Summer Heat Safety Tips

Whether cheering on young graduates, picnicking in local parks, or exploring beachside boardwalks, much of life moves outside in the summertime. Individuals living with paralysis can safely enjoy the festivities of the season but should be aware that a spinal cord injury impacts the body’s ability to regulate temperature, increasing the risk of heat exhaustion and heatstroke. Skin must also be monitored carefully for sunburn, which can cause pressure wounds and infection —and trigger autonomic dysreflexia, a life-threatening medical emergency that affects people with spinal cord injuries at the T6 level or higher.

Understanding seasonal risks and following simple precautions can help prevent heat-related complications without limiting life’s enjoyment.

Stay hydrated: Drink lots of water before, during and after any outdoor activities. Limit caffeine and alcohol, which can increase dehydration.

Wear sunscreen: Always apply sunscreen when going outdoors, no matter the time of year. On both sunny and cloudy days, sunscreen helps protect skin from ultraviolet rays, which cause sunburn and increase the risk of skin cancer. Sunburns may also cause skin breakdowns among people living with spinal cord injuries. Completely cover all exposed skin (including tops of feet) with a thick layer of water-resistant, broad-spectrum sunscreen with an SPF of at least 30. (Most adults need to use one ounce -- roughly the amount in a shot glass -- to fully cover their body.) Apply to dry skin about 15 minutes before going outside and then reapply at least every two hours, or after being in the water.

Wear protective clothes: Wide-brimmed hats shield the head, neck and upper chest from the sun. Clothing with built-in UV protection may help prevent sunburn, while lightweight wicking fabrics can keep the body cooler and limit excessive moisture buildup that can lead to skin breakdown.

Pay attention to skin: Daily skin inspections are important for people living with paralysis, especially in the summer. Continue to monitor skin for sunburn or breakdowns caused by burns or excessive moisture. Call a doctor immediately if new wounds appear.

Protect equipment: Wheelchairs can become extremely hot when left in the sun or even just from being outside on a hot day. Overheated equipment can easily burn the skin of individuals who brush up against hot armrests and seats, or place bare feet on a metal footrest. When leaving a wheelchair outdoors, place it in a shady spot and cover it with a towel to prevent its overheating. Also, be aware of hot car interiors; open windows or run air-conditioning for a couple of minutes before use when possible.

Map local options for staying cool: During extreme heat waves, it’s critical to have access to air-conditioned spaces. Big box stores with wide aisles can provide quick respite from the heat, along with movie theaters and many public libraries. When temperatures rise, local government leaders often open cooling centers in schools, government buildings or recreation centers to provide residents with a place to safely cool off. Contact local or regional public health departments to identify what is available (and to double-check accessibility) in your community.

Pay attention to your surroundings: If you notice people around you sweating profusely, take it as a sign to seek out cooler spaces indoors or out of the sun.

Consider timing: Plan to exercise or be outdoors early or later in the day to avoid peak temperatures between 10 am and 2 pm. On extra hot or sunny days, avoid spending more than 15 minutes at a time outside.

Be prepared: Always carry water, along with spritz bottles and towels. Spray or apply damp towels to the skin to help cool off. Keep an emergency supply in the car or travel bag to have on hand when needed.

Warning signs
Reddening face and neck, headaches, dizziness, stomach cramps and nausea are all signs that the body is overheating. Respond to symptoms as soon as they appear by immediately finding an indoor space with a fan or air-conditioning. Drink fluids and sponge off with a cool towel. If symptoms do not improve or body temperature is higher than 100, seek medical attention.

Also, watch for signs of autonomic dysreflexia (AD), which can include high blood pressure, pounding headache, flushed face, sweating above the level of injury, goose flesh below the level of injury, nasal stuffiness, nausea, and a slow pulse. Carry a Reeve Foundation AD card in case of emergency.

Sources: Craig Hospital, Shirley Ryan AbilityLab, Shepherd Center, U.S. Food & Drug Administration, Christopher & Dana Reeve Foundation.