Temperatures were in the 100s when Vanessa Dunn, a 29-year-old Los Angeles-based makeup artist, was driving back home to California from Virginia last summer. After hours on the road and drinking limited water, she was struck by a severe case of dehydration and heat stroke.
”I wasn’t drinking enough water because I didn’t want to stop to pee,” she says. When she finally pulled over for the night she felt light-headed, and she couldn’t keep food down when she tried to eat. She even threw up blood.
”I was in incredible pain, and dizzy,” she says. “[I went] to the ER, turned out there was blood because my throat was so dry.”
Her story is not unusual. In 2014, more than 13,000 people visited the emergency room because of a heat-related illness such as heat stroke, according to data from the Centers for Disease Control. And on average, about 675 people die in the U.S. every year from heat-related illnesses.
Heat stroke is the most severe form of heat-related illness. It’s less common than other issues such as heat exhaustion (characterized by heavy sweating, weakness, cold, pale or clammy skin, fainting, a fast or weak pulse, and nausea or vomiting) or heat syncope (fainting). But heat stroke can happen quickly, to anyone, and can result in irreversible damage or death.
Heat stroke is an extreme elevation of your body temperature that occurs when your body stops being able to regulate itself, according to Dr. James Wantuck, chief medical officer at PlushCare, an online urgent care provider. “If a fever is like an infection turning up your body’s thermostat, heat stroke is like a broken air conditioner,” he says.
Your body does an expert job of keeping its temperature around 98.6 degrees Fahrenheit under normal circumstances. When you’re in a hot environment, your body will regulate its temperature by “radiating heat into the air, driving your brain to find a cooler environment, and sweating to cause evaporation and cooling,” Wantuck says.
But, he adds, “radiating heat and finding cooler air don’t work when the temperature is higher than your body temperature, and sweating doesn’t work when the humidity is higher than about 75 percent — conditions that happen frequently in the summertime.”
That inability to cool down can cause a host of physiological events to occur. They include a raised heart rate, as the heart beats faster to eliminate heat in the body more quickly; inflammation resulting from heat-related cell damage; and the production of “heat-shock” proteins, which try to protect your cells from heat damage.
If cell damage does occur, it can affect enzyme function.
“Without normal enzyme function, your body’s ability to make energy becomes broken, leading to effects similar to cyanide poisoning [such as] multi-organ failure,” Wantuck says. “Your nervous system is the most sensitive to high heat, which is why confusion, incoordination and loss of consciousness are common symptoms of heat stroke.”
For anyone who you are worried may have heat stroke, getting them cooled and to an emergency room are the first priorities.
Dr. James Wantuck, chief medical officer at PlushCare
If you’re out in the sun or exercising on a hot day, look out for signs of heat stroke. They include: sweating profusely; feeling weak, lightheaded or confused; a rapid and strong pulse; headache; muscle and stomach cramps; flushed, pale, dry or clammy skin; or body temperature over 103 degrees Fahrenheit.
If you notice any of these symptoms in yourself or a friend, move to a cooler location immediately, remove excess clothing and try to cool down with cold cloths or even a cold bath.
”We recommend calling 911, and if they are young, placing the person into a water bath with ice,” Wantuck says. “If they are older, [use] ice packs and [pour] cold water on them. [Keep cooling them] until the person starts shivering, or about 15-20 minutes, and their symptoms have gone away.”
“For anyone who you are worried may have heat stroke, getting them cooled and to an emergency room are the first priorities,” he says.
To prevent heat stroke, Wantuck recommends seeking air conditioning on hot days — especially for older adults and those with medical conditions or taking medications that can disrupt that body’s ability to regulate its temperature. You should also stay hydrated, and avoid enclosed environments and layers of clothing.
For athletes of any stripe, Wantuck says to remove excess equipment (where possible), take frequent breaks and gradually build up a tolerance to heat.
For Dunn, having heat stroke was an eye-opener. “It was a really scary experience,” she says. She urges everyone she knows to stay hydrated on hot days. “I hope no one goes through [heat stroke].”