Houston Methodist<\/a> Hospital, said during heat waves anyone who comes in with a fever of 102 or higher and no clear source of infection will be looked at for heat exhaustion or the more severe heatstroke.<\/p>\n\u201cWe routinely will see core temperatures greater than 104, 105 degrees during some of the heat episodes,\u201d Gandhi said. Another degree or three and such a patient is at high risk of death, he said.<\/p>\n
How heat kills<\/h2>\n
Heat kills in three main ways, Jay said. The usual first suspect is heatstroke \u2014 critical increases in body temperature that cause organs to fail.<\/p>\n
When inner body temperature gets too hot, the body redirects blood flow toward the skin to cool down, Jay said. But that diverts blood and oxygen away from the stomach and intestines, and can allow toxins normally confined to the gut area to leak into circulation.<\/p>\n
\u201cThat sets off a cascade of effects,\u201d Jay said. \u201cClotting around the body and multiple organ failure and, ultimately, death.\u201d<\/p>\n
But the bigger killer in heat is the strain on the heart, especially for people who have cardiovascular disease, Jay said.<\/p>\n
It again starts with blood rushing to the skin to help shed core heat. That causes blood pressure to drop. The heart responds by trying to pump more blood to keep you from passing out.<\/p>\n
\u201cYou\u2019re asking the heart to do a lot more work than it usually has to do,\u201d Jay said. For someone with a heart condition \u201cit\u2019s like running for a bus with dodgy (hamstring). Something\u2019s going to give.\u201d<\/p>\n
The third main way is dangerous dehydration. As people sweat, they lose liquids to a point that can severely stress kidneys, Jay said.<\/p>\n
Many people may not realize their danger, Houston\u2019s Gandhi said.<\/p>\n
Dehydration can progress into shock, causing organs to shut down from lack of blood, oxygen and nutrients, leading to seizures and death, said Dr. Renee Salas, a Harvard University professor of public health and an emergency room physician at Massachusetts General Hospital.<\/p>\n
\u201cDehydration can be very dangerous and even deadly for everyone if it gets bad enough \u2014 but it is especially dangerous for those with medical conditions and on certain medications,\u201d Salas said.<\/p>\n
Dehydration also reduces blood flow and magnifies cardiac problems, Jay said.<\/p>\n
Attacking the brain<\/h2>\n
Heat also affects the brain. It can cause a person to have confusion, or trouble thinking, several doctors said.<\/p>\n
\u201cOne of the first symptoms you\u2019re getting into trouble with the heat is if you get confused,\u201d said University of Washington public health and climate professor Kris Ebi. That\u2019s little help as a symptom because the person suffering from the heat is unlikely to recognize it, she said. And it becomes a bigger problem as people age.<\/p>\n
One of the classic definitions of heat stroke is a core body temperature of 104 degrees \u201ccoupled with cognitive dysfunction,\u201d said Pennsylvania State University physiology professor W. Larry Kenney.<\/p>\n
Humidity matters<\/h2>\n
Some scientists use a complicated outside temperature measurement called wet bulb globe temperature, which takes into account humidity, solar radiation and wind. In the past, it was thought that a wet-bulb reading of 95 Fahrenheit (35 Celsius) was the point when the body started having trouble, said Kenney, who also runs a hot box lab and has done nearly 600 tests with volunteers.<\/p>\n
His tests show the wet-bulb danger point is closer to 87 (30.5 Celsius). That\u2019s a figure that has started to appear in the Middle East, he said.<\/p>\n
And that\u2019s just for young healthy people. For older people, the danger point is a wet bulb temperature of 82 (28 degrees Celsius), he said.<\/p>\n
\u201cHumid heat waves kill a lot more people than dry heat waves,\u201d Kenney said.<\/p>\n
When Kenney tested young and old people in dry heat, young volunteers could function until 125.6 degrees (52 degrees Celsius), while the elderly had to stop at 109.4 (43 degrees Celsius). With high or moderate humidity, the people could not function at nearly as high a temperature, he said.<\/p>\n
\u201cHumidity impacts the ability of sweat to evaporate,\u201d Jay said.<\/p>\n
Rushing to make patients cool<\/h2>\n
Heatstroke is an emergency, and medical workers try to cool a victim down within 30 minutes, Salas said.<\/p>\n
The best way: Cold water immersion. Basically, \u201cyou drop them in a water bucket,\u201d Salas said.<\/p>\n
But those aren\u2019t always around. So emergency rooms pump patients with cool fluids intravenously, spray them with misters, put ice packs in armpits and groins and place them on a chilling mat with cold water running inside it.<\/p>\n
Sometimes it doesn\u2019t work.<\/p>\n
\u201cWe call it the silent killer because it\u2019s not this kind of visually dramatic event,\u201d Jay said. \u201cIt\u2019s insidious. It\u2019s hidden.\u201d<\/p>\n<\/div>\n
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