1.Now a days progressively increasing the sorrounding temperature,evaporative regulation some times, causes some sorts of weakness,sleeplessness and cramps and also severe imbalance leads to heat stroke,or dehydration causing heat exaustion and both syndromes are distigushable and require different treatment measures.Heat stroke condition happens a result of an excessive raise in body temperature.When sweating and its evoporation are sufficient the thermal loss maintain the body temperature and continue to do,so until to fill up again the water level is maintained.The thermoregulatory mechanism may fail if the internal conditions are adverse,such as relative deficiency of water in the body or if the external conditions may unbearable under intense solar radiation,high temperature or very hot winds.Heat exhaustion occurs more commonly than heat stroke.In heat exhaustion the main effects are not due to the rise of body temperature as in the case of heat stroke and not so much due to excessive sorrounding temperature,but are the result of water and salt exhaust due to excessive sweating.The reasons are:-
2.Very high temperature causes excessive sweating. High temperature and very high atmospheric humidity or stagnant air retard efficient evaportion of sweat which drips off the body as useless perspiration with out causing body cooling.3.Water requirement in hot weather is higher than in cold weather or a temperate climate.If water intake is also reduced,its excretion also is reduced.But normal water loss necessary to remove the toxic metabolic products has to continue in concenterated urine.
iii.Excessive sweating also causes salt excretion.Normally 15 grammes of salt intake is required daily.Any salt taken over this daily necessary is excreted in the urine.If the intake is reduced or excretion in sweat is increased,salt is conserved by diminishing its excretion in the urine.
4.Water constitutes about 70% of the body weight or about 50 litres.Out of which 30% or 15 litres is extracellular and 70% or about 35 litres is in intracellular comparments,75% of extracellular fluid or about 11 litres exists as tissue fluid and 25 % or about 3 litres as circulating plasma.Maintainance of the fluid balance and its relative distribution in the 3 compartments of the body is important for the health of the cells and tissues and is kept constant.
5.Other effects of heat are Heat cramps and Prickly heat which occur due to intracellular over dehydration and hyperactivity of acrine sweat glands respectivily.It is due to non adaptation to hot climate and fatigue,more in the cases of Heat cramps.Any muscle may go into cramp,but fatigued muscle is more susceptible.
6.The effects of heat are widespread in the subtropics in the hot season.They occur less commonly in the tropics than generally expected or supposed,especially heat stroke.The centres of heat are the shores of Persian Gulf and the central and north western plains of India.The great majority of cases occur in Punjab.Most cases occur during the week or two prior to the onset of the mansoons and during breaks of the mansoons when atmospheric temperature and humidity is very high.In the north
and west the dangerous period is towards the end of June or later.In central India it is in mid-June.While in south and eastern India it is in May and early June are critical periods.During the hot weather it can happen any part of India.Onset of heat strock is sudden and heat exhaustion is gradual.High atmospheric temperature is the most important primary cause.Adapted men can withstand temperatures of even 43 digree centigrade in a dry atmosphere.when the temperature rises to 46 or so in the presence of wind vilocity of more than 35 km per hour,the danger point approaches and the heat stroke may occur.Constant exposure to the sun glare is irritating to the point of causing distress,headaches,mental irritablity and actual exhaustion.High atmospheric humidity is an important factor in the causation of heat effects.Air movement is also an important atmospheric factor which decides the human thermal comfort.The combination contributes a greater heat load to the body and produces discomfort with a temperature of 43 digree centigrade and relative humidity of 20% as obtained in the punjab.Fluid loss in excessive sweating affects cooling capacity of the body.In the plains of India in hot weather,the minimum water loss in sweat and urine by an individual doing moderate work is 8 litres a day.Prolonged work in close places is more harmfull than in the open areas.Overcrowding increases the temperature and humidity of the room and bad ventilation aggravates these conditions.lack of sleep and rest are predisponding factors.Food requirement of persons in hot weather is the same to which they are accustomed.Rapid consumption of alcohol in large quantities may increase the attack.
7.Prevention of effects of heat:-The fluid intake must be enough to produce sweat and compensate for loss of water in it.The salt intake should compensate for its excessive loss in sweating.Rest and sleep must be adequate as the recovery must compensate for the work.Adaptation is the most important and valuable preventive measure against the effect of heat.The ability to do hard work in a hot climate can be achieved in about 2 -3 weeks by gradual habitation procedure.Bathing must be ensured every day,where it is possible arrangemade should be made on the banks of a running stream as it is benificial.Improved shower baths also are of great value.An active,healthy,clean skin is an important agent for dissipation of heat through radiation,convection and evaporation.Clothing must be normally light and loose and permeable to water and air.Houses must be spacious,well ventilated and cool.Health education to all in preventive measures is important by giving simple talks on the causes and prevention of the effects of heat and simple precautions to avoid the risk of developing them.People should be educated to recognise the early symptoms of effects of heat such as weakness,headache,giddiness,absence of thirst and feeling of vomiting.
8.First aid and early treatment:- This is important and necessary to arrest the progress of the illness and avoid permanent neurological injury and save life.All must be prepared to act soon in case of emergency.Temperature must be rapidly reduced by spraying cool water(not ice cold) and fanning,thirst is put out by giving enough cool water,but not too much.When cooling is reduced it falls to 39 digree centigrade the patient is removed to heat stroke centre.Dehydration is treated by the administration of fluids and elecrtolytes.Cases of pure water loss hould be given water only.In serious cases with anorexia,nausea and vomiting with hypertension/hypotension should be transfered to nearest hospital for further management.
and west the dangerous period is towards the end of June or later.In central India it is in mid-June.While in south and eastern India it is in May and early June are critical periods.During the hot weather it can happen any part of India.Onset of heat strock is sudden and heat exhaustion is gradual.High atmospheric temperature is the most important primary cause.Adapted men can withstand temperatures of even 43 digree centigrade in a dry atmosphere.when the temperature rises to 46 or so in the presence of wind vilocity of more than 35 km per hour,the danger point approaches and the heat stroke may occur.Constant exposure to the sun glare is irritating to the point of causing distress,headaches,mental irritablity and actual exhaustion.High atmospheric humidity is an important factor in the causation of heat effects.Air movement is also an important atmospheric factor which decides the human thermal comfort.The combination contributes a greater heat load to the body and produces discomfort with a temperature of 43 digree centigrade and relative humidity of 20% as obtained in the punjab.Fluid loss in excessive sweating affects cooling capacity of the body.In the plains of India in hot weather,the minimum water loss in sweat and urine by an individual doing moderate work is 8 litres a day.Prolonged work in close places is more harmfull than in the open areas.Overcrowding increases the temperature and humidity of the room and bad ventilation aggravates these conditions.lack of sleep and rest are predisponding factors.Food requirement of persons in hot weather is the same to which they are accustomed.Rapid consumption of alcohol in large quantities may increase the attack.
7.Prevention of effects of heat:-The fluid intake must be enough to produce sweat and compensate for loss of water in it.The salt intake should compensate for its excessive loss in sweating.Rest and sleep must be adequate as the recovery must compensate for the work.Adaptation is the most important and valuable preventive measure against the effect of heat.The ability to do hard work in a hot climate can be achieved in about 2 -3 weeks by gradual habitation procedure.Bathing must be ensured every day,where it is possible arrangemade should be made on the banks of a running stream as it is benificial.Improved shower baths also are of great value.An active,healthy,clean skin is an important agent for dissipation of heat through radiation,convection and evaporation.Clothing must be normally light and loose and permeable to water and air.Houses must be spacious,well ventilated and cool.Health education to all in preventive measures is important by giving simple talks on the causes and prevention of the effects of heat and simple precautions to avoid the risk of developing them.People should be educated to recognise the early symptoms of effects of heat such as weakness,headache,giddiness,absence of thirst and feeling of vomiting.
8.First aid and early treatment:- This is important and necessary to arrest the progress of the illness and avoid permanent neurological injury and save life.All must be prepared to act soon in case of emergency.Temperature must be rapidly reduced by spraying cool water(not ice cold) and fanning,thirst is put out by giving enough cool water,but not too much.When cooling is reduced it falls to 39 digree centigrade the patient is removed to heat stroke centre.Dehydration is treated by the administration of fluids and elecrtolytes.Cases of pure water loss hould be given water only.In serious cases with anorexia,nausea and vomiting with hypertension/hypotension should be transfered to nearest hospital for further management.
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