HT Health Talk: The plains of North India are scorching with the scorching heat of June The temperature is continuously crossing 40 degrees Celsius.The line between heat discomfort and medical emergency is blurred. The difference between morning and evening coolness is decreasing, making people more vulnerable to serious heat illnesses.. Read this also HT Health Talk: You asked, our experts answered how to manage summer migraines
Many people use ‘heat exhaustion’ and ‘heat stroke‘Synonymously, but medically, they are completely different animals. Understanding the threshold at which one enters the other can save a life. Furthermore, if you suspect that someone around you has suffered heatstroke, your immediate action before emergency medical services arrive is vital.
in this week HT Health TalkWe bring you exclusive information from Dr. Santosh Pandey, Consultant, Emergency Medicine and Trauma Care, Medanta, Noida. Ahead, Dr Pandey answers important questions from Hindustan Times readers, busts common summer myths and provides a medical roadmap to avoid extreme heat stress. Read this also 24-year-old student from Bengal dies of heat stroke, first heat-related death in Delhi’s RML
1. We often hear ‘heat exhaustion’ and ‘heatstroke’ used interchangeably, but medically, they are quite different. What are the main differentiating signs that tell a family member or bystander that someone has gone from exhaustion to life-threatening sunstroke?
Heat exhaustion and heatstroke exist on the same spectrum, but heatstroke is a medical emergency. A person suffering from heat exhaustion may experience heavy sweating, weakness, dizziness, etc. HeadacheNausea, muscle cramps, and a rapid pulse while remaining alert and responsive. Heatstroke occurs when the body’s core temperature rises dangerously high, usually above 40 degrees Celsius, and the brain begins to deteriorate. Warning signs include confusion, disorientation, slurred speech, seizures, loss of consciousness, or unusual behavior. If a person becomes mentally altered or unresponsive after being exposed to heat, it should be considered heatstroke and emergency medical help should be sought immediately.
2. It is a common belief that a person suffering from heatstroke will always be sweating profusely. Is it true that lack of sweating (dry, hot skin) is actually a sign of advanced heatstroke, and why does the body stop sweating?
A common misconception is that all heatstroke patients stop sweating. In fact, some individuals, especially those with extreme heatstroke, may continue to sweat. However, hot, dry skin may be a sign of advanced heatstroke. Normally, sweating helps cool the body through evaporation. During severe heat stress, the body’s cooling systems can become overwhelmed, leading to dehydration and, in some cases, failure of sweat production. As a result, body temperature rises rapidly, increasing the risk of organ damage. The absence of sweating should never be used alone to diagnose heatstroke; Changes in mental status remain the most important warning sign.
3. If someone is suspected of having sunstroke, what are the immediate ‘do’s’ and ‘don’ts’ while waiting for an ambulance? Should we submerge them in ice, or might that shock their system?
If heatstroke is suspected, call emergency medical services immediately and move the person to a cool, shady or air-conditioned area. Remove excess clothing and begin active cooling using cold water, wet towels, fans, or ice packs placed on the neck, armpits, and groin. If the person is conscious and able to swallow, small sips of cool fluids may be given. Do not force them to drink fluids if they are confused or unconscious. Full body immersion in cold water is highly effective for severe heatstroke when done appropriately, but unsupervised. ice immersion May not be practical in all settings. The priority is rapid cooling while waiting for professional medical care.
4. Many fitness enthusiasts keep track of the temperature, but how does high humidity change the way our bodies cool themselves during an outdoor run or workout? At what temperature/humidity combination should one do their workout strictly indoors?
Humidity significantly affects the body’s ability to cool itself. Sweat cools the body only when it evaporates from the skin. In high humidity, sweat does not evaporate efficiently, causing heat generation even if the temperature is not very high. This increases the risk of heat exhaustion and heatstroke during outdoor workouts. Individuals should pay attention to the heat index, which combines temperature and humidity. When temperatures exceed approximately 32–35 °C with high humidity, vigorous outdoor exercise should be reduced or shifted indoors. The exact range may vary depending on age, fitness level, conditioning and underlying health conditions.
5. With temperatures crossing 40 degrees Celsius in the plains this June, the difference between morning and evening is decreasing. When is the safest time for outdoor exercise, and how should a person modify the intensity of their workouts during a heat wave?
During a heat wave, the safest time for outdoor exercise is usually around sunrise, when temperatures and solar radiation are at their lowest. Evening workouts can still be risky because roads, buildings and concrete surfaces continue to emit stored heat after sunset. Exercise intensity should be reduced during periods of extreme heat, with longer rest intervals and increased hydration. Activities that normally seem manageable may become significantly more demanding during a heat wave. Individuals should listen to their bodies and stop exercising if they experience dizziness, extreme fatigue, headache, nausea, or unusual shortness of breath.
6. Are there certain demographic groups – such as teenagers or older adults who enjoy their daily outdoor walks – whose bodies regulate heat differently, causing them to suffer from heat exhaustion more quickly than others?
Some groups are more vulnerable because their bodies regulate heat less efficiently. Older adults often have a decreased ability to sweat, decreased thirst sensation, and may be taking medications that affect hydration or temperature regulation. Children and adolescents may also be at greater risk during intense physical activity because they generate significant metabolic heat. with persons obesityPeople with heart disease, diabetes, kidney disorders, or taking certain medications are especially susceptible. Outdoor workers and athletes are also at risk due to prolonged exposure and exertion. Understanding individual risk factors is important to prevent heat-related illnesses during extreme weather conditions.
7. People are asked to ‘drink plenty of water’ during heat waves. However, can drinking too much plain water without replacing electrolytes cause a dangerous drop in blood sodium levels? How do we strike the right balance?
While staying hydrated is essential, excessive consumption of plain water without adequate electrolyte replacement can sometimes lead to hyponatremia, a condition where sodium levels in the blood become dangerously low. Symptoms may include headache, nausea, confusion, muscle cramps, and in severe cases, seizures. This is more common during prolonged physical activity with heavy sweating. The goal is balanced hydration rather than simply drinking large amounts of water. Most people can maintain this balance through a combination of water, electrolyte-rich beverages, and regular meals. Those exercising for long periods of time during extreme heat may benefit from drinks that replace both fluids and electrolytes.
8. Is there any medical truth in the warning that drinking ice-cold water immediately after coming inside from the scorching sun can cause a ‘shock’ to the body or blood vessels, or is it completely safe?
There is very little scientific evidence for this drink ice cold water After coming indoors from a hot environment, the body experiences a dangerous ‘shock’. For most healthy individuals, cold water is safe and can also help lower body temperature and improve comfort. Some people may experience temporary discomfort, stomach cramps or sensitivity if they drink very cold liquids rapidly, but this is usually not harmful. The key is gradual rehydration rather than consuming large amounts at once. Individuals with specific medical conditions affecting swallowing or digestion may require individualized advice from their healthcare provider.
9. How do traditional Indian summer drinks like aam panna, buttermilk/chaas and lemonade compare to modern commercial sports drinks or standard ORS (Oral Rehydration Salts) when it comes to dealing with extreme heat conditions?
Traditional Indian beverages like Aam PannaButtermilk and lemon water can be excellent choices for maintaining hydration, especially when prepared hygienically and with appropriate amounts of salt and sugar. These drinks provide varying levels of fluids and electrolytes, while also being culturally familiar and affordable. Commercial sports drinks can be useful during prolonged or intense exercise because they contain measured amounts of carbohydrates and electrolytes. When dehydration is significant due to excessive sweating, illness or heat-related conditions standard ORS remains the preferred option. The best choice depends on the level of physical activity, duration of exposure, and degree of fluid loss.
10. Why do so many people experience severe loss of appetite, bloating, or sluggish digestion during heat waves? What effect does shifting our blood flow from the gut to the skin to cool the body affect our digestive health?
Many people experience loss of appetite, bloating or digestive problems during extreme heat. One reason is that the body prefers to cool itself by increasing blood flow to the skin. This can reduce blood supply to the digestive tract, slowing digestion and increasing feelings of heaviness or loss of appetite. Heat can also affect hydration levels and alter normal gastrointestinal function. As a result, lighter meals, fruits, vegetables, and adequate fluid intake are often better tolerated during hot weather. Eating large, heavy or extremely fatty foods can increase discomfort and put additional stress on the body.
11. Many budget or local fitness centers in India operate without air conditioning, relying solely on exhaust fans and wall fans during the evening rush. From a sports medicine perspective, what are the hidden health risks of working in a closed, highly humid environment where many people are simultaneously emitting body heat? At what point in such an environment does ‘pushing your limits’ become a direct path to heat exhaustion or rhabdomyolysis (severe muscle breakdown)?
Overcrowded gyms without adequate ventilation can become high-risk environments during hot weather. As multiple individuals exercise together, heat and moisture accumulate in the body, increasing both temperature and humidity levels. Fans can improve comfort but do not effectively reduce ambient heat or humidity. Under such conditions, sweat evaporates less efficiently, increasing the risk of dehydration, heat exhaustion, heatstroke, and decreased exercise performance. In severe cases, prolonged intense exertion in hot, humid environments can contribute to exertional rhabdomyolysis, a serious condition involving muscle breakdown that can damage the kidneys. Symptoms such as dizziness, confusion, severe cramps, extreme fatigue or dark urine should never be ignored.
