Vital organ damage to death: Mumbai doctors share tips to protect yourself from heatstroke in summer

The temperature in Mumbai has been inching closer to 40 degrees with a persistent heatwave alert from the IMD. Though Mumbai doctors are not yet receiving cases of heatstroke, they predict the rise in cases as the summer season marches into May.

Giving in to the soaring temperatures, Mumbaikars are spotted wearing sunglasses, caps and other headgear to keep their body temperature under normal limits. The sale of chilled water bottles and other fizzy drinks has shot up. Summer drinks like aam panna, nimbu paani and nariyal paani have taken centre stage.

While Mumbaikars are trying their best to keep themselves cool during this blazing heat, the risk of heat-induced ailments like heatstroke cannot be ignored. Considering this, Mid-day.com dialled city health experts to seek guidance on how citizens can protect themselves from heatstrokes.

Dr Bikky Chaurasia, consultant, internal medicine, Kokilaben Dhirubhai Ambani Hospital, Dr Gaurangi Shah, consultant - general medicine, P. D. Hinduja Hospital and MRC, and Dr Geeta Makhija Chhabria, consultant, general medicine, Jaslok Hospital & Research Centre share detailed guidance on heatstroke protection.

"Heatstroke occurs when the body can no longer control its temperature. The body's temperature rises rapidly, the sweating mechanism fails, and the body fails to cool down. When heatstroke occurs, the body temperature can rise to 106°F or higher within 10 to 15 minutes," Shah tells Mid-day.com.

"Our body functions best at an internal temperature of about 37°C (98.6°F), but everyone has their own ‘normal' body temperature which may be slightly higher or lower. Our bodies also constantly adapt their temperature to environmental conditions. It goes up when we exercise, for instance, and it is lower at night and higher in the afternoon than in the morning.

The organ systems that work together to maintain body temperature are the nervous system, the muscular system, and the vascular system. Our internal body temperature is regulated by a part of our brain called the hypothalamus. The hypothalamus checks our current temperature and compares it with the normal temperature of about 37°C."

He adds, "If our temperature is too low, the hypothalamus ensures that the body generates and maintains heat. Contrastingly, if our current body temperature is too high, heat is given off or sweat is produced to cool the skin."

When sweating and other mechanisms to reduce temperature fail, the body refuses to cool down and its temperature rises rapidly causing a heatstroke.

Who is more at risk of heatstroke in summer?
Chaurasia: Several factors can increase the risk of heatstroke for some individuals during the summer. These include:

1. Elderly individuals: Older adults may have less efficient heat regulation systems.

2. Children: They may be less aware of the need to hydrate or take breaks from physical activity.

3. People with chronic illnesses: Conditions like heart disease, diabetes, or obesity can make it harder for the body to regulate temperature.

4. Outdoor workers: Those who work outdoors are at higher risk due to prolonged exposure to high temperatures.

5. Athletes: Especially during intense training or competitions, athletes can be vulnerable to heatstroke if they don't take proper precautions.

6. Individuals with certain medications: Some medications can interfere with the body's ability to regulate temperature.

7. People living in urban areas: Urban heat islands can make cities significantly hotter than surrounding areas, increasing the risk of heat-related illnesses.

Also Read: Aamsul Saar to Kokum Hummus: Try these refreshing Kokum-infused drinks and dishes to beat the Mumbai heat

What can trigger a heatstroke?
Chaurasia: Here are some reasons that can cause one to suffer from a heatstroke

1. High temperatures: Exposure to extreme heat, especially during heatwaves, can cause stress to the body's cooling systems.

2. Humidity: High humidity levels make it harder for sweat to evaporate, reducing the body's ability to cool down.

3. Dehydration: Insufficient fluid intake or excessive fluid loss through sweating can lead to dehydration, impairing the body's ability to regulate temperature.

4. Strenuous physical activity: Engaging in vigorous exercise or labour in hot conditions can generate excess heat, especially if proper hydration and rest are lacking.

5. Underlying health conditions: Certain medical conditions or medications can affect the body's ability to regulate temperature, increasing susceptibility to heatstroke.

6. Alcohol consumption: Alcohol can impair judgment and interfere with the body's ability to regulate temperature, increasing the risk of heat-related illnesses.

7. Clothing and environment: Wearing tight or heavy clothing, or being in confined spaces with poor ventilation, can contribute to heat buildup in the body.

Are there any specific types of heatstroke depending on the severity?
Shah: There are two forms of heatstroke -- Classic and exertional. Classic heatstroke typically affects elderly individuals with chronic medical conditions while Exertional heatstroke affects otherwise healthy people who engage in strenuous exercise in hot or humid weather. Classic heatstroke patients often present with hot, dry skin because of a failure of the normal sweating response, also known as anhidrosis. Whereas in exertional heatstroke, anhidrosis Instead, prolonged sweating occurs following the cessation of exercise. In elderly people who experience classic heatstroke, the mortality exceeds 50 per cent. The mortality rate in exertional heatstroke is less than 5 per cent.

What are the common symptoms of heatstroke?
Chhabria:

1. High body temperature: A core body temperature of 104 F (40 C) or higher, obtained with a rectal thermometer, is the main sign of heatstroke.

2. Altered mental state or behaviour: Confusion, agitation, slurred speech, irritability, delirium, seizures and coma can all result from heatstroke.

3. Alteration in sweating: In heatstroke brought on by hot weather, your skin will feel hot and dry to the touch. However, in heatstroke brought on by strenuous exercise, your skin may feel dry or slightly moist.

4. Nausea and vomiting: You may feel sick to your stomach or vomit.

5. Flushed skin: Your skin may turn red as your body temperature increases.

6. Rapid breathing: Your breathing may become rapid and shallow.

7. Racing heart rate: Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.

8. Headache: You might experience a throbbing pain in your head.

Also Read: Scorching summer in Maharashtra: Mumbai expert shares handy tips to protect children from the heat

How can heatstroke be prevented?
Chhabria: Heatstroke is predictable and preventable. Take these steps to prevent heatstroke during hot weather:

1. Drink plenty of fluids: Staying hydrated will help your body sweat and maintain a normal body temperature.

2. Avoid dehydrating fluids: Beverages like tea, coffee and alcohol cause the body to dehydrate raising the risk of summer ailments.

3. Wear loose-fitting, lightweight clothing: Wearing excess clothing or clothing that fits tightly won't allow your body to cool properly and also hamper the free flow of air leading to trapped heat in the body.

4. Protect against sunburn: Sunburn affects your body's ability to cool itself, so protect yourself outdoors with a wide-brimmed hat and sunglasses and use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours â€" or more often if you're swimming or sweating.

5. Take extra precautions with certain medications: Be on the lookout for heat-related problems if you take medications that can affect your body's ability to stay hydrated and dissipate heat.

6. Never leave anyone in a parked car: This is a common cause of heat-related deaths in children. When parked in the sun, the temperature in your car can rise to 20 degrees F (more than 11 C) in 10 minutes. It's unsafe to leave a person in a parked car in warm or hot weather, even if the windows are open or the car is parked in the shade. If you park your car keep it locked to prevent your child from entering.

7. Don't over-exert yourself during hot hours of the day: If you can't avoid strenuous activity in hot weather, drink fluids and rest frequently in a cool spot. Try to schedule exercise or physical labour for cooler parts of the day, such as early morning or evening.

8. Get acclimated: Limit time spent working or exercising in heat until you're conditioned to it. People who are not used to hot weather are especially susceptible to heat-related illness. It can take several weeks for your body to adjust to hot weather.

Also Read: Greasy and itchy skin in summer? Here is an easy guide for healthy skin during the hot season

What complications can a heatstroke lead to?
Shah: Complications of heatstroke include Acute Respiratory Distress Syndrome (ARDS), Disseminated Intravascular Coagulation (DIC), Acute Kidney Injury (AKI), liver injury, hypoglycaemia, rhabdomyolysis (severe muscle injury), and seizures.

Despite normalisation of core temperature with cooling, many patients continue to display core temperature disturbances and multi-organ dysfunction. Research has shown that even reversible complications following heatstroke may take longer than seven weeks to resolve.

Chabbria: Heatstroke can result in several complications including death, depending on how long the body temperature is high. It can cause vital organ damage like your brain or other vital organs to swell, possibly resulting in permanent damage. Death can occur if vital organ damage continues or is permanent and major.

What should one immediately do in case of a heatstroke?
Chhabria: Heatstroke requires immediate medical treatment. If you're waiting for an ambulance to arrive, try to cool the person as much as possible by:

1. Applying ice packs to the neck, groin and armpits.
2. Encouraging them to drink slightly salted fluids, such as sports drinks or salted water.
3. Have them lie down in a cool, shady, well-ventilated environment.
4. Immersing them in cool water, if possible.
5. Sprinkling water on them and blowing air across their bodies (evaporative cooling).
6. Monitoring their breathing carefully and removing any airway blockages.
7. Don't give any medications, including aspirin and acetaminophen.
8. Remove any clothing that is tight or heavy.

At the hospital, the person with heatstroke may receive:
1. Cooled intravenous fluids through a vein in their arm.
2. Cooling blanket.
3. Ice bath.
4. Medication to prevent seizures.
5. Supplemental oxygen.

Sometimes cold-water lavage is necessary. This treatment uses catheters (thin, flexible tubes) to fill body cavities with cold water. This helps lower the body temperature overall. The catheter may go into the rectum or down the throat.Healthcare providers stop cooling treatments once the body reaches about 102 degrees Fahrenheit (38.9 degrees Celsius).

What OTC medications should be taken to ease the effects of heatstroke?
Chaurasia: There is no specific medication to keep handy in heatstroke but a few things can be kept handy such as ors solution.

Shah: Do not take paracetamol, aspirin or other such medicines to treat fever/high body temperature due to heatstroke. This worsens the condition and causes liver damage.

Disclaimer: This information does not replace professional medical advice. Consult a qualified specialist or your physician for personalised guidance.