How do we tackle heat stroke and dehydration? Hema Vijay talks to experts

The fiery ‘katri' season has passed us by, but then, Chennai is famous for being hot, hotter, or hottest, despite a few intermittent showers. So, as we sweat it out during the day and yearn for twilight to smile upon the city in the hope that it will get a little cooler, we need to guard against dehydration and heat stroke. Dehydration and heat stroke can prove fatal, if not treated soon enough. Habitual dehydration also puts us at risk of developing kidney stones and other disorders. And watch out: children and elderly persons are especially susceptible to dehydration.

While summer makes us most vulnerable to dehydration, we are also at risk when we sweat excessively after vigorous workouts, during strenuous sports and activities such as hiking, prolonged travel in dry climes, outdoor work, or when we develop severe diarrhoea, vomiting and fever, or use diuretics, or if we are diabetics and suffer renal disorders.

Some of us simply forget or fail to drink adequate water, which makes us more vulnerable to dehydration. “Kids don't realise they need to drink a lot of water, many might not even know how to ask for water, while elderly persons might not feel like drinking the required quantity,” says Dr. M. K. Ramkumar, general physician. He continues, “Every morning, I drink about half a litre of water soon after brushing my teeth. Drinking enough water has protected me against dehydration, and urinary problems, among other things.” He suggests that we should inculcate in kids the habit of drinking plenty of water.

Recognising the symptoms

“Thirst is the first symptom. Then you notice sunken eyes, parched tongue and cracked lips, drying up of mucous membranes (as in the inner lining of the nose), and dry skin which doesn't come back to its original contours when pinched,” says Dr. R. Parthasarathy, general physician. Other symptoms include reduced frequency of urination, fatigue, light-headedness, dizziness and confusion, faster breathing and rapid heart beat. In babies, dehydration may be indicated through crying without tears, absence of urination for more than three hours, sunken abdomen, eyes or cheeks, high fever and listlessness. Different individuals may exhibit different symptoms.

Sometimes if a person does not sweat enough to lower body temperature, the body heat may shoot up causing fatal heat strokes. Again, infants, elderly persons and people who work or play outdoors, and those on certain types of medications are most susceptible to heat stroke. Heat stroke can occur suddenly, and the individual may develop headache, feel dizzy, confused and disoriented, and even become unconscious. “Heat stroke requires emergency medical treatment. But, until a hospital is reached or medical help arrives, as a first aid measure, it's important to move the individual to a cool place, remove his clothing, gently apply cool water to the skin, icepacks in the arm pits and the groin, and fan him. Keep the person lying down with his feet slightly elevated,” says Dr. Parthasarathy. If the patient is coherent, try oral rehydration and replacement of electrolytes. Intravenous fluids may also be required. Don't crowd around the patient. He should be able to breathe freely and get enough oxygen.

Water replacement alone will not do. Besides water, sweating deprives our body of essential salts such as sodium, potassium, phosphates and calcium bicarbonate.

“Mild dehydration is treated by drinking water with a pinch of salt (which replaces sodium salts) and sugar and tomato juice to replace the potassium that has been lost. The foolproof remedy is, however, the electrolyte drinks available in the market, which have the right balance of electrolytes,” says Dr. Ramkumar. Sponging with water-soaked towels will help.

For kids, it is best to consult a physician. If dehydration is severe, intravenous fluids may be required. But whatever the intensity, immediate treatment is essential.

Dos and Don'ts

* Drink at least two to three litres of water everyday.

* Keep replacing electrolytes, especially when you sweat excessively such as during sports or prolonged exposure to the sun. Merely drinking water or fruit juices will not do.

* Maintain the electrolyte balance during illness or heat exposure with scientifically formulated electrolyte mixtures.

* Keep a supply of electrolyte formulations or sports drinks handy during summer, especially for children and elderly persons.

* If you do have to stay outdoors, acclimatise your body to the heat by gradually increasing your time outdoors. Always travel with a bottle of water.

* Use hats or umbrellas and sunglasses, and wear light-coloured, light-weight and loose-fitting clothes.

* Avoid the sun, especially between 1 p.m. and 3 p.m. when its intensity is at its highest.

* Avoid drinks such as coffee, tea, soda and alcohol which dehydrate the body. Opt for tender coconut water, lemon juice with salt and sugar, paanagam (traditional jaggery-ginger-lemon drink), diluted buttermilk, lassi with salt and sugar, and fruit juice

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