Heatstroke can be ‘sneaky.’ Here is the ‘major red flag’ you need to pay attention to

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Hot weather is forecast this week with the heat index possibly breaking 100 degrees on some days. What’s certain is that extreme heat can be dangerous to your health.

“The first and foremost important thing to remember is that heat exhaustion, heatstroke, can be kind of sneaky,” said Dr. Neil Roy, chief medical officer at Adventist HealthCare Shady Grove Medical Center and an emergency room physician.

There are a few cardinal warning signs of heat-related ailments.

The first one is feeling lightheaded, dizzy, or weak — or recognizing that your loved ones are confused or are acting differently from their baseline.

“As that progresses, confusion is a major red flag,” Roy said. “And then, when they stop sweating and their mouths become dry. Those are red flags for heat exhaustion, heat stroke.”

At the sign of any of these symptoms, “the first thing to do is get inside and start hydrating,” Roy said.

“If you’re outside or your loved one or your friends are outside, and now they’re saying, ‘Hey, I feel kind of lightheaded, I’m feeling a little dizzy.’ The first thing to do is go inside, remove yourself from the heat, and then hydrate,” Roy said. “After those two steps have been taken care of, and if the symptoms don’t go away, then I would seek medical attention.”

That’s especially important is someone is experiencing confusion, Roy said. In that case, he recommends calling 911 and having the person go to a hospital to get checked out.

“Once confusion and changes in your mental status have become really pronounced, those are the reasonable times to seek medical attention,” he said.

Roy said it’s important to think ahead if you’re going to be out in the heat.

“In advance, you want to hydrate with water or sports drinks fairly regularly. … You want to have one 8-ounce bottle of water every hour (that) you’re in the heat and more if you’re (exerting yourself),” Roy said. “Hydration is one of the major pillars in preventing both heat exhaustion and dehydration.”

Drinking alcohol, however, can worsen the effects.

“Drinking alcohol also minimizes your thirst drive,” Roy said. “Typically, we see people that are in their mid-20s or 30s, and they had been drinking beer outside, and they won’t recognize the heat come on. And when they come to the ER, they come in typically confused and their body temperature is very high.”

Hot weather is nothing to be trifled with. Don’t forget that car temperatures can go up very quickly and to not leave children or animals unattended in the car.

“I think the biggest take-home point is to take the heat seriously,” Roy said.

Our most vulnerable citizens

It’s especially important that people aged 65 and older, and children six years old and younger drink enough water when out in extreme heat. Roy said that heat related illnesses can be a particular risk to seniors and small children.

“As we get older and younger — the extremes of age — our needs change. Older patients … typically have a lower drive for thirst, meaning they’re not going to be thirsty the way they would be 20 years ago. So if you’re in the slightly older age category, hydrating more is really important because your body is not going to tell you that you’re dehydrated,” said Roy.

The same is true for children, so parents or guardians must ensure that small kids are properly hydrated when outdoors in the hot weather.

“Children under the age of five or six may not recognize when they’re thirsty in advance. They’ll be outside, running around playing, even swimming, and not drinking water and staying hydrated. So hydrating at a similar rate, with or without sports drinks plus water, is really important among the pillars of preventing both dehydration and heat exhaustion,” said Roy.

Seniors and small children are no strangers to the hospital emergency room during heat waves.

“We’ll see it in older patients that will come in not acting right, being confused, not behaving normally and have high body temperatures. And then there are pediatric patients — we’ll see 1, 2 or 3-year-olds that have been outside and their body temperatures have just risen, risen, risen,” said Roy.

WTOP’s Jack Moore contributed to this report. 

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Dick Uliano

Whether anchoring the news inside the Glass-Enclosed Nerve Center or reporting from the scene in Maryland, Virginia or the District, Dick Uliano is always looking for the stories that really impact people's lives.

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