception of the thirst stimulus and often take drugs with complex effects, including diuretics or those that reduce blood pressure. It is therefore essential to ensure that they remain well hydrated and to discuss this with a GP, who will assess the possible rescheduling of therapy if appropriate.
Finally, let’s not forget our four-legged friends! They don’t sweat like we do and we may not notice certain symptoms right away, but the general rules apply in exactly the same way: in the event of an illness, get them into the shade and in a cool place, bathe their paws/flaps and the parts with little hair and call your vet if it doesn’t pass quickly or signs of danger appear.”