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The red flag is up for heat stroke


by Eduardo Gonzales, MD

hot heat stroke

The Department of Health (DOH) has recently advised the public to take precautions against heat stroke because of expected high heat indexes this summer. What is heat index? What is heatstroke and how can we prevent it?


Heat index is the temperature people feel as opposed to the temperature measured by instruments. It is a value that combines air temperature and relative humidity. When relative humidity is high, which is often the case in the Philippines, the heat index is significantly much higher than the air temperature.

We normally cool ourselves by sweating. Heat is removed from our body when sweat evaporates from our skin. High relative humidity reduces the evaporation rate of sweat resulting in a lower rate of heat removal from our body. Thus, for us in the Philippines, where relatively humidity often exceeds 70 percent or higher, a room temperature of only 32 °C can have a heat index of 41 °C  or higher.


a heat index between 41 and 54 degrees, which will be commonplace in the Philippines this summer, is dangerous and likely to cause cramps, exhaustion, and even heat stroke after continuous activity. Temperatures across the country have been rising since early March and, to date, the heat index has gone above 41 degrees several times. Thus, the Department of Health (DOH) has raised the red flag on heat stroke and has urged the public to take precautionary measures to prevent the condition. Especially susceptible to heat stroke are the senior citizens because their temperature-regulating mechanisms do not function very well anymore, those who are working outdoors, and commuters in VEHICLES THAT DO NOT HAVE AIR-CONDITIONING UNITS.


Heat stroke is the worst form of a continuum of heat disorders that include heat syncope, heat cramps, and heat exhaustion.

Heat syncope is typified by transient loss of consciousness while heat cramps are characterized by muscle spasms. In both, the skin is moist, the pulse is weak, and the person may complain of dizziness, lightheadedness, or headache. People with heat syncope or cramps should be placed in a cool environment and given lots of fluids.

Heat exhaustion, on the other hand, is characterized by slight to moderate fever, increased pulse rate, moist skin, thirst, anxiousness, and sometimes, incoherence and disorientation. Heat exhaustion can progress to heat stroke, a life-threatening emergency that is marked by a very high body temperature (41oC or higher). People suffering from heat exhaustion or stroke should be brought to the hospital. First aid measures include cooling of the skin by spraying with water or by applying cold compresses or ice packs.

Heat stroke


To prevent heat stroke, avoid or protect yourself from the sun, do not overexert, and keep yourself hydrated.

  • Avoid the sun between 10 a.m. and 2 p.m. when it is hottest. Confine your outdoor activities to the early morning and late afternoon hours. Likewise, avoid being under sun for long stretches.
  • “Slip a shirt and slap a hat.” Clothing and hats offer the best protection against the sun. Wear loose, cool, and light colored clothing, and change clothes when sweating profusely.
  • Apply sunscreen cream liberally when you go out in the sun.
  • Take fluids liberally. When exposed to the sun, drink two to four glasses of fluids (water is best) per hour. Don’t drink alcohol, coffee, or beverages that contain large amounts of sugar—these actually cause you to lose more body fluid. Also, avoid very cold drinks, because they can cause stomach cramps. If you sweat too much, sports beverages could be taken instead of plain water.
  • Avoid strenuous exercises during daylight hours. Perform them after sundown.

Incidentally, never leave children or animals in parked cars. The sun can make car interiors unbearably hot.

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