How to identify: The difference between dehydration and heat stroke

The global warming trend is clearly felt in Israel. The number of heatwave days is increasing, and with them the intensity of extreme heat. For example, last April, record temperatures were recorded that had not been seen here for 30 years. Heat waves have a far-reaching effect on the human body, leading to an increase in morbidity and mortality. It is vital to know how to deal with heavy heat loads to survive them safely.

In heatwave days, we see a sharp rise in cases of dehydration, especially in sensitive populations such as children and the elderly, explains Dr. Muhammad Kabaha, medical director at the Meuhedet urgent care center in Hadera. Early detection and informed treatment can prevent severe complications such as heat stroke and hospitalization. Therefore, preparation and understanding of the critical differences between dehydration and heat stroke are essential.

Dehydration: A common but dangerous condition

Dehydration occurs when the body's fluid balance is disrupted, and fluid loss through sweating, urine, vomiting, or diarrhea is not sufficiently replenished, explains Dr. Kabaha. In the general population, signs of dehydration include increased thirst, dark urine or infrequent urination, fatigue, headaches, dizziness, and dryness of the mouth and tongue.

In children, signs of dehydration may be more subtle and include:

1. Crying without tears

2. Lethargy and lack of response

3. Decreased frequency of urination (less than 1–2 wet diapers in 12 hours)

4. Sunken fontanelle in infants

5. Body temperature that rises without another explanation

Heat stroke: A medical emergency

According to Dr. Kabaha, heat stroke is a medical emergency that requires immediate treatment and can cause brain damage and even death. It develops when the body temperature rises above 40 degrees and fails to drop. Signs of heat stroke include confusion, slurred speech, loss of consciousness, red, hot, and dry skin, rapid pulse, rapid breathing, and lack of sweating.

In children, heat stroke can develop faster, says the doctor. The risk is especially high in infants and young children due to a large body surface area relative to volume and immature heat regulation mechanisms. Signs include a change in consciousness, extreme irritability or apathy, seizures, and repeated vomiting.

Distinguishing the two: When to suspect a transition?

Heat stroke usually develops after a stage of advanced dehydration. The appearance of confusion, behavioral changes, cessation of sweating, and high fever require immediate medical intervention.

Prevention

Preparations should be tailored to age groups:

• For infants and children: frequent drinking, even if they do not ask, staying in the shade and in an air-conditioned place, light and bright clothing. Most importantly: do not leave children in the car, not even for a minute.

• For adults and the elderly: drink proactively throughout the day, monitor urine color, avoid physical exertion during hot hours, and monitor medications that increase risk (such as diuretics).

When to seek urgent medical care?

In any case of decreased consciousness, confusion, seizures, or high fever that does not respond to fluids, one should immediately seek a doctor's examination or go to urgent care centers.

Treatment of heat stroke in medical facilities involves immediate cooling of the body (cold compresses, fans, intravenous cold fluids), constant monitoring of body temperature, blood pressure, and neurological function, and oxygen administration if necessary. One should quickly go to the emergency room if there is neurological damage, hemodynamic instability, or body temperature above 40 degrees that does not respond to treatment.