Question
What is the difference between heat cramps, heat exhaustion, and heat stroke?
Answer
Heat injury is quite common. There are three different levels of heat injury. Heat cramps are followed by heat exhaustion in terms of intensity, and then that will be followed up by heat stroke, which will be the most severe.
Heat Cramps
Heat cramps are involuntary muscle spasms.
Heat Exhaustion
With heat exhaustion, the athlete will present with cool or moist skin. They might have heavy sweating and/or feel faint or dizzy. They might also present with a weak or rapid pulse. Other symptoms include orthostatic hypotension, muscle cramps, nausea, and headache.
Our treatment for heat exhaustion will include moving the athlete to a cooler spot such as underneath a medical tent, underneath a tree, or inside if possible. We want to make sure that the athlete hydrates with water or a sports drink. It'll be beneficial to put a cool towel or compress on areas of the body that have a large blood supply. That would include the wrists, the groin, or the neck. Finally, we also want to remove or loosen clothing as appropriate.
Heat Stroke
Heat stroke is a medical emergency. If you have an athlete that you suspect is having a heat stroke at the time, absolutely 911 needs to be called ASAP. The athlete will present with a lack of sweating despite the heat. They will be dizzy and faint, and they might even have a loss of consciousness. The athlete will be weak. They'll likely report a throbbing headache and may even slur their speech. The athlete's skin will be red and hot. Other symptoms include rapid heartbeat, rapid yet shallow breathing, and a body temperature above 104 degrees Fahrenheit. And they could even have a seizure when it starts to get very serious.
Onsite treatment after 911 has been called will be to apply ice packs to the armpits, the neck, the back, and the groin. Again, areas with blood supply very close to the skin. If possible, you will want to immerse the athlete in cool water. And again, it's a medical emergency and could lead to death, so it's important that 911 or EMT are called and alerted to the situation.
For more information on treating athletes, check out this course: Managing the Triathlete: Considerations of the Sport in Relation to Rehabilitation of the Competitive Athlete by Heather Smith, PT, DPT, OCS
