BETHLEHEM, Pa. — Heat-related illnesses can be tricky, Dr. Andrew Miller said Monday, with patients often reporting varying symptoms, such as general fatigue, nausea and dizziness.
“Most often, people come in and it's really vague,” Miller, regional vice chairman for Lehigh Valley Health Network's department of emergency and hospital medicine, said.
“They just don't feel well, and that's kind of the most common complaint, and they don't even know why, and they didn't put together that it's the heat.”
“It can hit anybody at any time — that's the honesty of it."Brian Wiese, director of Sports Medicine Operations at St. Luke's University Health Network
After breaking high temperature records Monday, and with the Lehigh Valley under an extreme heat warning through Wednesday, area doctors are preparing for an uptick in heat-related illnesses.
They're urging residents, especially vulnerable populations such as children and seniors, to seek air-conditioning and keep hydrated.
“It can hit anybody at any time — that's the honesty of it,” Brian Wiese, director of Sports Medicine Operations at St. Luke's University Health Network, said.
“With the cascade of what it is, thermoregulation is the name of the game. And, at either end of the life spectrum, you're not as good at thermal regulating, so children/infants to elderly — that's where there's going to be some more concerns.”
‘The heat that's getting to them’
A heat illness could be mild, such as heat rash or heat cramps, Miller, who also serves as chief of LVHN’s Division of Pediatric Emergency Medicine, said.
Or it can be more serious, such as heat exhaustion and heat stroke.
It’s a spectrum, and can affect all ages.
Heat rash and heat cramps present like they sound — a bumpy, red rash, and leg and abdomen cramping, respectively.
“Further along, you get heat exhaustion, where you're just feeling fatigued and crying a lot, for the kids — and, actually, the adults could cry, too — and just not feeling well,” Miller said.
Next, he listed heat syncope, when a person could faint or pass out because of heat.
“And then, the extreme and the most serious, of course, is heat stroke, which can be a precursor of death from heat-related illness,” he said.
“They may just be crying, and you may just think they're hungry, for instance, but it really could be the heat that's getting to them.”Dr. Andrew Miller, regional vice chairman for Lehigh Valley Health Network's department of emergency and hospital medicine
However, if a person with heat stroke gets appropriate treatment, there’s a very good chance they’ll recover, doctors said.
“The great statistic that exists with exertional heat stroke is if there is appropriate treatment within 30 minutes of identification and onset, there's a 100-percent survivability rate,” Weise said.
“It's not many conditions you can say that for.”
Oftentimes, children will experience the earlier effects of a heat-related illness.
“Really keep an eye on the kids, especially nonverbal kids — infants or toddlers that can't really explain why they're feeling bad,” Miller said.
“They may just be crying, and you may just think they're hungry, for instance, but it really could be the heat that's getting to them.”
‘That's what I'm used to’
Similarly, seniors and the elderly population don’t regulate heat well.
They might think they’re tolerating warmer temperatures without air conditioning, but they could be dehydrating themselves, doctors said.
“The reality is you have to kind of keep on top of them, because they're already kind of vulnerable, and not having the air-conditioning running during this kind of thing can really be a disaster,” Miller said.
“It's pretty common that we'll hear of patients when they come in, their house was, like, 80 degrees, and they'll be like, ‘Oh, that's what I'm used to.’
"But the reality is that that can be a major problem in this situation.”
"The summer season is arriving in full swing, and in the coming days, we are expecting hazardous heat conditions. Be vigilant for signs of heat-related illnesses. Remember to drink plenty of fluids and check on your friends, family and neighbors.Lehigh County Coroner's Office release
So far this year, there have been no heat-related deaths in Lehigh County, according to County Coroner Daniel A. Buglio.
“It's going to get hot!" officials from the coroner's office posted on Facebook Friday.
"The summer season is arriving in full swing, and in the coming days, we are expecting hazardous heat conditions.
“Be vigilant for signs of heat-related illnesses. Remember to drink plenty of fluids and check on your friends, family and neighbors.
“Please do not leave your pets outdoors without shelter and water, and never leave them locked inside a vehicle. Let’s look after one another and take extra care of our senior citizens.”
Last summer, the first and only heat-related death in the county was reported in July.
A 93-year-old Upper Macungie Township woman died from hyperthermia attributed to “severe heat conditions” in her home.
Environment, hydration
If residents are venturing outside during the heatwave, paying attention to the environment, as well as the time of day, is important.
“If you can get to a surface that doesn't make the climate hotter, make that choice,” Wiese said.
“Time of day — mornings, late afternoons are obviously going to be better than your middle-of-the-day and your peak temperatures and your direct sunlight, because that obviously affects some things.
“If you're able to get inside or to a shaded area, that's going to decrease temperature gradient, for sure. Still doesn't eliminate it, right?
"Just because you all of a sudden get to go play on a field that has mostly shaded coverage doesn't mean it's going to minimize or completely mitigate somebody from cascading to a heat illness, but it doesn't hurt.”
Hydration also is very important, and residents may need more than just water.
“You want to get something with electrolytes mixed in to try to minimize the sugar intake,” Miller said. “So every couple bottles of water, you want to add something with electrolytes.
"If you just drink free water without sodium, then you'll start feeling sick from low sodium, too, because you're sweating out sodium.”
Avoid dehydrating caffeinated drinks, especially energy drinks, Weise said.
Get out of the heat
It may seem intuitive, but it bears repeating often during extremely hot temperatures — the main way to treat heat-related illness is to get out of heat and cool down.
If there’s no air-conditioner at home, residents can stay cool by taking advantage of free pools, splash parks and water curtains some municipalities are offering, or going to a movie theater or mall — even a cold shower could help.
Area doctors could be seeing the impacts of the heat through the end of the week, when temperatures are expected to rebound.
“What we know is that once we start a heat wave like this … is we'll see patients starting now, but really even two to three days after the heatwave is over."Dr. Andrew Miller, regional vice chairman for Lehigh Valley Health Network's department of emergency and hospital medicine
“What we know is that once we start a heat wave like this … is we'll see patients starting now, but really even two to three days after the heatwave is over,” Miller said.
It wouldn’t be a matter of symptoms delayed, but an accumulation for those thinking they can push themselves during extreme temperatures, he said.
For example, if a person keeps up their same level of activity during the heatwave, and continues to do so even when temperatures cool, they could make themselves sick.
“If their body is physiologically not recovered from managing itself over the hot days, well, then that threshold might lessen a little bit,” Weise said.
“And then, therefore, that day where it's a little bit not as hot, but the exertion or the other factors or variables at hand come into a play, then you might trip that threshold as is.
"Because that threshold can migrate up and down based on recovery, based on the mitigation strategies, based on individuals.”
