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Heat stroke

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Your PH woke you before dawn with coffee, the time when the jackals called for the last time and the birds started to move. The open Land cruiser took you to the start of the kudu track the tracker reported the previous day. You remember zipping up your warm hunting parka against the predawn chill.

The tracker was a master and brought you within sight of the bachelor herd after 2 hours of tracking.

"Take him, the big one on the left", the PH whispered. You were too excited and your shot pulled up high and to the right. The kudu bull swung around and disappeared into the bush.

"Crap!" Your PH looked away and you could see him clench his jaw muscles.

Now, 6 hours later, you are still on the track. Everyone is tired and your PH is irate. It is hot and your parka does not help.

You have a headache and you are tired. You have not had a drink of water in 4 hours.

You feel like a fool for wounding an animal that you know you will have to pay for even if you do not find it. Your heart is beating like a drum in your ribcage.

Suddenly everything becomes absolutely still.

You stop and stare incredulously at your beautiful .375 Holland & Holland as the barrel very slowly starts to bend and droop like melting wax in the heat. You remember that the rifle was a $70,000 gift from your wife and you start to panic. You shout at your stupid PH to bring ice but he screams back that he already has your money so you can bugger off.

"If only the barrel was still straight, Id shoot you in the ass for your insolence" you mumble to yourself. Cuddling the rifle lovingly in your arms you sit down slowly and tears flow unashamedly from your closed eyes over your cheeks.

You feel a touch on your shoulder and look up.

"You OK?" You hear your very worried PH ask as the trackers come and help to carry another crazed mlungu (white man) back to the Land cruiser.

You have just experienced heat stroke and it is one of the bush killers that is often overlooked.

Hyperthermia is an elevated body temperature due to failed thermoregulation. Hyperthermia occurs when the body produces or absorbs more heat than it can dissipate. When the elevated body temperatures are sufficiently high, hyperthermia is a medical emergency and requires immediate treatment to prevent disability and death.

Heat stroke is the most severe form of hyperthermia and is a life-threatening emergency. It is the result of long, extreme exposure to the sun, in which the heat-regulating mechanisms of the body eventually become overwhelmed and unable to effectively deal with the heat, causing the body temperature to climb uncontrollably.

It is a condition that develops rapidly and requires immediate medical treatment.

Causes

Our bodies produce a tremendous amount of internal heat and we normally cool ourselves by sweating and radiating heat through the skin. However, in certain circumstances, such as extreme heat, high humidity or vigorous activity in the hot sun, this cooling system may begin to fail, allowing heat to build up to dangerous levels.

If a person becomes dehydrated and cannot sweat enough to cool their body, their internal temperature may rise to dangerously high levels, causing heat stroke.

Symptoms

Heat stroke presents with a hyperthermia of greater than >40.6 C (105.1F) in combination with confusion and a lack of sweating

Symptoms may include:

  • headache

  • dizziness

  • disorientation, agitation or confusion

  • sluggishness or fatigue

  • seizure

  • hot, dry skin that is flushed but not sweaty

  • a high body temperature

  • loss of consciousness

  • rapid heart beat

  • hallucinations

  • Precautions

  • Avoid substances that inhibit cooling and cause dehydration such as alcohol, caffeine, stimulants and medication.

  • Wear light, loose-fitting safari clothing will allow perspiration to evaporate and cool the body.

  • Wear a wide-brimmed khaki hat to keep the sun from warming the head and neck and block the powerful radiation from hurting the eyes. Vents on a hat will allow perspiration to cool the head.

  • Postpone tracking until after the heat of the day if possible.

  • It is important to recognize that humidity reduces the degree to which the body can lose heat by evaporation

  • Drink plenty of liquids to replace fluids lost from sweating.

  • Remember - thirst is not a reliable sign that you need fluids. A better indicator is the color of urine. A dark yellow color may indicate dehydration.

    It is debated whether water or sports drinks are more effective to regain fluids; however, drinking only water without ingesting any salts will lead to a condition known as hyponatremia, or low sodium, which can cause sudden death from heart attack. By sweating and urination, humans lose salts, which need to be replaced along with fluids.

    Treatment

    It is important for the person to be treated immediately as heat stroke can cause permanent damage or death. There are some immediate first aid measures you can take while waiting for help to arrive.

  • Get the person to rest in a cool, shaded area with their feet slightly elevated

  • Give cool fluids such as water or sports drinks (that will replace the salt that has been lost). Salty snacks are appropriate as tolerated.

  • Loosen or remove clothing.

  • Apply cool water to skin.

  • Apply ice packs to the groin and armpits.

  • Do not use an alcohol rub.

  • Do not give any beverages containing alcohol or caffeine. Remove clothing and gently apply cool water to the skin followed by fanning to stimulate sweating.

  • Mitch Mitchell is a bow hunter, outdoorsman and the author of several books on African wildlife and survival

    Intravenous fluids are often necessary to compensate for fluid or electrolyte loss.

    Bed rest is generally advised and body temperature may fluctuate abnormally for weeks after heat stroke.


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