Timely information on 'How not to fry'.

We are into July and the mercury is rising.

The northeast and mid-west are breaking records for electricity use. The grids are stressed. It won't take much to see brownouts and power failures. Down here in Florida many, or at least some, of us are acclimated to the heat. Farther north the average person has little experience with dealing with real heat without using AC.

http://scienceblogs.com/casaubonsbook/2010/07/how_not_to_fry_keeping_cool_wi.php

Generally, I don't run my AC until August. And even then mostly it is a late evening thing for a few weeks. Last year I didn't run my AC at all. I get along pretty well with ventilation and shade, a small fan to help move the air, as much bare skin as legally permissible, and drinking a lot of water.

How do you all handle the heat?

Do you have a plan to handle a situation of high heat and no AC?

I'd have to retreat into my basement if the AC/power was out for a long time. It's pretty cool down there.

I was stationed in FL for 3 years and found the summer heat and humidity there unbearable. Entire months of black flag days (no outdoor physical activity).

Conversely, I always got a kick of Floridians retreating inside and layering up in the winter months when the thermometer dipped to a "frigid" 60.

I used to be able to handle humid 40°C and no AC no problem, but since moved up north and adapting to the -20 temp, even 30 is on the hot side. But if it comes down to it I'm sure I can still re-adapt pretty quickly.

I'm not as far north as you, but I know what you mean. This last winter we saw it get down under -30 F and I'm sure it'll be well over a hundred within a week or two.

I lived in So.Florida & Worked with a Construction co. building homes,mostly in Boca Raton,& Tamarac/Pompano area.Summertime was Easily 95degrees/95%humidity,24/7! It was against the law for any construction crew,to Not provide Cold water(coolers had to have ice in them at All times)& we had been inspected at least 3 times a week.The heat was Brutal,as was the humidity but we endured regardless,Thanks to Good ol'Suthn'Food-Grits n'Greens n'Gizzards,& Lotsa'Busch Beer!I didn't have A/C where I lived but,there was a canal out the back gate,that saw my presence,More often than Not.When I wasn't fishin' with a Cane pole,I was swimmin/floatin'usually!

A bunch of us Southern boys and girls (La. and Fla.) were sent to March AFB in Riverside, CA, for some DMAT training, where we were repeatedly cautioned about the "dangerous" heat prevailing in that desert clime. We were laughing our posteriors off. Barely 90 degrees, with no humidity at all, plenty of shade, cold water, and a steady breeze. Who were they kidding! I was looking for a sweater.

"follow the dog"..when they head to the basement so do i.

I turned off the AC today, it's 33°C inside right now and I actually feel relatively comfortable. So I guess if I can adapt to this in a few hours, I can probably do much higher in a few days. 15 years of living in humid 40° weather and largely without AC does have some benefit.

Humidity is the key...what's the relative humidity?

Around 70% inside, 50% outside

It's not that they can't handle heat, it's that you wimps down south can't handle cold!! Seriously, they swing 130 degrees in 4 months. Give them a break!

I grew up in SoCal. 105-110 is hot, but whatever. Shade, water, big deal. 40 was crazy cold. Humidity sucks..(insert favorite noun here). Then I moved... and found that -5 is freaking cold, but not much different than +5. personally, I'd rather need a jacket or sweater than be stuck in that tropic humidity crap y'all deal with.

I have no plans. I work in a building with a/c. When I get home, the A/C is set to 82. If that breaks, I have a wading pool out back I can sit in if needed. Or drive 2 blocks with my Kayak and go out onto the Elizabeth River. Worse comes to worst, I head to Virginia beach, 25 miles away.

Been there; done that. I keep a poly fleece jacket in the truck for movie theaters and doctor's offices. Then again I've taken friends on summer camping trips who seem to spend all their time in AC and they suffered. Ironic that people come down to Florida 'for the weather' and then stay inside with the AC cranked so low they could hang meat.

Seems to be a common theme with humanity. The story is that Arizona used to be valued as a destination for allergy sufferers because it had few flowers and low pollen counts. OF course as soon as the people moved there the first thing they do was plant flowers. I'm told that in much of Arizona the pollen count is about what it is in the rest of the country.



I've seen people try to cool off using 'swamp coolers'. These units push air over a water saturated absorbent material. The idea is to force evaporation of the water and drop the temperature. Problem is that if you blow air at 100% humidity over water the water has no place to go and the temperature doesn't drop.

Same with sweat. At 100% humidity sweat doesn't evaporate and you stay wet and hot. Dry heat isn't bad. Wet heat is like living in a plastic bag. In a high humidity situation you lose more heat by radiation and convection than evaporation. The working solution is to get naked so the sweat falls off and body is free to radiate heat. Staying in the shade to avoid direct heat and keeping the air moving so you to shed heat faster.

The other thing people need to learn is to slow down. Try to do too much too fast and you overheat and fall out. A slow, measured pace gets more done in the long run.

Working construction over 100F and 100% humidity we went to a 20/20/20 system. Twenty minutes working heavy physical labor, twenty resting in the shade, twenty minutes light work. Even then during the 1200 to 1400 time period we pretty much eliminated the heavy physical labor part if it was in the sun.

Fold-up 12' by 12' shade pavilions are very handy to keep the sun at bay. If you have a choice get one in a light color with vent in the peak of the roof. Place a large jug of ice water and a industrial size fan under it and you have a workable cooling station. Keep one of these set up close to all the work locations and work in shifts and you can get a lot done without anyone falling out.

I've seen too many guys, it is almost always guys, who try to 'tough it out' get laid low by heat. If you think setting up and maintaining a cooling station is expensive try paying for a couple of serious cases of genuine heat stroke.

Myth: You can send someone into shock if you cool them off too fast. This is false. Having ice dumped on you is not comfortable in normal conditions but most people barely feel it if they are dangerously overheated.

If someone is suffering heat stroke don't hesitate to cool them off as fast as possible because their brain is literally cooking. Packing the groin, neck and armpits in ice is the best way to cool them. If they get to the point they need it they are usually only semi-conscious and won't feel it much. Once iced down transport them with the ice in place. Generally there is no need to worry about frostbite or hypothermia if transport can be accomplished in ten or fifteen minutes.

I used to work in Las Vegas, outdoors, with poor or no a/c, and practically DIED every summer. Never got used to it in six years and was glad to see that place in my rear-view mirror.

My work now is driving. I have good a/c, always carry a crate of bottled water, and while waiting, I can park in the shade. If it's really hot, I take a thin towel (like a dishtowel) and soak it, wring it, and hang it around my neck, occas. wiping my arms with it. I have access to cold water at every depot or train yard.

When I'm home, if it's cool enough, I do some work early and late. I don't do much of anything in the heat of the day but rewet my towel and drink and cruise the internet or read. I don't have a/c, and not much air pollution. Hot spells don't really last too long here (humidity 40-50%), and when it is hot, I just don't get much done around the house.

In the past, when I've been traveling with my dog, I kept 'dog towels' handy. She could lay on a wet towel, and if it was very bad with little shade, I would cover the dog with a wet towel, too, and the evaporation would cool her (heaviness of panting being the gauge).

I run the sprinklers in the areas of grass that will be shady during the heat of the day for the dogs and chickens to lie in. The chickens pant and really suffer in the heat. They like to wade through very shallow water (like 1/2" or less), so I will let the hose run very slowly on a shady, hard-packed spot. I refill the water bowls every evening and check them every morning, and they all have water bowls in several places.

I also have the saucers from plant pots filled with water for the wild birds. It is said that if you keep water available in summer, birds and animals won't go after your garden crops (esp fruit) as much. I don't know if it's true, but I do it anyway.

Sue

The Paramedics I take my MRT class from always advise against this.

Just my 2c.

MarkO is correct.

"Treatment of hyperthermia consisting of measures which will rapidly lower core body temperature. However, care must be taken to avoid causing vasoconstriction or shivering. Vasoconstriction will impede heat loss and shivering will create heat."
http://www.rnceus.com/hypo/hypertreat.html

When I worked for a vet in SoCal, we got a couple cases of dogs left in hot cars every summer. While we hosed them down with cool tap water and placed cold packs around their head in their armpits and groin area, my vet warned us that they couldn't be packed in ice or immersed in very cold water. The highest rectal temp I every saw was 112F in a Springer Spaniel. Yes, he died.

Sue

~9:45 PM and a balmy 94° here (north-end of Phoenix). Moved here from Santa Barbara (where heat not an issue) when retired eight years.

Despite low humidity, 110°+ days are still hot, by anyone's standards. Quickly learned, outdoor activities best done early A.M.

We manage to stay comfortable thanks to:

- Installed pool immediately after bought home.
- 'Plantation shutters' on all windows and atrium doors. Big help.
- South- and west-facing windows are manufacturer-tinted.
- R-50 ceiling insulation.
- Home divided into two zones, each with own A/C and furnace, set in sync with time-of-day and usage. Normally use A/C mid-May through August.
- Ceiling fans in all rooms and two on rear covered-patio.
- Installed misting system on rear covered-patio.
- When out and about with car(s), park facing sun, use foil-faced windshield sunshades.
- Both cars carry small insulated coolers. Our habit: toss couple of bottled waters in if driving beyond immediate area.
- Uniform du jour: shorts, sandals, t-shirt, baseball cap (and good sunglasses).
- During Spring/Summer, 80% of cooking done on small outdoor BBQ grill (connected to natural gas).

That's what was taught in the past, and is still sometimes taught today in EMS education. But it is wrong.

The gold standard for treating hyperthermia is full immersion in an icewater bath. This is what the top athletic trainers do, both at the world class and local high school levels.

The only valid exceptions are people who are very aged or who have seriously pathological cardiac dysrhythmia problems. In just about everyone else, rapid cooling via water at or just above freezing is the gold standard.

Since someone developing heat stroke will almost certainly have altered mental status, care must be taken to keep their airway clear during the water immersion.

Look to some of the more recent research for the details. Don't rely on stuff written 5-10 years ago.

I wonder if you guys are confusing heat with cold?

I've heard the "don't warm too fast" theory with hypothermic patients, the idea being if you warm them externally, you open the vaso-constricted vessels and then they go into shock, which in a hypothermic state is just making things worse.

Either way, the shivering aspect is something to consider. You just have to cool them faster - ice water enema, anyone?

Sorry it took me so long, but I found the material I wanted to link in my earlier post.

Dr. Doug Casa, PhD, is considered one of the most up-to-date experts on exertional heat stroke. Here is a video of Dr. Casa at a seminar. There are more videos with Dr. Casa on YouTube to peruse too.

The Korey Stringer Institute is an extension of the University of Connecticut and is dedicated to research and prevention of heat injuries. Dr. Casa is affiliated with the KSI. Check their site for tons of info.

Specifically from this page at the KSI:

"Myth: 'Peripheral Vasoconstriction (PVC) delays cooling'

Fact: While PVC may occur during cold water immersion (CWI,) it is greatly overshadowed by the great conductive and convective thermal transfer which cools the body rapidly. Furthermore, PVC certainly occurs when a normothermic individual is placed in a cold water bath. Although PVC may minutely increase core body temperature initially, even in a EHS victim, a rapid decrease in body temperature will immediately follow.

Myth: 'Shivering delays cooling'

Fact: Similar to PVC (peripheral vasoconstriction), shivering will certainly occur when a normothermic individual is placed in a cold water bath. However, this is seldom the case with a hyperthermic individual. Research shows that powerful rapid cooling will still occur in hyperthermic individuals with few occurrences of a shivering response."

Lastly, remember this nugget: "today's heat illness started with yesterday's training". Heat injury is a cumulative thing; you are not out of the woods after the initial cooling. Heat injury has been shown to incite an inflammatory response in the body that takes time to recover from. If you push yourself day after day in the heat, you are risking heat injury more than you think, especially if you do not sleep in cool conditions at night.

Maybe but that's the way I'm taught and I'm expected to respond to incidents according to my training and scope of practice.

You might want to bring this up with a representative on the policy and procedures board. They may want to modify standards to incorporate the improved understanding in their next update evolution. As medical knowledge and equipment evolve over time policy, procedure, and training have to be updated and most EMS bureaucracies have a board or committee established to keep up.

And how fast do bureaucracies usually move ??

That wooshing noise you just heard was a glacier passing a bureaucracy.

Good article. Of course wet cloths, fans (if there's power), a dip in the bathtub (or whatever) will help cool you down. I believe someone mentioned misting systems, but I don't believe anyone mentioned personal misters. They don't require electrical power (they do require water). I bought one of this brand: http://www.mistymate.com/ *

I didn't pay anywhere near those prices though. I don't know that this is the best mister out there; this is just the one I happen to have. Works well in a relatively dry climate like S. California. Not so sure this would work in that soup that some call air along the gulf coast.

HJ

*I have no connection to or financial interest in said brand.

"The gold standard for treating hyperthermia is full immersion in an icewater bath. This is what the top athletic trainers do, both at the world class and local high school levels.

"The only valid exceptions are people who are very aged or who have seriously pathological cardiac dysrhythmia problems. In just about everyone else, rapid cooling via water at or just above freezing is the gold standard."

"But I didn't know he had a heart problem... so, Doc, how fast does rigor mortis set in in ice water?"

Maybe it's true, maybe the overheated sports people are in great shape except for being stupid enough to get themselves into hyperthermia, but... why does shocking the body like that make me so uncomfortable?

Sue

"but... why does shocking the body like that make me so uncomfortable?"

That's my instinct too. Wouldn't you want to cool the person down more gradually? This sounds something like forcing a dehydrated person to drink several quarts of ice-cold water in rapid succession. Doesn't seem right.

I remembered seeing this same wording somewhere in the literature, and today I found it on MedScape (registration is free if you don't have a login there):

Cold Water Immersion: The Gold Standard for Exertional Heatstroke Treatment

"Recently (in a historical sense, i.e., 50 to 100 yrs or so ago), a widely circulated opinion has encouraged some in the medical community to avoid using cold water immersion (CWI) for the acute treatment of heatstroke.[19,30] This line of thinking has reached the medical community, including athletic trainers, team physicians, emergency department physicians, emergency medical technicians, registered nurses, first aid-trained coaches, and others. The number one criticism of CWI is that patients will actually heat up (or at least not cool down) in CWI because of peripheral vasoconstriction (PVC) and shivering. However, scientific evidence strongly refutes this criticism. Evidence from basic physiological studies looking at the effect of CWI on cooling rates in hyperthermic individuals and treatment of actual EHS victims clearly shows that CWI has cooling rates superior to any other known modality.[2,10,11,21,22]

We have recently stated, "it is quite difficult, if not impossible, to kill an otherwise healthy athlete experiencing EHS if rapid cooling via cold/ice water immersion is implemented within a few minutes after collapse".[9]



From the above link: "Any delay in the process of rapidly cooling an individual experiencing EHS, whether it is caused by a delay in the initiation of treatment or the use of an inferior coding modality, can dramatically increase the likelihood of morbidity and mortality associated with the condition."

Glock-A-Roo, thanks for providing the quotes, and the link.

People worried that cooling a person down too fast by packing on ice or ice-water immersion causing heart attack or that shivering or vasoconstriction might slow cooling should consider that there are situations where people find themselves in ice-water. A well known, and well studied, situation is the effect on survivors of a sinking or aircraft ditching in cold water.

Consider that people who abandon ship and step off into freezing water without protection don't tend to die of heart attacks, nor does vasoconstriction or shivering make much difference. The heat-sink effect of ice-water is so profound that shivering and vasoconstriction don't seem to make much difference on how long you survive.

In fact if vasoconstriction was effective in protecting your core from heat loss there would be no significant advantage to the Heat Escaping Lessening Posture (HELP) where you ball up form fists and tuck your arms in tight. The fact is that the HELP posture works and can significantly increase the time you stay alive in cold water. Which conversely suggests that vasoconstriction isn't very effective.

Of course ice-water immersion is only indicated if the person is at or very near 106F. Lesser cooling methods are entirely acceptable for less drastic situations and heatstroke is always best handled by prevention.

A person drifting into full-on heatstroke represents a massive and protracted failure to take action to control their body temperature. Except in a few rare cases it takes a considerable amount of time to progress to heatstroke. Intervention, by any handy means, at any earlier time will almost always prevent heatstroke. Something as simple as moving a person into the shade, having them rest, and having them sip water can often eliminate the problem before it becomes a medical emergency. Moistening the clothing and fanning can help speed cooling.

But if and when a person crosses the line into heatstroke you need to pull out the biggest guns you have. The biggest and most reliable gun we have for dropping core temperature is ice-water immersion. If you have ice on hand there is no reason to not use it. If there is no ice available use whatever method you can make happen with the materials you have. The goal has to be to drop their core temperature by the most effective means available.

I grew up in Texas on a farm, so we had heat and humidity. Our home had a window refrigerated A/C in one room. We had a whole-house fan that exhausted into the attic. We ran that at night. Basically, we just sweated.

My wife and I camp at Burning Man every year, and it hits the hundreds on occasion and nineties most days, but there's no humidity. We have a shade tarp with flaps to the ground on 2 sides. This shades us from exposure to the sun without blocking any air flow. This means we stay ambient temperature, but not higher. I drink copious amounts of water and stay out of the sun during the heat of the day. We have water misters (those spray bottles for misting plants or your clothes if you iron by hand), and we spray each other to cool off occasionally. We bring a plastic tub and soak our feet in it - it's surprising how cooling that is, just sticking your feet in a tub of ambient temp water. Basically, we just sweat.

The good thing about the location at Burning Man is that it's high desert so it gets cool at night.

Drinking a lot of plain water may bring on hyponatremia, so at Burning Man we watch our electrolyte intakes to make sure we're getting enough. We drink juices and eat salty food.

Many people run around naked, but I have vitiligo, so I keep my skin covered in cotton and breathable fabrics that soak up sweat and evaporate it. I wear a hat any time I'm out in the sun instead of a cap. The hat has a reasonably broad brim and a stampede string so it doesn't blow off.

If you can conserve sweat, you can do fairly well. Spraying a mist on the skin can be shockingly cold and take your breath away if you do it right. There's no way to stay cool if you have no power, so shade that doesn't block breezes and trap heat, keeping hydrated (with electrolytes), and managing my activities is the way I handle it.

A personal observation on outdoor clothing for mild activity, and not intended to get into the "cotton v.synthetic" controversy. I am an old fart, living on the Gulf coast of Florida. I have been a competative shooter for the last 30 or so years, and currently shoot several pistol and 3gun matches a month. June through August can be brutal, especially if the range is a sand pit, and relative humidity is high. I use Bullfrog 30spf on face and exposed skin, nylon shorts, boxers, cape back long sleeved DuPont "cool max or supplex" nylon flats fishing shirts, wide brimmed Dorfman Pacific vented hat, CamelBak, moisture wicking socks, and New Balance synthetic shoes. In an iced down cooler, 3 bottles of Gatorade (I'm a UF grad)couple of waters, and one of the cooling scarves with the water absorbing crystals. I can go through 70oz in the CamelBak and the EGR's in a typical match. Having access to the neck scarf and cold water for hat and bandana makes management of core body temp a little easier. I have a case of water and half dozen bottles of Gatorade in the car, and consume at least one during the hour drive home. regards Les

The general rule of thumb is that in moderate dry heat thin loose-fitting absorbent clothing holds sweat and allows evaporation to more efficiently cool you.

In high humidity you go with bare skin so the sweat falls off because it isn't going to evaporate.

If your in the sun a wide brimmed hat creates shade and light colored clothing absorbs less heat.

It all changes when heat goes well over 100F. At those temperatures the air is dry but extremely hot. So high that exposure to untreated air is harmful. In those conditions you see heavier insulating clothing that shroud the body and create a micro-climate like a space suit. Think of traditional Arab dress where the entire body is covered.

Of course in high heat you need to slow down. And many cultures stop work in the heat of the day. A work day that runs 0800 to 2000 with a four hour break from 1200 to 1600 can be quite effective in the summer when its daylight until 2100. I have also seen jobs run from 0500 to 1300. The long lunch system has the advantage that the crews essentially start fresh two time a day when energy and concentration are at their best.