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Welcome to this edition of AMC.

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Tell you how I got better. I'm glad to be

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here, but a mission

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to. Well, I think that we're, we're talking, we're gonna

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talk about everybody's Arkansas is

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the 2nd highest prescriber.

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Welcome to AFMCTV. I'm Robin

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Libetter. Thank you for joining us. Today I have

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with me Hannah Keefer, and she is

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a nurse practitioner specializing in family

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medicine at Mercy Clinic Free Ferry

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in Fort Smith. Hannah, thanks for being here.

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Hi, thank you for having me. I appreciate it.

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So temperatures are hot. We

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are in the height of summer here.

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We're talking about heat exhaustion

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and heat stroke. Tell me what the differences

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are. So with heat exhaust exhaustion,

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you can kind of think of it as,

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um, you know, kind of the

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beginning of, OK, what are the

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warnings that we look for. So

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heat exhaustion, we really want to watch

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for um

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those signs of, OK, we're we're sweating

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quite a bit. We're still having maybe some.

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Could have some of that cool clammy skin,

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um, getting a little more fatigued

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with heat stroke and, you

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know, more severe cases, you know, we're

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looking at, OK,

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are we still sweating? Are we still, is

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our body still able to

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cool off?

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Um, or are we getting to the point where we are overheated

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and our body cannot cool,

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um, cool us down anymore?

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You know, with heat,

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stroke,

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um, you know, more severe, we're looking at, OK, this

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is emergent.

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Um, where we do want to have that patient

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evaluated, um, immediately

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because again, our body is not able to cool at that point,

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so we wanna make sure that they're not

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um having any,

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um, failure as far as organs

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or, you know, neurological problems.

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So heat stroke very serious,

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you should immediately go to the ER,

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correct? Or is heat exhaustion

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just as serious?

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So heat exhaustion is serious as

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well, but you want to check for, again,

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are, is, is the person you're around

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able to answer those questions? Are we able to

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get them to,

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um, with heat exhaustion, you can try

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by getting them to a cool place,

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you know, giving them some water, just slow sips

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of water.

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Are we able to cool back down, you

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you know, if we're not having that improvement, you

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know, in a

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2030 minute period, then

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we need to look at, you know, emergency

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uh visit. Heat stroke, yes,

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medical emergency, they need to be seen,

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um, they need more immediate attention.

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And are certain groups, kids, seniors,

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even athletes more at risk?

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So definitely kids and older

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adults, you know, are more at risk.

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Um, you know, with kids even, they're not able

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to tell us, um, always.

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Um, they also don't

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sweat like adults do. So,

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you know, we wanna make sure they definitely stay

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hydrated when they're out in the sun, you know, of course,

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they get to playing and they don't, you know, think,

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OK, there's changes going on.

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Um, with the little ones, you also wanna watch and make sure

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that they're not, um,

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You know, becoming

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more quiet and less hyperactive, you know, more

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tired, things like that.

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Um, with the older adults though, you know, you,

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you don't have that response again,

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like, uh, you know, you or I do.

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So those two populations are,

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um, need to be on alert for a little

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bit more and make sure they're in cool

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areas, staying hydrated, you know, taking

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breaks. And how much water

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should the average person drink on a hot day?

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Is it different for everyone?

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So males and females are different,

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um.

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You know, on an average day, a

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woman, 2.7 L.

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We're talking liters here and then a male about 3.7,

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but

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again, on a hot day where we're sweating quite a

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bit. We're putting out that fluid, we want

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to replace it.

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So you could even increase that by about a liter

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per adult per female and male.

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But part of that is not just

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drinking water. You want to replace

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your electrolytes. So, sodium

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and potassium, and um

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we want to,

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especially if we're putting it out, we want to put it back

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in, but we want to put the good fluid back into

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not just water.

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So our sports drinks, electrolyte drinks better

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than water in the heat?

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They are, but, you know, with those,

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of course, as people know, you need to watch

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the sugar intake.

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Um, Gatorade, Powerades, those aren't

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always the,

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you know, the best to go to because they do have

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um high sugar content.

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Um, obviously, they are,

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you're still putting some of those electrolytes back in,

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sodium, things like that.

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Um, but even the, um,

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you know, liquid IV is a good one

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where we're not

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just putting a whole bunch of sugar back in but we're getting those electrolytes.

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You know, easy little packets you can

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carry with you, put it in your water and

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drink that, but especially when you're

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excessively sweating throughout the day, yes.

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And what is, what are some of the best ways

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to prevent heat-related illnesses

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when spending time outside?

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So with preventing heat-related illnesses,

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you know, you definitely want to make sure you're taking

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those breaks in the shade.

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Um, you want to carry

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water with you,

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um, some type of, you know, rehydration

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with you at all times. Take those little sips.

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The peak hours throughout the day, especially

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right now, you know, 11 to 4. So

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if we can avoid those activities and

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wait till early morning, evening, even

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when we're mowing the lawn, things like that, you

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know, try to avoid those high peak um

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hours when we're gonna be sweating

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quite a bit.

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Um, but I think the main thing is

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breaks

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water even if we're not thirsty.

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Um, to really prevent the heat exhaustion

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and heat illnesses.

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Is it possible to overhydrate or

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drink too much water?

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Yes.

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So that's why we talk about electrolytes

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because,

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you know,

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if you get too much water, you know, we're over,

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um,

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we're diluting too much, so you can

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have, um, you can cause hyponatremia,

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which is low sodium,

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um, so that can be dangerous as well. So you

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really wanna get balance,

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um. You know, as far as

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looking at

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how much we're, we're

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urinating as well, you don't want to

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put in,

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you know, more than you're putting out and then over dilute.

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So, yes, you can overhydrate. That

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is something to be cautious with as

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well. And what's some simple advice do

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you give patients to stay safe in

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extreme heat?

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So I do tell my patients, you know, right

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now, especially with all the outdoor activities,

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is, you know,

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Sunscreen,

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sun protection as far as light colors,

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you know, avoid the dark colors.

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Um,

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you know, everyone loves their water bottles right

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now, so I tell them fill their water bottle

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up the first thing of the day.

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As soon as you hit that empty mark, go fill it up

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again. Just keep it on hand. That reminds you to

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take those frequent drinks.

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Um, and then again, just

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funny shade, uh,

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something as simple as that,

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um, can help quite a bit.

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So could you show or describe what someone should

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do if they suspect heat exhaustion in

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a friend or family member?

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Should they take them to their PCP? I

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mean, what, what are some things that they immediately even

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could do? So immediately

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you can move that person to, again, a

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cool shaded area wherever you can find.

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Um, you can even use some cold rags,

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um, you know, drips of cold water,

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and then, you know,

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take smaller sips, but try to

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start hydrating them. Don't just, you know,

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have them chug a whole liter of water, but, you know, small

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sip sips

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and making sure that they're not um

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Worsening in those symptoms as far as, you

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know, worsening confusion or

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um any neurological signs like that.

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And there are common myths with heat exhaustion,

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and what are some that you hear

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that may be misconceptions?

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Well, one of those, which, you know, I think we kind

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of touched on is, you know,

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people do think that you can just, you only

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get heat exhaustion when it's 110

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outside. um.

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You can,

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you know, really have problems and dehydrate yourself

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if we're outside. It's 80 degrees

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with humidity as high as it is in Arkansas.

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Um, so you really have to be aware,

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although it may not be.

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Just blistering hot, you can still have

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that heat exhaustion in those lower temps

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but high humidity. So it's all about,

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you know, how we're um how our bodies are excreting

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that and how much we're excreting

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versus replacing.

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Well, Hannah, thank you for talking about this

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important information, valuable information

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for the community, but also for the healthcare community

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understand the signs and especially

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when they are many times the front line

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to to people to educate and

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and to be able to make sure that people you want to take

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care of themselves. Yeah, absolutely. Thank

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you for having me. And that's it for this

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episode of AFMCTV. Have a great day. Thanks

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for watching.