Global Outdoor Emergency Support

Myths, tips, and tricks for heat illness

My first experience with the power of heat illness was in the “Flaming Mountains” of the Gobi Desert. It is the second-lowest elevation on earth, second only to Death Valley.

While I was there, I provided medical care for an ultramarathon and acted as the “camel” who carried water for distressed runners. I traversed the desert on foot, giving fluids and what words of support I could. 

This blasted lunar landscape was extremely hot, without a breath of wind or shade, and it had a labyrinth of slot canyons to navigate. Every time we’d stop to rest, runners would drop to their knees on the scorching sand, and there was a trail of collapsed runners dotting the route.

While an extreme example of heat illness, this experience gave me first-hand insight into just how bad this environmental emergency can be. 

Summer Heat

Heat illness is a risk to everyone, regardless of age or fitness. You have likely heard of “heat domes” or even personally experienced these intense heat waves that are cooking parts of the world right now. No one is immune to their effects.

Unfortunately, there are 600 to 700 annual deaths per year from heat illness in the US. In 2003 there were heat waves in Europe that were responsible for 15,000 deaths in France alone.

Emergency Departments across the US are even using body bags to improvise rapid cooling resuscitation for heat stroke victims in these climate change-induced extreme weather patterns. 

But you don’t have to stay stuck inside all day this summer. With a bit of understanding and the right tips and tricks, you can have fun and stay safe regardless of your planned level of activity.

Woman traveler drinking water

Myths About Heat Illness

There are some myths about heat illness out there that need to be dispelled.

Myth #1: Drinking lots of water is a safe way to prevent heat illness.

False. You do want to be well-hydrated before prolonged exposure to hot temperatures, as optimal hydration will allow more efficient sweating and circulation to cool the body. Dehydration will lead to greater core temperatures and greater sense of exertion. The concern is that too much water can dilute out your salt levels, leading to a serious disease called hyponatremia. Healthy people die every year from overhydration. And even your favorite sports drink or electrolyte mix will still dilute the salt levels in your blood. So when you’re hydrating, drink when you are thirsty and make sure to eat salty snacks to avoid hyponatremia. 

Myth #2: Humid temperatures are not dangerous because you sweat more.

False. Humidity means there is moisture in the atmosphere, and this leads to a lower “water vapor gradient” between your skin and the air. This means that sweat will have a more difficult time evaporating off your skin. When sweat changes from liquid to gas form (aka “evaporation”), it uses up energy and helps your body gets rid of heat. Poor sweating mean less efficient heat dissipation in humid environments. 

Myth #3: Lack of sweating differentiates heat exhaustion from heat stroke.

False. Heat exhaustion encompases a variety of symptoms that can be distressing or even debilitating. These symptoms all represent the body’s lack of acclimatization with the heat. Heat stroke is a medical emergency, and is diagnosed by a core temperature above 104F (40C) with signs of central nervous system dysfunction (like altered mental status, seizures, confusion, coma, etc.). Sometimes a dysfunctional brain can cause an erroneous lack of sweating during heat stroke, but not always. A person with heat stroke can have hot and dry or wet and clammy skin. 

Myth #4: Dunking a heat stroke victim in cold water is dangerous because the cold will make them shiver and inadvertently warm them up.

False. Cold water immersion is the gold standard to treat heat stroke. The colder the water temperature, the better to overcome the body’s hot core temperature (also known as the “temperature gradient”). Ice-cold water immersion has been shown to safely cool heat stroke victims before shivering can occur. This is what we do in the emergency department, and you can do it too in an emergency outdoor situation. Cooling with misting spray water or a fan feels lovely, but will not significantly cool the body’s core temperature. 

Hiker among sand dunes in the desert

Tips and Tricks

Here are some tips and tricks to safely play and adventure in the summer heat. Be prepared! If you’re heading out into hot temperatures:

  • Wear light colored and loose fitting clothing.
  • Shade your head.
  • Try to avoid the hottest parts of the day.
  • Drink plenty of cool water
  • Remember your salty snacks to help prevent hyponatremia (over-hydration).
  • Consider a spray bottle to mist the face and hair and clothing to optimize evaporative cooling.
  • Avoid hot humid days for big outdoor activities.
  • If you’re planning on exerting yourself in the summer heat, consider heat acclimation. Plan ahead and do 1-2 hour exertions in hot weather. After about 10 days your body will become “acclimatized” and better able to tolerate hotter temperatures and cool you down more efficiently. (See: USA Today how to stay cool during extreme heat and Washington Post heat wave safety)

If you or someone else is overheating and feeling: nauseous, dizzy, headachy, cramps, and / or fatigue, these are all early warning signals that the body is not dealing with the heat stress well. Stop and cool down in the shade. Eat salty snacks and hydrate. Wet the hair and shirt and face with water. When feeling up for it, cautiously go back out into the heat and have fun. 

Your Digital Guide to Heat Illness

Download the GOES Health App to help you prepare for and respond to complications from heat illness. As always, our our outdoor emergency medical team is standing by in case you need help. We’re here to give YOU the tools and knowledge you need to stay safe and have fun. So get out there!

Dr. Grant Lipman

Grant Lipman, MD founded GOES based on a dream that technology can be used to empower people to have fun and stay safe outdoors. He is an Emergency Medicine Physician and was trained as an Wilderness Medicine Fellow at Stanford University School of Medicine.