Different populations and situations require modified approaches to heat illness prevention and treatment.
Children and Heat Illness:
Why Children Are High-Risk:
- Don't sweat as efficiently
- Higher surface area to mass ratio
- Produce more heat during exercise
- May not recognize symptoms
- Depend on adults for hydration
Modified Response:
- Lower threshold for medical care
- Cool more gradually
- Monitor more closely
- May not complain of symptoms
- Watch behavior changes
Prevention in Children:
- Mandatory water breaks
- Limit outdoor time in heat
- Never leave in vehicles
- Light-colored, loose clothing
- Monitor urine color
Elderly and Heat Illness:
Increased Risk Factors:
- Decreased thirst sensation
- Medications affecting thermoregulation
- Chronic conditions
- Social isolation
- Poor mobility
Special Considerations:
- May not feel hot
- Confusion may be baseline
- Need neighbors to check
- Air conditioning crucial
- Hydration reminders
Athletes and Workers:
Exertional Heat Illness:
- Can occur in moderate temperatures
- High humidity increases risk
- Acclimatization takes 10-14 days
- Previous heat illness increases risk
- Supplements may increase risk
Return to Activity:
- Medical clearance required
- Gradual return protocol
- Start in cool conditions
- Monitor closely
- May have permanent sensitivity
Medications That Increase Risk:
Common Medications:
- Diuretics (water pills)
- Beta blockers
- Antihistamines
- Psychiatric medications
- Blood pressure medications
- Stimulants (including ADHD meds)
Illegal Drugs:
- Amphetamines
- Cocaine
- MDMA (Ecstasy)
- LSD
- PCP
Environmental Factors:
Heat Index Considerations:
- Combines temperature and humidity
- 90°F + 70% humidity = 106°F heat index
- Above 90°F heat index = increased risk
- Above 105°F = dangerous
- Above 130°F = extremely dangerous
Urban Heat Islands:
- Cities 5-10°F hotter
- Concrete retains heat
- Less air movement
- Fewer cooling options
- Higher nighttime temperatures