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3 BIG Questions: Dr. Andrew Koslow Heatstroke_448549798.jpg

3 BIG Questions: Dr. Andrew Koslow

Recognizing and treating heat-related illnesses

By Debbie Gardner

     With the first major heat wave of the summer already in the books in early June, it looks like its going to be a hot summer! With heat-related illnesses on the rise nationwide, Prime reached out to Dr. Andrew Koslow, associate medical director for America Family Care (AFC) of Massachusetts for a refresher on what to look for, and how to treat, heat-related illnesses.

        A graduate of Drexell University College of Medicine in Pennsylvania and an emergency medicine physician at Signature Healthcare in Brocton, Massachusetts, before joining AFC, here’s what Dr. Koslow shared:

Q: What are the most common heat illnesses and risk factors?

“High heat and humidity are common in Western Massachusetts and summer vacation destinations during the summer, so it’s important to understand the risk of heat-related illnesses and how to address them before they become life-threatening — which can happen very fast.

        “The most common heat-related illnesses are heat cramps, heat exhaustion and heat stroke.

        “Those most at risk for heat-related illnesses include children, the elderly and people who take medications that increase their sensitivity to heat; however, anyone can be affected under the right conditions.

        “Too much sun exposure and high temperatures increase the risk, as does dehydration. It’s essential to stay hydrated, ideally with water, when you are in the sun and heat. As we get older, our bodies lose their ability to conserve water efficiently, and our sense of thirst becomes less acute. This heightens the risk of dehydration, potentially causing serious health issues including heat exhaustion and heat stroke.

        “Older adults also have less ability to regulate temperature than younger adults, They sweat less, usually have poorer circulation and have other physiological limitations. For example, dementia and other cognitive impairments might leave older adults with limited ability to understand when they are too hot or what steps to take when they are. On a somewhat similar note, impaired mobility might keep someone from moving to shade or getting to fluids.”

Q: What are the symptoms to watch for with a heat-related illness, and what steps should you take immediately to treat the condition?

        “Heat cramps are painful muscle spasms that can occur when someone is working or exercising in a hot environment. Typically, they can be relieved with rest, fluids and electrolytes (found in sports drinks); however, heat cramps can also be a symptom of heat exhaustion, which may require medical care.

        “Symptoms of heat exhaustion often include heavy sweating, muscle cramps, weakness, headache and dizziness, fainting, cold and clammy skin, nausea or a fast, weak pulse.                         “If this happens, move the person to a cool place, loosen their clothing and have them take small sips of cool water. The goal is to cool the body down, so try a cool bath or shower if you can, or use cold, wet cloths.

        “If the symptoms worsen, last longer than an hour or include vomiting, medical help is needed. Heat exhaustion can quickly progress to heat stroke, which can cause permanent damage to the brain, heart, kidneys and muscles, or even death.

        “Heat stroke is characterized by a body temperature 103° F or higher, skin that is hot and flushed, a throbbing headache, dizziness, confusion, loss of consciousness, nausea and vomiting, a racing pulse and rapid breathing. Some people also experience seizures, slurred speech, delirium and agitation. 

        “It’s important to call 911 as soon as any of these symptoms develop.

Heat stroke is a medical emergency that requires immediate care to prevent lasting damage or death. The outcome worsens the longer treatment is delayed. While waiting for emergency help, try to lower the person’s body temperature with cold, wet towels or a cool bath or shower. “

Q: There’s another condition called heat intolerance. Are the symptoms different than those for heat illnesses? What steps should you take to mitigate this condition?

        “Heat intolerance can cause you to feel overheated and may cause heavy sweating. It can be triggered by variety of medications — from blood pressure and cholesterol medications to those for diabetes, overactive bladder and Parkinson’s — and health conditions — such as diabetes and cardiovascular disease.

        “Other factors can include alcohol use, menopause, infections and age. Older adults are less able to adjust to temperature extremes and more likely to be taking medications that increase the risk for heat intolerance.

        “The ways to reduce the likelihood of heat intolerance are the same as for all heat-related illnesses: keeping hydrated, staying in a cool setting and limiting time out in hot, humid weather. It’s also a good idea to talk to your doctor or pharmacist about any medications you are taking that may increase your risk of sun sensitivity or heat intolerance, so you can take steps to mitigate these effects.”

Editor’s Note: The Center for Disease Control now has an interactive map available that shows the risk for extreme heat in your area. Visit and enter your zip code to get a localized forecast.