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Preventing heat rash, fainting

Willie Jones, age 52, made national news when he was admitted to Grady Memorial Hospital, Atlanta, Ga., on July 10, 1980, with heatstroke on a day when the temperature reached 90 degrees with 44 percent humidity. His body temperature was found to be 115.7 degrees - a world record for a survivor of high body temperature.

The Chicago heat wave during July 1995 when 700 people died from heatstroke also made media headlines.Both events were spectacular and newsworthy. However, never making the headlines are the less known but common heat maladies: prickly heat, heat edema and heat syncope. Prickly heat, also known as heat rash, is an itchy skin rash caused by trapped sweat. When the narrow ducts carrying sweat to the skin surface get clogged, the trapped sweat causes inflammation, which produces irritation (prickling) and itching. Prickly heat usually consists of a rash of very tiny blisters but also can appear as large, reddened areas of skin.

Prickly heat is most common in warm, humid climates, but people who wear too much clothing in cold weather also can develop the condition. The most common areas for prickly heat are the trunk and thighs.

Reducing sweating usually controls the problems. Keeping the skin cool and dry by avoiding conditions that increase sweating are important; air-conditioning is ideal.

Heat edema, swelling of the feet and ankles, is often reported during the summer months. It is worse during the first few days of heat exposure. The swelling is usually minimal and often resolves after several days of heat exposure.

It is more common in women who are not accustomed to a hot climate. It is related to salt and water retention and tends to disappear after acclimatization. Elevating the swollen feet can help. Wearing support pantyhose is questionable.

Syncope is better known as fainting. It happens to those who are exposed to and unaccustomed to hot temperatures. Pooling of blood in the legs can cause any person to "faint" with prolonged standing. This condition makes people more susceptible in hot temperatures when the peripheral blood dilate. Sweating further increases the risk. Therefore, the band person or soldier in a parade on a hot summer day is an ideal candidate for this form of heat illness.

Most victims can be treated by raising their legs while lying down. The victim should receive fluids, if not nauseated, and be encouraged to avoid prolonged standing. If possible, the individual should be removed from the hot environment to a cool location.

Alton Thygerson, professor of health sciences at Brigham Young University, is the National Safety Council's first aid and CPR author and technical consultant. For more information, the National Safety council First Aid Handbook by Thygerson is available in local bookstores.