Heat-related illnesses.

Heat-related illnesses cause 240 deaths annually. Although common in athletes, heat-related illnesses also affect the elderly, persons with predisposing medical conditions and those taking a variety of medications. Symptoms range from mild weakness, dizziness and fatigue in cases of heat edema, to syncope, exhaustion and multisystem complications, including coma and death, in cases of heat stroke. Milder heat-related symptoms can be treated with hydration, rest and removal from the hot environment. Heat stroke, a life-threatening problem, must be treated emergently. Prompt recognition is critical since rapid cooling is the cornerstone of treatment and must not be delayed. Fluid resuscitation with dextrose and normal or half-normal saline is also important. These therapies should be instituted while the patient is being stabilized. Heat illness may be prevented by recognizing which individuals are at risk, using appropriate hydration and paying attention to acclimatization and environmental conditions. Preventive care should include drinking plenty of fluids before, during and after activities, gradually increasing the time spent working in the heat and avoiding exertion during the hottest part of the day.