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Heat stroke is common among
Referring to the reported deaths of three cadets while undergoing military training, I wish to alert the army, the police, medical personnel, large agricultural employers and the public about a dangerous medical condition called heat stroke.
By Alex G Coutinho Referring to the reported deaths of three cadets while undergoing military training, I wish to alert the army, the police, medical personnel, large agricultural employers and the public about a dangerous medical condition called heat stroke. Heat stroke is a sudden, often fatal condition that is brought about when the body can no longer control its internal temperature resulting in the body temperature increasing from 37Âºc up to 42Âºc and 44Âºc. This results into massive disruption of body processes manifesting as collapse, confusion, coma and convulsions (the 4 Câ€™s) often accompanied by bleeding.The patient vomits and defecates blood. Heat stroke can kill within a few hours on onset. The major cause of heat stroke is excessive unaccustomed exercise in non-acclimatised individuals in conditions of high ambient temperatures combined with high humidity. (Dry bulb temperature 35Âº C and wet bulb temperature over 25 C) This is often a common problem among army and police recruits, mine workers and agricultural workers exposed to the sun. I have seen and treated several cases of heat stroke while working in Swaziland, a few of which resulted in deaths. Prevention of heat stroke involves a few basic principles. l Acclimatisation of individuals to hard work or exercise should be done gradually over five to 10 days, even in â€œfit and tough â€œ individuals l On hot and humid days there should be avoidance of heavy work/exercise in the direct sun between 12.00 noon and 4.00 p.m. l Certain individuals are more at risk and need to be excused from heavy work/exercise until they are prepared. These include obese people, recent heavy consumption of alcohol, co-existing fever for example due to malaria, excessive warm clothing, previous history of heat exhaustion and history of heart disease. l While exercising or /working in hot humid conditions, there should be regular breaks each hour, with sufficient fluid replacements containing small quantities of salt (similar to Oral Rehydration Solution) as part of the problem is loss of salt due to excessive sweating. l Individuals who get heat exhaustion (a milder form of heat stroke) need to be properly rested for three to five days, before embarking on any further work/exercise as they are more at risk of heat stroke on subsequent days, if they resume heavy work/exercise immediately. l There needs to be more awareness of the causes, dangers and management of heat stroke. Emergency treatment for heat stroke and heat exhaustion is to try and rapidly cool the person down by applying cold water to their body and fanning them. Individuals who are in coma need to have the basics of resuscitation for example ABC- airway, breathing, circulation support. However heat stroke is a medical emergency that needs heroic interventions in hospital to avert death. While I obviously cannot state that the cause of death of these army cadets was in fact heat stroke, it is my duty as a Public Health Practitioner to alert the relevant people about this little known and often fatal condition in the hope that deaths due to heat stroke can be prevented. The writer is a medical doctor ends