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When Heat Turns Deadly

Hyperthermia is a serious medical condition in which the body's temperature reaches higher than normal levels, often due to prolonged exposure to heat or excessive physical activity. Heat stress incidents can be fatal.  When body temperatures are above 104 °F (40 °C) it is considered life-threatening. At 106 °F brain death begins.  At 113°F death is nearly certain.

Heat related illness are well-known mitigating factors to an officer or warrior’s performance.  Law enforcement officers who work outdoors in the heat are at a far greater risk for these illnesses than is the general public.  Additional significant risk factors include; being outside in the glaring sun, in sometimes triple digit temperatures, carrying additionally heavy equipment and body armor (which decreases sweating) while performing physically demanding work.   

The three most common forms of heat related illnesses officers are at risk for are heat stroke, heat exhaustion, and heat rash.  It is essential that officers be aware of the symptoms and first­-aid of these conditions not only for themselves, but to recognize them in their partners, detainees, and citizens.  Failure to do so can lead to death. 

Heat Stroke:  AKA Sun Stoke

Heat stroke is the most serious heat-related disorder. Heat stroke accounts for approximately 300 deaths per year in the U.S. Heat causes more deaths annually than hurricanes, lightning, tornadoes, floods and earthquakes combined. Additionally, the CDC states that heat related deaths are underestimated by as much as 54%. It occurs when the body becomes unable to control its temperature: the body's temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Heat stroke is anytime when the body reaches over 103 °F. When heat stroke occurs, the body temperature can rise to 106 °F or higher within 10-15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not given promptly.  Symptoms of heat stroke:

  • Hot, dry skin or profuse sweating
  • Hallucinations
  • Chills
  • Throbbing headache
  • High body temperature
  • Confusion/dizziness
  • Convulsions
  • Temporary blindness

True heat stoke requires that the individual is admitted to the hospital. The goal is to lower the body temperature as quickly as possible. Remember, that many individuals who suffer from heat stoke may act drunk or combative. Keep this in mind before you haul them off to a hot patrol car, a holding cell or jail. 

 First Aid for Heat Stroke: 

  • Call for an ambulance and notify your supervisor.
  • Move your colleague to a cool shaded area.
  • Cool using methods such as: soaking their clothes with water, spraying, sponging, or showering them with water and fanning their body.

Heat Exhaustion

Heat exhaustion is the body's response to an excessive loss of the water and salt, usually through excessive sweating. Officers most prone to heat exhaustion are those that are elderly, have high blood pressure, and those working in a hot environment.  Symptoms of heat exhaustion:

  • Heavy sweating
  • Extreme weakness or fatigue
  • Dizziness, confusion
  • Nausea
  • Clammy, moist skin
  • Pale or flushed complexion
  • Muscle cramps
  • Slightly elevated body temperature
  • Fast and shallow breathing

First Aid for Heat Exhaustion

  • Have them rest in a cool, shaded or air-conditioned area.
  • Have them drink plenty of water or other cool, nonalcoholic beverages.
  • Have them take a cool shower, bath, or sponge bath.

***Experiencing heat exhaustion and not intervening ASAP makes someone more likely to develop heat stroke, which can be deadly.

Heat Rash:   AKA Vest Rash

Heat rash is a skin irritation caused by excessive sweating during hot, humid weather.  Symptoms generally include red clusters of pimples or small blisters on the neck and upper chest.  Officers are particularly prone to heat rash due to their bullet resistant vest.  Shirts that are even slightly wrinkled and wet will create rash lines under the vest which are susceptible to both fungal and bacterial infections.  Let the affected area dry out completely. Powders and creams are effective treatments and provide comfort. 

Three Additional Heat Related Illnesses

  1. Sunburn:  Symptoms usually include redness and pain. In severe cases there may be swelling of skin, blisters, fever and headaches. First aid includes using an ointment for mild cases of blisters; if the blister breaks a dry sterile dressing.   A physician should be seen for extensive cases.
  2. Heat Cramps:  Symptoms include muscle pains or spasms, usually in the abdomen, arms or legs.  First aid includes stopping all activity and resting in an air-conditioned or shaded area. Drink cool water, clear juices or sports drinks. Seek medical attention if cramps continue.
  3. Heat syncope is fainting as a result of overheating.  Treatment is similar to that for other types of fainting; position the person in a sitting or supine position with their legs raised. Administer water slowly and move him/her t to a cooler area.

Know your personal risk factors for heat illness:  age (the elderly and the young are at the greatest risk), degree of acclimatization, overall health, water, alcohol and caffeine consumption, and use of prescription medications that affect the body's water retention or other physiological responses to heat.

Ten Tips for Officers to Prevent Heat Illnesses

  1. Check the heat index before and temperature/humidity forecast before each shift.
  2. Have a back-up vest carrier—change that out and launder it regularly
  3. Wear a moisture wicking shirt which is designed to move sweat away from the wet areas, and into the dry areas through capillary action.  Some officers report that these shirts cause their vest to ride up and choke them.  The other option is wearing a couple of clean white t-shirts.  Bring extra shirts. 
  4. If you have a choice related to uniforms, wear a white shirt or tans.  Totally black uniforms just make the hot summer sun worse.  Loosen your clothing to allow for perspiration to evaporate, aiding in the cooling process.
  5. Stay in your patrol car as much as possible with the AC vents pointed at you.  If you can’t be in your car find shade, take a cool-down rests in the shade for a period of no less than five minutes as needed.
  6. Humidity matters; although you sweat about the same in Florida as you do in Arizona humidity does not allow the sweat to evaporate off your body, so you are literally drenched in sweat.  Plan accordingly.
  7. Buy an emergency heat stress kit, or ask command to provide one, and carry it in your patrol car.  These come with instant cold compress ice packs, electrolyte replenisher tablets, water packets and forehead thermometers.
  8. Keep bottled water in a cooler, and away from the sun. 
  9. Keep cool water on your head; a wetted sweat band works fine.  Hats and caps are also recommended.  Wear sunscreen.
  10. Never allow yourself to become dehydrated.  The suggested amount of water is one quart of water per officer per hour when conditions are favorable for heat related illnesses.  Avoid drinks with excessive amounts of sugar and carbohydrates, these ingredients may make you feel full or even ill.

Keep your cool – if you can.  I live in Tucson, and right now, if you factor in the wind chill index, it is only 104 °F.