The weather in Qatar is hot and dry throughout the year, except for the few winter months. The period between May and September is the peak summer time. It is extremely hot and humid in the day, while the nights are warm. Since most of the country is a desert, the temperature remains above 42°C most of the time in the day. Public should take necessary precautions to safeguard against heat-related illnesses as the summer temperature continues to rise. While heat stroke can occur at any time of the year, cases of heat-related illnesses are more common in Qatar during the summer months.
Heatstroke is a condition caused by your body overheating, usually as a result of prolonged exposure to or physical exertion in high temperatures. This most serious form of heat injury, heatstroke, can occur if your body temperature rises to higher. The condition is most common in the summer months especially in Qatar and other Middle East countries. 
Heatstroke requires emergency treatment. Untreated heatstroke can quickly damage your brain, heart, kidneys and muscles. The damage worsens the longer treatment is delayed, increasing your risk of serious complications or death.
Symptoms:
1- High body temperature: A core body temperature of 40 Celsius or higher, obtained with a rectal thermometer, is the main sign of heatstroke.
2- Altered mental state or behaviour: Confusion, agitation, slurred speech, irritability, delirium, seizures and coma can all result from heatstroke.
3- Alteration in sweating: In heatstroke brought on by hot weather, your skin will feel hot and dry to the touch. However, in heatstroke brought on by strenuous exercise, your skin may feel dry or slightly moist.
4- Nausea and vomiting: You may feel sick to your stomach or vomit.
5- Flushed skin: Your skin may turn red as your body temperature increases.
6- Rapid breathing: Your breathing may become rapid and shallow.
7- Racing heart rate: Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.
8- Headache: Your head may throb.

Causes:
1- Exposure to a hot environment. In a type of heatstroke, called non-exertional (classic) heatstroke, being in a hot environment leads to a rise in core body temperature. This type of heatstroke typically occurs after exposure to hot, humid weather, especially for prolonged periods. It occurs most often in older adults and in people with chronic illness.
2- Strenuous activity: Exertional heatstroke is caused by an increase in core body temperature brought on by intense physical activity in hot weather. Anyone exercising or working in hot weather can get exertional heatstroke, but it’s most likely to occur if you’re not used to high temperatures.
In either type of heatstroke, your condition can be brought on by:
1- Wearing excess clothing that prevents sweat from evaporating easily and cooling your body
2- Becoming dehydrated by not drinking enough water to replenish fluids lost through sweating

When to see a doctor
If you think a person may be experiencing heatstroke,
1- Take immediate action to cool the overheated person while waiting for emergency treatment.
2- Get the person into shade or indoors.
3- Remove excess clothing.
4- Cool the person with whatever means available — put in a cool tub of water or a cool shower, spray with a garden hose, sponge with cool water, fan while misting with cool water, or place ice packs or cold, wet towels on the person’s head, neck, armpits and groin.
5- Immediately dial 999 and seek emergency assistance.

Prevention
Heatstroke is predictable and preventable. Take these steps to prevent heatstroke during hot weather:
1- Wear loose fitting, lightweight clothing: Wearing excess clothing or clothing that fits tightly won’t allow your body to cool properly.
2- Protect against sunburn: Sunburn affects your body’s ability to cool itself, so protect yourself outdoors with a wide-brimmed hat and sunglasses and use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or sweating.
3- Drink plenty of fluids: Staying hydrated will help your body sweat and maintain a normal body temperature.
4- Take extra precautions with certain medications: Be on the lookout for heat-related problems if you take medications that can affect your body’s ability to stay hydrated and dissipate heat.
5- Never leave anyone in a parked car: This is a common cause of heat-related deaths in children. When parked in the sun, the temperature in your car can rise 20 degrees F (more than 6.7 C) in 10 minutes.
It’s not safe to leave a person in a parked car in warm or hot weather, even if the windows are cracked or the car is in shade. When your car is parked, keep it locked to prevent a child from getting inside.
6- Take it easy during the hottest parts of the day: If you can’t avoid strenuous activity in hot weather, drink fluids and rest frequently in a cool spot. Try to schedule exercise or physical labor for cooler parts of the day, such as early morning or evening.
7- Get acclimated: Limit time spent working or exercising in heat until you’re conditioned to it. People who are not used to hot weather are especially susceptible to heat-related illness. It can take several weeks for your body to adjust to hot weather.
8- Be cautious if you’re at increased risk: If you take medications or have a condition that increases your risk of heat-related problems, avoid the heat and act quickly if you notice symptoms of overheating. If you participate in a strenuous sporting event or activity in hot weather, make sure there are medical services available in case of a heat emergency.

Precautions for diabetic patients
Diabetic patients are more susceptible to overheating. They should
1- Exercise in cool place
2- Check blood glucose more often, heat can cause glucose levels to fluctuate.
3- Do note store Insulin or Diabetes medicines in extreme temperature. Never store in car or car’s gloves compartment

l Dr. Subramaniyan Kuppusamy is a Specialist in Emergency Medicine at Aster Hospital, Doha
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