Summer is approaching, and so are outdoor concerts and festivals. Fans will be spending long hours in the sun and in large crowds, which can come with health risks in our hot, dry climate. Dr. Radosveta Wells is an associate professor of emergency medicine at Texas Tech Health El Paso. She spoke with Scott Brocato about precautions attendees can take.
Scott Brocato:
As an emergency physician, how common is it for you, your staff, or your students to treat patients in the summer with heat-related conditions, as hot as it can be in the summer in the borderlands?
Dr. Radosveta Wells:
It is not uncommon to see patients with signs of dehydration and heat illness, especially if they have been exposed to the elements for a longer period of time or if they have had to walk for a long time, or if they have not been well hydrated during those episodes.
Scott Brocato:
And are those the common things you find that they don't do to prepare to do before they go to these events--they don't get enough hydration, etc.?
Dr. Radosveta Wells:
That is one of the common things. And also sometimes people travel for those events. Sometimes people are not used to our climate and particularly the dryness of the climate. And additionally, they are involved in some amusing entertaining events, so that takes their attention away from being careful about their own health and their surroundings, and they may just forget to drink water sometimes.
Scott Brocato:
Well, let's talk about some of the precautions that you've recently recommended that people do before going, starting with hydration: hydrating early and often. How much and what should people be partaking before they attend these events?
Dr. Radosveta Wells:
So obviously everybody's a little bit different. So people usually would know how much water they drink normally, but in cases like this, they may need to start drinking a little more water ahead of time, not just when it already is at the event or during the event. So it is important not to let yourself start feeling thirsty. If you start feeling thirsty, it may be already too late. So it's important to keep that hydration going in a regular intervals so that your body feels like it normally does.
But also there are other things to keep in mind. Sometimes just water is not enough. There should be also some electrolytes. There should be some regular food intake as well. And especially people who take medications, sometimes heat exposure and prolonged walking and prolonged standing can exacerbate the effects of some of those medications and cause dehydration to be worse. So definitely a little more than the usual hydration and definitely starting early.
Scott Brocato:
And alcohol does not figure into the hydration process, I assume?
Dr. Radosveta Wells:
Actually, it makes things worse for several reasons. First of all, because being intoxicated can prevent people from recognizing some of the symptoms of dehydration that may be early, like dizziness, a headache, feeling a little confused. So those might be signs of dehydration that may be covered up by the effects of alcohol. That's one thing.
The other thing that's very important, alcohol is a type of a diuretic. In other words, it works like some of those fluid pills that people take for different medical conditions, and it makes people have higher rate of urination, and that way they are losing more of the circulating fluid that they have in their bodies. So it is very important if people drink alcohol to alternate it with water. and especially some electrolytes as well, because it gives the idea that they're all hydrated because they need to go to the bathroom, but it actually might be making things worse.
Scott Brocato:
What are some of the signs for heat-related illnesses?
Dr. Radosveta Wells:
Definitely signs of dizziness and headache could be early warning signs. Any type of confusion can be a sign of very advanced heat illness, actually. And so that's why sometimes the combination with exhaustion and dehydration and alcohol intake can mimic some of those signs of very severe heat illness, and people may not recognize that that's what's happening. So it is important to act immediately when people start feeling any of those symptoms, because if they drink some water, eat some food, and they feel better, okay, that's a good sign. But if they do all the right things and they're still not getting better, they definitely need to seek medical attention.
Scott Brocato:
One of your other recommendations: you mentioned eating food, eating regularly. Do you recommend certain types of food?
Dr. Radosveta Wells:
Certainly it would be better to eat healthy foods and certainly not very sugary, high carb foods. It's better to eat more protein and more balanced food, vegetable kind of diet. And certainly enough salt intake because sometimes if people drink too much water, there isn't enough salt in the system, that can also cause some headache, confusion, and dropping the normal amount of salt in our bodies. So it is important to balance that as well.
Scott Brocato:
And know your limits with walking and standing?
Dr. Radosveta Wells:
Definitely. It's important to wear the right kind of clothing. If there is a lot of sun exposure, definitely that worsens the heat exposure, it can cause some sunburn. and also increases the dehydration. So having sun protection, sunblock, sunglasses, hats, clothing that is breathable, but covers enough of the body so that they're protected from the sun. And shoes. It's very important to have the right kind of shoes so that you don't get blisters, which can cause infection in the long run.
And also, it's a lot of fun to go around in those big venues, but sometimes they're very large and going from one place to another can be exhausting for people who are not used to that kind of physical activity. So it is good to plan early on how much time you're giving yourself so that you can take breaks as often as you need.
And another thing is be with the people who know you, who you can rely on, who understand you, and who can recognize sometimes that you're not feeling well and will be there to assist.
Scott Brocato:
And finally, sunscreen. What do you recommend as far as sunscreen? A minimum SPF?
Dr. Radosveta Wells:
SPF, a minimum of 30, normally of SPF in order for it to be useful. And also it's important to remember that applying it in the morning one time is not enough. Usually every couple of hours it has to be reapplied, especially if people are sweating. And if they're exposed to any kind of a wet environment, like pools or getting poured water on or something like this, so SPF 30 sunscreen and we apply. And also definitely some sun protection with clothing. And also don't forget the eyes. We have such high UV exposure here. It's important to protect the eyes with sunglasses as well.
