Heat illness and sunburn: When to seek care

August is the perfect time to soak up the last full month of summer in Wisconsin, but high temperatures and extended sun exposure can quickly turn outdoor fun into a health emergency. Knowing when to cool off, hydrate and seek medical care can make all the difference.

To help families stay safe in the sun, we asked for tips from two experts at Ascension Columbia St. Mary’s - Milwaukee: Rachel Zientek, RN, trauma coordinator in the Emergency Department and Xia Olig, RN, Burn Center coordinator. Together, they shared what they want everyone to know about recognizing heat and sun related emergencies and preventing serious injuries before they happen.

Recognizing heat exhaustion and heat stroke

According to Nurse Rachel Zientek, heat exhaustion and heat stroke are often confused, but the two conditions are very different. “While both are caused by the body overheating, heat stroke is much more serious and requires immediate emergency medical treatment,” Zientek explained.

Heat exhaustion often develops after extended time in the heat and may cause:

• Cool, pale or clammy skin
• Dizziness or weakness
• Headache
• Heavy sweating
• Muscle cramps
• Nausea
• Rapid pulse

Many people recover by moving to a cool place, resting and drinking fluids.

Heat stroke, however, is a life-threatening emergency. Warning signs include:

• Body temperature of 104°F or higher
• Confusion or altered mental status
• Hot, flushed skin
• Little or no sweating
• Loss of consciousness
• Seizures

“If you suspect someone is experiencing heat stroke, call 911 immediately,” said Zientek. “Begin cooling the person while waiting for emergency responders by moving them to a shaded or air-conditioned area and applying cool water or ice packs to the neck, armpits and groin.”

Don't overlook dehydration

Heat illness and dehydration often go hand in hand. Early symptoms of dehydration include:

• Dark-colored urine
• Decreased urination
• Dizziness
• Dry mouth
• Fatigue
• Headache
• Thirst

Left untreated, dehydration can become severe and may cause rapid heart rate, confusion, fainting or an inability to keep fluids down. Zientek recommends seeking emergency care if someone experiences persistent vomiting, severe dizziness or fainting, confusion, significant weakness or has not urinated for an extended period. She notes that young children, older adults and people living with chronic medical conditions are especially vulnerable and may need medical attention sooner.

One of the biggest misconceptions about hydration is waiting until you're thirsty. “Staying well hydrated throughout the day—not just when you feel thirsty—is one of the most effective ways to prevent heat illness,” said Zientek.

She also recommends:

• Avoiding outdoor activities during the hottest part of the day whenever possible. In Wisconsin, 3:00 p.m. to 5:00 p.m. is when temperatures peak on most summer days.
• Increasing your fluid intake before and during outdoor activities.
• Listening to your body. Dizziness, nausea, excessive fatigue and muscle cramps are early warning signs that it's time to cool down and rehydrate.
• Taking frequent breaks in shaded or air-conditioned spaces.

Know the signs of a serious sunburn

While many sunburns heal on their own, Nurse Xia Olig said some burns require medical attention. “A mild sunburn is typically pink, dry and painful and usually heals within a few days,” Olig explained.

However, she encourages people to seek medical care if they notice:

• Fever
• Foul odor from the burn
• Increasing drainage from burned skin
• Increasing swelling or pain

“These symptoms should never be ignored because they can indicate a more serious burn or infection,” Olig said.

For mild sunburns, Olig recommends gentle skincare that supports healing. Her advice includes:

• Keep the skin moisturized with an unscented, oil-based lotion
• Take cool or lukewarm showers instead of hot showers.
• Wash with a mild, fragrance-free soap.

She also advises reading labels carefully before using over-the-counter skin products. “Avoid products that contain alcohol or perfumes because they can further irritate damaged skin,” Olig said.

Just as important is knowing what not to use. Olig warns against applying:

• Butter
• Ice directly to the burn
• Mayonnaise
• Salt
• Scented soaps or body washes

These home remedies can interfere with healing, increase irritation and may raise the risk of infection.

Protect your skin before the damage is done

According to Olig, prevention is always easier than treatment. She recommends:

• Applying sunscreen of at least SPF 30 before sun exposure every day. It's recommended to use sunscreen when the UV index is 3 or higher. 
• Reapplying sunscreen as directed on the label.
• Wearing hats, sunglasses and protective clothing, including lightweight long sleeves and pants.

Olig also points out that older adults and young children are especially susceptible to severe sunburn because their skin is thinner and more fragile, making thermal injuries more severe.

Know when to seek care for heat illness and sunburn

Whether it's recognizing the first signs of dehydration or knowing when a sunburn needs medical attention, the overarching advice is simple: pay attention to your body's warning signs and don't wait to seek care if symptoms become severe.

Know where to go when you need care quickly. Find emergency care in Wisconsin.

This blog is intended for general informational use. Any health-related information shared is not meant to provide or replace professional medical advice and does not establish a patient-provider relationship. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room.