By Rick Ryckeley
Fayette County Fire & Emergency Services

Last weekend was a holiday weekend - the kick off of summer. Everyone headed to the beaches to soak up the sun and suds and some teenagers I saw soaked up a little too much of both. I went down to Panama City, Florida, to see my Dad. There were parties on and off the beach and all seemed to have the same theme "let's drink as much as we can." I saw a large quantity of adult beverages being consumed in the hot sun, and many intoxicated people were walking and driving around because of it. This was not a cool thing to see. When I got back, I was talking to The Boy about my trip. I saw his eyes wandering when I started to talk about teenage drinking so I took another route.

I said, "Did you know a person could drink so much water on a hot day that they could become intoxicated?" Now normally, being a teenager, he doesn't hear what is said unless it's repeated four times, but this he heard the first time.

"Dad, you mean to tell me that a person can get drunk off water? I don't believe it."

I'm not a betting man, but this was an opportunity that I couldn't pass up. "If I can prove that a person can become intoxicated by drinking too much water, you have to cut the grass."

He said, "And if you can't, you have to let me drive your truck."

"Deal." And with that I brought out my trusty medical book. Turning to the chapter on heat-related emergencies, I proceeded to read what the most common ones were.

"Dad," he says as he interrupts me (teenagers interrupt quite often), "What does any of this have to do with water intoxication?"

I explained that while working in hot climates, there is a chance of falling ill due to heat cramps, heat exhaustion, and heat stroke or - if you take in too much water - water intoxication. Heat cramps are painful, uncontrollable muscle spasms that occur in the fingers, legs, arms, or abdomen. The Boy interrupts again.

"You mean, if I walk outside on a hot day, I'm going to curl up into a ball and have muscle cramps all over my body?"

"No, just listen." I explained to him that heat cramps come from being outside doing strenuous work or playing in heat for an extended period without proper fluid and sodium replacement. When you sweat, water comes to the surface of the skin in an attempt to cool the body off. The water brings with it sodium and other electrolytes which need to be replaced. Too much water and sodium drawn out of the body's cells without replacement will result in muscle cramps. Persons suffering from heat cramps should be removed from the heat and their sodium/electrolyte intake increased.

Heat exhaustion is the most common of all heat-related illness. It affects a person working in a hot environment for a long period of time without proper fluid replacement. A person can lose about eight cups of fluid per hour working in hot high humidity, such as outdoors in June-July-August here in Georgia. The body expands the blood vessels to place more blood in the arms and legs which leads to lower blood return to the heart. This can cause a person to become dizzy and collapse. A person suffering from heat exhaustion could have nausea/vomiting, muscle cramps, headaches, and if left untreated, this can lead to heat stroke.

When the body temperature goes above 105 degrees, cell death and collapse occur. This condition is called heat stroke. If a person has been working in the heat, his skin should be wet, but with heat stroke, the skin will be hot and dry. The person could lose consciousness or even have a seizure. Upon arrival at the scene, the medics will remove the patient from the heat, establish IVs to replace fluids, try to get the core temperature down and possibly assist with the patient's breathing. Heat stroke is a true emergency and EMS should be called immediately.

"But what does any of this have to do with water intoxication?" The Boy asked.

The fluid lost during hot days needs to be replaced, but replacement of the sodium is also important. Working outside and drinking water faster than the fluid loss you can run the risk of taking in more liquid than your body can utilize. If you continue, a condition called water intoxication can occur. With the sodium and electrolytes not being replaced, a person could have headaches, nausea and vomiting, altered mental status or even go into a coma. You should get the person out of the hot weather and not let them drink any additional water, and call EMS or the family doctor.

"So I should not drink water if Iím outside?" He asked.

Once again The Boy has taken selective hearing to a new art. I said, "No. Sports drinks are high in sodium and electrolytes and consumed along with the correct water intake you should be okay on a hot day. Now go cut the grass."

"But it's hot. I might get muscle cramps, heat exhaustion or heat stroke. I can't go outside and work." I just gave him a glass of water and a sports drink and told him that the grass would not cut itself.

Even the mildest heat-related illness could become dangerous; call 911 if you suspect anyone is having an adverse reaction to the heat this summer.

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