Heat Illness: Myths, Tips, and Tricks

In the “Flaming Mountains” of the Gobi Desert, I first witnessed the gravity of heat illness. 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” carrying water for distressed runners. I traversed the desert on foot, providing fluids and whatever 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.

This experience is an extreme example of heat illness, but it 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 may have heard of “heat domes,” or even personally experienced the intense heat waves that have been cooking parts of the world. No one is immune to their effects.

 

Unfortunately, there are 600-700 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.

Recently, emergency Departments across the US have even started using ice-filled body bags to improvise rapid cooling resuscitation for heat stroke victims in these extreme, climate change-induced, weather patterns. 

But just because temperatures are rising, it doesn’t mean you should stay stuck inside all 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.

 

🤯 Myths & Misconceptions

What heat illness myths have you learned that need to be dispelled?

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

False. It’s true that you 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 a greater sense of exhaustion. But too much water can dilute your salt levels, leading to a serious disease called hyponatremia. Even your favorite sports drink or electrolyte mix will still dilute the salt levels in your blood. Healthy people die every year from overhydration. So when you’re hydrating, just drink when you’re 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. This leads to a lower water vapor gradient between your skin and the air, meaning sweat will actually have a more difficult time evaporating off your skin. When sweat changes form from a liquid to gas (aka “evaporation”), it uses up energy and helps your body get rid of heat. Poor sweating means less efficient heat dissipation in humid environments – that’s why they feel hotter and can contribute to greater heat illness risks. 

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

False. Heat exhaustion encompasses 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 104ºF (40ºC) 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, so it can 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 and can help prevent overheating, but will not significantly cool the body’s elevated core temperature.

💡 Tips & Tricks

Want to safely play and adventure in the summer heat? Here are some tips and tricks to stay prepared if you’re heading out in hot temperatures:

  • Wear light colored and loose fitting clothing.
  • Shade your head.
  • Try to avoid being outside during the hottest parts of the day.
  • Drink plenty of cool water.
  • Remember your salty snacks to help prevent hyponatremia (overhydration).
  • Consider a spray bottle to mist the face, 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 well with the heat stress.

  • Stop and cool down in the shade. 
  • Eat salty snacks and hydrate. 
  • Wet the face, hair, and shirt with water. 
  • When feeling up for it, you can (cautiously) return to your adventure.


🤳 Your Digital Guide to Heat Illness

Download the GOES Health App to help prepare for and respond to complications from heat illness. And with GOES+, 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 safer and have fun. So get out there, we’ve got you!

Share this post:

Latest articles

Tick Talk

Learn more about ticks and what makes them tick. Prevent tick-borne illness and know what to do in case of a tick bite, with GOES.

cottonmouth snake in swamp

Scale up your snake safety

With more snakes on the trail, use GOES to learn more about venomous snakes and what (not) to do in a snakebite situation.

Stay in the loop with the latest articles.