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Heat Stroke and SCI

Summer Heat and Spinal Cord Injury

Summer heat and heat stroke can pose significant challenges for individuals with spinal cord injuries (SCI). These extreme temperature events can exacerbate the already complex health issues. People with SCI face challenges with their ability to regulate body temperature. Reduced sweating, impaired circulation, and limited mobility can all contribute to an increased risk of heat-related illnesses such as heat exhaustion and heat stroke. Recognizing and understanding the necessary precautions are crucial for ensuring the safety and well-being of people with SCI during the scorching summer months.

Here’s an overview of the risks, recognition of heat stroke signs, and appropriate responses:

Dangers of Heat Waves for People with Spinal Cord Injury

Some of the reasons summer heat and heat stroke with SCI can happen quickly.

1. Impaired Thermoregulation: Paraplegics often have difficulty regulating their body temperature due to disrupted nerve signals affecting sweat production and blood flow.

2. Reduced Sensation: They may not feel the typical warning signs of overheating, such as sweating or discomfort, leading to a delayed response to rising temperatures.

3. Dehydration: Reduced mobility can limit their ability to access fluids, increasing the risk of dehydration, which exacerbates heat-related illnesses.

4. Medication Side Effects: Some medications commonly taken by paraplegics can impair sweating or increase heat sensitivity.

Medications That Increase Risk to Heat Exhaustion

Several medications commonly prescribed to paraplegics can increase the risk of heat exhaustion. These medications can impair the body’s ability to regulate temperature, alter sweating mechanisms, or affect hydration levels. Here are some of the medications to be aware of:

1. Anticholinergic: These medications block the action of acetylcholine, a neurotransmitter involved in sweating. Reduced sweating impairs the body’s ability to cool itself.

   – Examples: Atropine, scopolamine, certain antidepressants (like amitriptyline).

2. Diuretics: Often prescribed for managing blood pressure and edema, diuretics increase urine production, which can lead to dehydration.

   – Examples: Furosemide, hydrochlorothiazide.

3. Beta-blockers: These medications can reduce the ability to sweat and increase the risk of dehydration by affecting the heart and blood vessels.

   – Examples: Propranolol, atenolol, metoprolol.

4. Antipsychotics: These can interfere with the body’s thermoregulatory processes.

   – Examples: Chlorpromazine, haloperidol.

5. Antidepressants: Certain antidepressants, particularly tricyclics and selective serotonin reuptake inhibitors (SSRIs), can affect sweating and temperature regulation.

   – Examples: Amitriptyline, fluoxetine, sertraline.

6. Sedatives and Tranquilizers: These can affect the central nervous system, altering the body’s response to heat.

   – Examples: Diazepam, lorazepam.

7. Antihistamines: First-generation antihistamines can reduce sweating and cause dehydration.

   – Examples: Diphenhydramine, chlorpheniramine.

Why These Medications Increase Risk

  • Impaired Sweating: Many of these medications reduce or inhibit sweating, which is a crucial mechanism for dissipating heat.
  • Dehydration: Diuretics and some other medications increase fluid loss, leading to dehydration.
  • Altered Heat Perception: Some medications can affect the brain’s ability to perceive and respond to changes in body temperature.
  • Cardiovascular Effects: Medications like beta-blockers can affect blood flow and heat distribution in the body.

Managing Medication Risks

1. Consult Healthcare Providers: Regularly review medications with healthcare providers, especially during the summer or in hot climates.

2. Stay Hydrated: Ensure adequate fluid intake, particularly when taking diuretics or other medications that increase fluid loss.

3. Monitor for Early Signs: Be vigilant about monitoring for early signs of heat exhaustion or dehydration.

4. Adjust Dosages: In some cases, healthcare providers might adjust dosages or suggest alternative medications during heat waves.

5. Educate and Inform: Ensure that caregivers and the person taking these medications are aware of the increased risks and know the steps to prevent heat exhaustion.

Recognizing the Signs of Heat Stroke

Heat stroke is a severe medical emergency especially for people with spinal cord injury and it is important to watch for:

  • High Body Temperature: A core body temperature of 103°F (39.4°C) or higher.
  • Altered Mental State: Confusion, agitation, slurred speech, irritability, delirium, seizures, or coma.
  • Flushed Skin: Red, hot, and dry skin without sweating.
  • Rapid Pulse: Strong but rapid pulse.
  • Nausea and Vomiting: Feeling or being sick.
  • Headache: Throbbing headache.
  • Dizziness or Fainting: Feeling lightheaded or faint.

What to Do When Suffering from Heat Stroke

It is important to understand what to do in the summer heat to prevent heat stroke with a SCI.

1. Move to a Cooler Environment: Immediately move the person to an air-conditioned room or a shady, cool place.

2. Hydrate: Offer cool (not ice-cold) water or sports drinks to help them rehydrate. Avoid alcohol and caffeine.

3. Cool the Body: Use cool, wet cloths on the skin, or have the person take a cool shower or bath. Fans can help, but direct air on wet skin is more effective.

4. Monitor Body Temperature: Use a thermometer to keep track of their body temperature.

5. Seek Medical Help: If symptoms worsen or don’t improve, call emergency services immediately. Heat stroke is life-threatening and requires urgent medical intervention.

6. Prevent Further Heat Exposure: Once stabilized, keep the person out of the heat and continue to monitor their condition closely.

By understanding these risks, recognizing symptoms, and knowing the appropriate responses, you can better protect people recovering from spinal cord injury from the dangers of heat waves. If you are not certain but suspect your loved one is suffering from a heat related illness move to a cooler environment and seek medical attention immediately.

The team at Wishart Brain and Spine Law want you to know that you are not alone. There is help for accessing resources and making sure that you are accessing all of the resources available for your loved one. If you need help with your insurance company and getting those resources in place please contact us today.


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