As summer temperatures soar across Spain and the rest of Europe, understanding the critical differences between heat exhaustion and heat stroke can literally mean the life or death of a loved one or a fellow tourist. While enjoying a cold drink on a sun-drenched beach is the ultimate holiday dream, prolonged exposure to extreme heat and high humidity can quickly trigger dangerous heat-related illnesses. Recognising early symptoms of overheating, staying hydrated, and knowing when to call emergency services are vital steps to staying safe in the sun this season.

We live in this lovely part of Spain, and we welcome many tourists. All of us however can be guilty when it comes to not taking advice about being out in the sun. It looks like being a scorcher this summer season.  I’ll be the first to admit that I love it. A cool beer on the beach and I’m as happy as Larry (whoever that is) However, the very sad fact remains that many people die every year from a form of overheating that we call heatstroke. Actually, it doesn’t sound dangerous and maybe it is time for a new name like ‘heat death’ for example for us all to take it seriously, because I’m not kidding you, it is a very serious – and life-threatening situation. It kills.

Our European continent is warming, there is no doubt about that, and we all need to adjust our lifestyle a little bit so that we don’t put ourselves, or others, at risk.

I’m not lecturing or wagging a finger – that’s not my style at all. I just want people to be aware how this danger can creep up, sometimes without us really realising what is happening. All I want to say is that if you suspect someone, even yourself, might be developing heat stroke get that phone out and call 112. Leave it too long and you will not be able to make the call, it really is that serious.

Heat exhaustion and heat stroke are two serious heat-related illnesses that can occur when the body overheats, often due to prolonged exposure to high temperatures or strenuous physical activity. Understanding the symptoms, causes, risk factors, and prevention methods for each is vital for health and safety, especially during hot weather or in hot environments.

What is heat exhaustion? Symptoms and causes

Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures, particularly when combined with strenuous physical activity.

Common symptoms of heat exhaustion:

• Heavy sweating
• Weakness
• Cool, pale, or clammy skin
• Fast, weak pulse
• Nausea or vomiting
• Muscle cramps
• Dizziness or fainting

Warning: If not treated promptly, heat exhaustion can quickly develop into a life-threatening heat stroke.

Key causes and risk factors:

High temperature and humidity: High environmental conditions increase the risk.

Dehydration: Insufficient fluid intake exacerbates heat-related stress.

Physical activity: Strenuous exercise, particularly in the heat, can lead to increased body temperature.

Medical conditions: Those with certain health issues, such as heart disease or obesity, are at higher risk.

Age: The elderly and young children are particularly susceptible.

What is heat stroke? A critical medical emergency

Heat stroke is a more severe condition and represents a medical emergency. It occurs when the body temperature rises above 40°C (180°F) due to prolonged exposure to high heat.

Warning signs of heat stroke:

• Hot, dry skin (absence of sweating)
• High body temperature
• Rapid, strong pulse
• Confusion or altered mental state
• Seizures
• Loss of consciousness

Without immediate treatment, heat stroke can result in permanent disability or death.

Factors that increase heat stroke risk:

The causes of heat stroke are similar to those of heat exhaustion but tend to occur when body temperature regulation fails, leading to overheating.

Risk factors include:

High humidity: This impairs the body’s ability to evaporate sweat and cool down.

Physical exertion: Exercising or working in hot conditions is a primary contributor.

Medications: Certain prescriptions (like diuretics or beta-blockers) affect how the body responds to heat.

Chronic illness: Heart disease, diabetes, or obesity increase susceptibility.

Alcohol consumption: Alcohol accelerates dehydration and impairs the body’s temperature control.

How to prevent heat exhaustion and heat stroke

Preventing a heat illness is entirely possible with a few smart adjustments to your daily summer routine:

• Drink plenty of fluids: Prioritise water and electrolyte-replenishing sports drinks. Avoid excessive caffeine and alcohol.
• Limit midday outdoor activities: Stay indoors or in the shade during the hottest parts of the day (usually between 2pm and 4pm).
• Wear appropriate clothing: Lightweight, loose-fitting, and light-coloured clothing helps keep the body cool.
• Seek air conditioning: Use fans, or spend time in air-conditioned environments to regulate your internal temperature.
• Know the signals: Keep a close eye on your companions and yourself for early symptoms.

First aid: Heat exhaustion management

If you notice someone showing signs of heat exhaustion, act quickly to cool them down:

1. Move to safety: Relocate the person to a cooler area, preferably indoors with air conditioning or into the shade.
2. Rehydrate: Provide water or lower-sugar sports drinks to replenish lost fluids and electrolytes. Do not force fluids if they are vomiting.
3. Loosen clothing: Remove any tight or excessive clothing to facilitate better air circulation.
4. Apply cool cloths: Soak cloths in cold water and place them on the skin, focusing on pulse points like the neck, armpits, and wrists.

Emergency action: Heat stroke management

If you suspect someone is suffering from heat stroke, you must act immediately.

1. Call emergency services immediately on 112: Heat stroke is a medical emergency and requires urgent care.
2. Cool the person down: While waiting for help, take actions to cool the person. Remove clothes and soak with cool water (this is a real emergency, so no time for modesty) or use ice packs where possible.
3. Monitor body temperature: Keep an eye on their temperature and continue cooling efforts until help arrives.

Conclusion: Stay safe in the sun

Understanding heat exhaustion and heat stroke is crucial, especially during hot weather and for those who engage in physical activities in the heat. Recognising the symptoms and knowing how to respond can prevent serious health consequences. Adopting preventive measures can help keep people safe from these heat-related illnesses. Awareness and education are the keys to ensuring health and safety in high-temperature environments.

Looking out for one another only takes a few moments, and yes, it can take a bit of courage to step up and take control of a situation, that’s something I know only too well, but the fact remains heat can kill. No one is going to criticise you for doing the right thing.

The information provided in this column is for educational and informational purposes only, and does not constitute medical advice. It is not a substitute for a professional medical consultation, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health provider with any questions you may have regarding a medical condition.

Dr Marcus Stephan