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Kenali tanda Dan Gejala Dehidrasi Pada Penderita Diare Posted on April 4, 2012 Di jaman modern ini ternyata

diare masih merupakan salah satu masalah kesehatan utama dari masyarakat di Indonesia. Diare hampir selalu termasuk dalam kelompok 3 penyebab utama kunjungan pasien ke puskesmas atau layanan dokter lainnya. Diare merupakan salah satu penyakit yang paling sering ditemukan pada anak di seluruh dunia, termasuk Indonesia. Diperkirakan anak berumur di bawah 3 tahun mengalami 2-3 kejadian diare per tahunnya. Meskipun sebagian besar diare pada anak akan sembuh sendiri (self limited), namun penanganan yang akurat tetap sangat diperlukan untuk mencegah terjadinya kekurangan cairan (dehidrasi).1 Pada orang dewasa, dperkirakan setiap tahunnya mengalami diare akut atau gastroenteritis akut sebanyak 99.000.000 kasus. Di Amerika Serikat, diperkirakan 8.000.000 pasien berobat ke dokter dan lebih dari 250.000 pasien dirawat di rumah sakit tiap tahun (1,5% merupakan pasien dewasa) yang disebabkan karena diare atau gastroenteritis. Kematian yang terjadi, kebanyakan berhubungan dengan kejadian diare pada anak-anak atau lansia, dimana kesehatan pada usia pasien tersebut rentan terhadap dehidrasi sedang sampai berat. Frekuensi kejadian diare pada Negara-negara berkembang termasuk Indonesia lebih banyak 2 sampai 3 kali dibandingkan Negara maju.2 Angka kejadian diare, di sebagian besar wilayah Indonesia hingga saat ini masih tinggi. Hasil Survei Kesehatan Rumah Tangga (SKRT) tahun 2004 angka kematian akibat diare 23 per 100 ribu penduduk dan pada balita 75 per 100 ribu balita. Selama tahun 2006 sebanyak 41 kabupaten di 16 provinsi melaporkan KLB diare di wilayahnya. Jumlah kasus diare yang dilaporkan sebanyak 10.980 dan 277 diantaranya menyebabkan kematian. Hal tersebut, utamanya disebabkan rendahnya ketersediaan air bersih, sanitasi buruk dan perilaku hidup tidak sehat. Apakah Diare? Diare adalah suatu keadaan dimana terjadi perubahan bentuk dan konsistensi tinja menjadi cair atau setengah cair dan frekuensi buang air besar encer lebih dari 3 kali per hari dengan/tanpa disertai lendir dan darah. Diare akut yaitu diare yang berlangsung kurang dari 15 hari. Sedangkan menurut World Gastroenterology Organisation Global Guidelines 2005, diare akut didefinisikan sebagai pasase tinja yang cair/lembek dengan jumlah lebih banyak dari normal, berlangsung kurang dari 14 hari. Diare kronik adalah diare yang berlangsung lebih dari 15 hari. Diare persisten merupakan istilah yang dipakai di luar negeri yang menyatakan diare yang berlangsung 15-30 hari yang merupakan kelanjutan dari diare akut (peralihan antara diare akut dan kronik, dimana lama diare kronik yang dianut yaitu yang berlangsung lebih dari 30 hari). 1 Diare infektif adalah bila penyebabnya infeksi. Sedangkan diare non infektif bila tidak ditemukan infeksi sebagai penyebab pada kasus tersebut. Diare organik adalah bila ditemukan penyebab anatomic, bakteriologik, hormonal atau toksikologik. Diare fungsional bila tidak dapat ditemukan penyebab organic. Tanda dan gejala Pasien dengan diare akut datang dengan berbagai gejala klinik tergantung penyebab penyakit dasarnya. Keluhan diarenya berlangsung kurang dari 15 hari. Diare karena penyakit usus halus biasanya berjumlah banyak, diare air dan sering berhubungan dengan malabsorbsi, dan dehidrasi sering didapatkan.2 Diare karena kelainan kolon seringkali berhubungan dengan tinja berjumlah kecil tetapi sering, bercampur darah dan ada sensasi ingin ke belakang. Pasien dengan diare akut infektif datang dengan keluhan yang khas yaitu nausea, muntah, nyeri abdomen, demam, dan tinja yang sering, biasa air, malabsorbsi, atau berdarah tergantung bakteri patogen yang spesifik. Pada bayi dan anak, mula-mula akan menjadi cengeng, gelisah, suhu badan mungkin meningkat, nafsu makan berkurang atau bahkan tidak ada kemudian akan timbul diare. Tinja makin cair mungkin mengandung darah atau lendir, warna tinja berubah menjadi kehijau-hijauan karena bercampur empedu. Karena seringnya defekasi, anus dan sekitarnya lecet karena tinja makin lama menjadi asam akibat banyaknya asam laktat yang terjadi dari pemecahan laktosa yang tidak dapat di absorbsi oleh usus. Gejala muntah dapat terjadi sebelum atau sesudah diare. Bila penderita telah banyak kehilangan air dan elektrolit, terjadilah gejala dehidrasi. Berat badan turun, pada bayi akan terlihat ubun-ubun cekung. Tonus dan turgor kulit berkurang, selaput lendir mulut dan bibir terlihat kering. Tanda Dan gejala dehidrasi Dehidrasi terjadi karena kehilangan air lebih banyak daripada pemasukan air. Derajat dehidrasi dapat dibagi berdasarkan gejala klinis dan kehilangan berat badan. Derajat dehidrasi menurut kehilangan berat badan, diklasifikasikan menjadi empat, dapat dilihat dari tabel berikut : Derajat dehidrasi berdasarkan kehilangan berat badan Derajat dehidrasi Penurunan berat badan (%) Tidak dehidrasi <2 Dehidrasi ringan 25 Dehidrasi sedang 5-8 Dehidrasi berat 8-10

Derajat dehidrasi berdasarkan gejala klinis Penilaian A B C Keadaan umum Baik, sadar Gelisah, rewel Lesu, tidak sadar Mata Normal Cekung Sangat cekung Air mata Ada Tidak ada Tidak ada Mulut, lidah Basah Kering Sangat kering Rasa haus Minum seperti biasa Haus, ingin minum Malas minum, tidak banyak bisa minum Periksa: Turgor kulit Baik (kembali Kurang-buruk Sangat buruk (kembali cepat) (kembali lambat) sangat lambat) Hasil pemeriksaan Dehidrasi beratBila ada Tanpa dehidrasi Dehidrasi ringan/ sedangBila ada 1 1 tanda ditambah 1/lebih tanda ditambah 1/lebih tanda lain tanda lain Saya kira anda sudah tahu apa itu dehidrasi. Dehidrasai adalah kondisi dimana tubuh kita banyak kehilangan air dan elektrolit (sodium, klorida, kalium). Elemen ini sungguh sangat dibutuhkan bagi tubuh kita agar dapat menjalankan fungsinya serta baik untuk kesehatan. Mungkin anda sudah tahu pula bahwa penyebab utama dehidrasi itu secara umum disebabkan karena seseorang tidak minum cukup air. Berikut ini adalah ciri-ciri bahwa anda kurang minum air atau dehidrasi : 1. Mulut Kering. Jika mulut anda terasa kering bisa jadi anda dehidrasi. Tapi biasanya juga mulut kering karena pengaruh efek samping obat-obatan yang dikonsumsi. 2. Sakit Kepala. Jika anda kurang minum maka kepala akan terasa sakit ditambah dengan rasa letih yang luar biasa. Cobalah minum air yang cukup hingga sakit kepala anda hilang. 3. Warna Urin Keruh. Jika anda dehidrasi maka warna air kencing anda akan berwarna keruh, kuning atau cokelat gelap. Cobalah minum air segera jika warna urin anda keruh. 4. Pusing. Pusing memang banyak penyebabnya. Bisa karena efek obat atau mengantuk. Namun jika anda merasa pusing disertai nyeri punggung dan pundak itu tandanya anda dehidrasi. 5. Lapar. Anda merasa lapar terus-menerus dan bila anda terlebih dahulu meminum air dan kemudian terasa lapar anda hilang, maka itu artinya anda hanya haus karena kurang minum. 6. Mengantuk. Lesu dan mengantuk adalah bisa jadi tanda Anda tidak minum cukup air. Ini cara tubuh melambat untuk menghemat air. Sebagai rekomendasi, minum air dingin perlahan dan lihat apakah Anda kembali segar. 7. Kulit Kering. Jika Anda merasa sudah sering menggunakan pelembab kulit, namun tetap bersisik dan kering, mungkin hal itu disebabkan oleh dehidrasi. Ingat, kulit yang sehat adalah kulit yang lembab. 8.Detak Jantung Meningkat. Jantung berdetak cepat dan berdebar merupakan salah satu tanda yang paling menakutkan dari dehidrasi. Kebanyakan orang dewasa memerlukan antara sekitar 2 liter air atau lebih setiap hari tergantung dari aktivitas, berat dan tinggi badan, serta gaya hidup. 9. Haus. Tentu saja ini gejala yang paling logis dari dehidrasi. Minumlah ketika Anda merasa haus atau merasa belum mencukupi kebutuhan air harian. Namun, jika Anda merasa sudah minum cukup air namun masih sering haus, bisa jadi itu tanda diabetes. Sumber:http://pancallok.blogspot.com/

Dehydration - Symptoms Depending on how much of your body weight is lost through fluids, dehydration can be described as mild, moderate or severe. Mild to moderate dehydration The first sign of dehydration is thirst. Other symptoms may include: dizziness or light-headedness headache tiredness dry mouth, lips and eyes concentrated urine (dark yellow) passing only small amounts of urine infrequently (less than three or four times a day) Moderate dehydration causes you to lose strength and stamina. It's the primary cause of heat exhaustion. You should be able to reverse mild to moderate dehydration by drinking more fluids, without medical attention. If dehydration is ongoing (chronic), it can affect your kidney function and cause kidney stones to develop. It can also cause: liver, joint and muscle damage cholesterol problems constipation Severe dehydration Untreated mild or moderate dehydration can lead to severe dehydration. Severe dehydration is a medical emergency and requires immediate medical attention. You should seek medical attention if you or your child has any of the following symptoms: dry, wrinkled skin that sags slowly into position when pinched up an inability to urinate, or not passing urine for eight hours irritability sunken eyes low blood pressure (hypotension) a weak pulse a rapid heartbeat cool hands and feet fits (seizures) a low level of consciousness feeling tired (lethargic) or confused blood in your stools (faeces) or vomit If not treated immediately, severe dehydration can lead to complications. You can even die from severe dehydration because the blood stops circulating. If you experience this level of dehydration, you may need to be admitted to hospital and be put on a drip to restore the substantial loss of fluids. When should I see my GP? You should visit your GP if your symptoms continue, despite drinking plenty of fluids or if you suspect that your baby or toddler is dehydrated. If your doctor suspects dehydration, you may be given a blood test or a urine test to check the balance of salts (sodium and potassium) in your body. Contact your GP or out-of-hours service straight away if you have any of the following symptoms: feeling tired (lethargic) or confused dry mouth and eyes that don't produce tears not passing urine for eight hours dry skin that sags slowly into position when pinched up rapid heartbeat blood in your stools (faeces) or vomit low blood pressure (hypotension) Also contact your GP if you or your child has diarrhoea that lasts longer than five days, or vomiting that lasts more than 24 hours in adults or 12 hours in a child. Elderly dehydration : symptom and sign Dehydration is a common condition that afflicts many people over the age of 65. Because the symptoms of dehydration are masked by the aging body, patients and caregivers typically overlook the warnings signs until it is too late. But, dehydration can be avoided if you are careful and know what the symptoms are. Dehydration is a condition when the body is losing more water than it is taking in. Loss of water can be due to medications, illnesses, inability to move around easily, diminished sense of thirst, or reduced kidney function. At times, seniors are dependent on caregivers who may not realize they are not taking in enough fluids.

A factor in elderly dehydration is the increased risk of contracting illnesses such as the common cold and influenza. These illnesses cause fluid loss that is not easily replenished. If possible, it is a good idea to take extra precautions during cold and flu season so your loved one does not get sick. Another reason elderly persons become dehydrated is because of their medication. With the various health conditions that develop in the senior years, it is not uncommon for people over the age of 60 to be taking multiple medications. Medications to monitor and control heart disease, hypertension, kidney disease, and liver disease are common diuretic medications prescribed for seniors. While the patients realize that these medications are diuretics, they often overlook their need to add more fluids to their daily diet as they take their prescribed medications, and this causes many of them to become dehydrated. Sometimes people in advanced years who live on their own do not drink enough water or other fluids to maintain their health. This can be for a variety of reasons, but a common reason is that deteriorating muscles make it more difficult for them to get up and move around, which discourages them from simply going into the kitchen for a glass of water. Some of them also find it difficult to regularly get up to go to the bathroom, so they purposely reduce the amounts of fluids they consume so they do not have to urinate as frequently. Friends and family who regularly visit with their loved one may not realize that the person is dehydrated until they are in an emergent situation. Usually, the first symptom of dehydration to present is a dark or malodorous urine. This is closely followed by decrease in urine output and chronic constipation. Urinary tract infections could develop over time. When the body is not properly flushing itself of toxins, these toxins can cause infections. So, if the person is not getting enough fluids, they are not voiding the toxins regularly. Some of the first symptoms of severe dehydration include chronic fatigue and lethargy. Many times the person will nap for a couple hours once or twice a day. As the dehydration develops, the muscles will become weak and sometimes the person will develop muscle cramps. Too often people excuse these symptoms as signs of aging, but more often than not it can be corrected by re-hydrating the person. Dehydration can also cause confusion and weakness. If your elderly charge is otherwise sound in mind and body, but suddenly displays confusion and/or weakness, they may be experiencing dehydration. Typically, an increase in their fluid intake will relieve these symptoms. However, these two symptoms can be indications of a number of different conditions. So, if the symptoms persist after increasing their fluids, you may want to consult a doctor to determine if there is another condition presenting itself. Headaches are also a common symptom of dehydration in younger people, as well as wrinkled or sagging skin. However, these symptoms may not be evident in elderly patients. Headaches alone do not necessarily indicate dehydration, but combined with any other symptom could identify possible dehydration. Checking the skin for proper elasticity also can help identify early stages of dehydration. Pull up the skin on the back of the hand, and if the skin does not return to its normal state within a second or two, the person is likely suffering from dehydration. More symptoms to look for include: dizziness, dry mouth, sudden problems with mobility, low blood pressure or severe change in blood pressure when standing up, rapid resting heart rate, irregularity in body temperature (too cold or feeling hot without producing sweat), inability to produce tears, or sunken eyes. Patients who are bed-ridden experience bedsores more readily when dehydrated than those who are able to get up and move around frequently. How can dehydration be prevented? Humans can only survive approximately four days without fluids. The goal is to not allow that to happen. Unfortunately, each persons hydration level is different. Where one person may need 6-8 glasses of water every day to stay hydrated, someone else may only need 4-6 glasses of water. Simply monitoring body weight daily can indicate if a person is entering a dehydrated state. If the person loses two or more pounds from the previous day and feels thirsty or has a severe headache, they are probably dehydrated. Prolonged dehydration can cause other health issues, such as cardiac or renal problems. Patients who already have cardiac or renal conditions will have more severe reactions to even slight dehydration. If your loved one has trouble walking or getting to the kitchen, consider keeping a water bottle or two next to their chair or bed. If they are not able to lift a full one liter bottle, then leave three 12 ounce bottles beside them. Also, water is not the only liquid they can consume to stay properly hydrated. Coffee, tea and lemonade are water based and will provide your loved one with a variety of fluids to consume, which will keep them from becoming bored with their fluid intake. In moderation, the caffeine in coffee and tea and the sugar in the lemonade should not adverse affect their metabolism or blood-sugar levels. Some of the things we eat, such as fruits, vegetables and soups, contain water and are good sources of hydration. If a glass of fluid is added to the daily meals, we can ensure that our loved ones are getting fluids regularly. According to information found on the MEDLINEplus website, some fruits and vegetables which are comprised of 90% or more water are: cooked asparagus, raw bell peppers, cooked or raw broccoli, raw cabbage, cantaloupe, cooked or raw cauliflower, raw celery, raw cucumbers, grapefruit, honeydew, raw lettuce, raw strawberries, raw tomatoes, and watermelon. Adding one or two of these items to every meal provides more fluid in the diet and satisfied the daily recommended serving of fruits and vegetables, which also provides vitamins and minerals the body needs. One of the most important ways to avoid dehydration is to be educated about the medications your loved one is taking. There are many medications that are diuretics, which means that more fluids will need to be consumed daily to avoid dehydration. Dispelling the Myths: MYTH: If they are dehydrated, they will be thirsty. TRUTH: As people age, they lose some of their basic senses. They can lose their sense of smell, sense of taste, and ability to identify when they are hungry or thirsty. Along with making sure your loved one eats properly, you also need to make sure your loved one is drinking enough fluids. MYTH: Every elderly person needs to be weighed every day to insure they are not losing too much weight and possibly dehydrating.

TRUTH: While it is a simple method to identify possible dehydration, it is not necessary to weigh the patient daily in every instance. An active elderly person who is mobile and does not require constant care would not need to weigh themselves every day to make sure they are not dehydrating. However, a patient in a nursing home especially if they have already experienced dehydration should be weighed at a minimum every two days to make sure they are not in danger of dehydration. MYTH: Using a scale that also measures body mass and hydration levels can help prevent dehydration. TRUTH: Dont believe the marketing on every product. Unfortunately, these scales have not proven to be accurate. Until the manufacturers can perfect the technology for these products, watch for other signs that your loved one is dehydrating. MYTH: The caffeine in coffee and tea will cause further dehydration. TRUTH: 1-2 cups of a caffeinated beverage will not be enough to cause dehydration in a person. However, large amounts of caffeine could trigger the diuretic properties of the substance. As with their food consumption and vigorous exercise, everything should be done in moderation. Because it is difficult to diagnose dehydration in elder persons in its early stages, severe dehydration frequently results in hospitalization. If left unchecked long enough, it can be life-threatening and can even result in death. It is important for caregivers and even elderly patients to be watchful of the symptoms and seek medical assistance if the symptoms persist beyond one or two days.

Dehydration in Adults Dehydration in Adults Overview Dehydration is a condition that occurs when the loss of body fluids, mostly water, exceeds the amount that is taken in. With dehydration, more water is moving out of our cells and then out of our bodies than the amount of water we take in through drinking. We lose water every day in the form of water vapor in the breath we exhale and as water in our sweat, urine, and stool. Along with the water, small amounts of salts are also lost. Recommended Related to Sporotrichosis Sporotrichosis is an infection of the skin caused by a fungus, Sporothrix schenckii. This fungus is related more closely to the mold on stale bread or the yeast used to brew beer than to bacteria that usually cause infections. The mold is found on rose thorns, hay, sphagnum moss, twigs, and soil. Therefore, the infection is more common among gardeners who work with roses, moss, hay, and soil. Read the Sporotrichosis article > > When we lose too much water, our bodies may become out of balance or dehydrated. Severe dehydration can lead to death. Causes of Dehydration in Adults Many conditions may cause rapid and continued fluid losses and lead to dehydration: Fever, heat exposure, and too much exercise Vomiting, diarrhea, and increased urination due to infection Diseases such as diabetes The inability to seek appropriate water and food (as in the case of an infant or disabled person) An impaired ability to drink (for instance someone in a coma or on a respirator or a sick infant who cannot suck on a bottle) No access to safe drinking water Significant injuries to skin, such as burns or mouth sores, or severe skin diseases or infections (water is lost through the damaged skin) Symptoms of Dehydration in Adults The signs and symptoms of dehydration range from minor to severe and include: Increased thirst Dry mouth and swollen tongue Weakness Dizziness Palpitations (feeling that the heart is jumping or pounding) Confusion Sluggishness fainting Fainting Inability to sweat Decreased urine output Urine color may indicate dehydration. If urine is concentrated and deeply yellow or amber, you may be dehydrated. When to Seek Medical Care Call your doctor if the dehydrated person experiences any of the following: Increased or constant vomiting for more than a day Fever over 101F Diarrhea for more than 2 days

Weight loss Decreased urine production Confusion Weakness Take the person to the hospital's emergency department if these situations occur: Fever higher than 103F Confusion Sluggishness (lethargy) Headache Seizures Difficulty breathing Chest or abdominal pains Fainting No urine in the last 12 hours Exams and Tests The doctor may perform a variety of simple tests at the examination or send blood or urine samples to the laboratory. Through tests and examination, the doctor will try to identify the underlying cause or causes that led to the dehydration. Vital signs o Fever, increased heart rate, decreased blood pressure, and faster breathing are signs of potential dehydration and other illnesses. o Taking the pulse and blood pressure while the person is lying down and then after standing up for 1 minute can help determine the degree of dehydration. Normally, when you have been lying down and then stand up, there is a small drop in blood pressure for a few seconds. The heart rate speeds up, and blood pressure goes back to normal. However, when there is not enough fluid in the blood because of dehydration and the heart rate speeds up, not enough blood is getting to the brain. The brain senses this condition, and the heart beats faster. If you are dehydrated, you feel dizzy and faint after standing up. Urinalysis o The color and clarity of urine, the urine specific gravity (the mass of urine is compared with that of equal amounts of distilled water), and the presence of ketones (carbon compounds-a sign the body is dehydrated) in the urine may all help to indicate the degree of dehydration. o Increased glucose in the urine may lead to a diagnosis of diabetes or indicate loss of diabetic control and a cause for the dehydration. o Excessive protein in the urine may signal kidney problems. o Signs of infections or other diseases, such as liver disease, may be found by urine testing. Blood chemistries o The amount of salts (sodium and potassium) and sugar as well as indicators of kidney function (BUN and creatinine) may be important to evaluate the degree of dehydration and possible causes. o A complete blood count (CBC) may be ordered if the doctor thinks an underlying infection is causing the dehydration. Other blood tests, such as liver function tests, may be indicated to find causes of the symptoms. Dehydration in Adults Treatment - Self-Care at Home Try to get people who are dehydrated (even those who have been vomiting) to take in fluids in the following ways: Sipping small amounts of water Drinking carbohydrate/electrolyte-containing drinks. Good choices are sports drinks such as Gatorade or prepared replacement solutions (Pedialyte is one example) Sucking on popsicles made from juices and sports drinks Sucking on ice chips Sipping through a straw (works well for someone who has had jaw surgery or mouth sores) Try to cool the person, if there has been heat exposure or if the person has an elevated temperature, in the following ways: Remove any excess clothing and loosen other clothing. Air-conditioned areas are best for helping return body temperatures to normal and break the heat exposure cycle. If air conditioning is not available, increase cooling by evaporation by placing the person near fans or in the shade, if outside. Place a wet towel around the person. If available, use a spray bottle or misters to spray luke-warm water on exposed skin surfaces to help with cooling by evaporation. Avoid exposing skin to excessive cold, such as ice packs or ice water. This can cause the blood vessels in the skin to constrict and will decrease rather than increase heat loss. Exposure to excessive cold can also cause shivering, which will increase body temperature-the opposite effect you're trying to achieve. Medical Treatment Treatment in the Emergency Department centers first on restoring blood volume and then body fluids, while determining the cause of the dehydration.

If your core body temperature is greater than 104 F, doctors will cool the entire body. They may promote cooling by evaporation with mists and fans or cooling blankets and baths. Fluid replacement o If there is no nausea and vomiting, fluid replacement is begun. You are asked to drink electrolyte/carbohydratecontaining fluids along with water. o If there are signs of significant dehydration (elevated resting heart rate, low blood pressure), fluids are generally given through an IV, a tube placed into a vein. Disposition o If your condition improves in the Emergency Department, you may be sent home, preferably in the care of friends or family who can help monitor your condition. o If you remain dehydrated, confused, feverish, have persistently abnormal vital signs, or signs of infection, you may need to stay in the hospital for additional treatment. Medications If fever is a cause of dehydration, the use of acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil) may be used. This can be given by mouth if you are not vomiting or as a rectal suppository if you cannot take anything by mouth. Next Steps Call or return to your doctor or the hospital as instructed. Follow-up Take prescribed medications as directed. Continue to keep yourself well hydrated with plenty of water or sports drinks. Watch for signs of dehydration in yourself and others. Prevention The foremost treatment for dehydration is prevention. Anticipate the need for increased fluid intake. Plan ahead and take extra water to all outdoor events and work where increased sweating, activity, and heat stress will increase fluid losses. Encourage athletes and outdoor workers to replace fluids at a rate that equals the loss. Avoid exercise and exposure during high heat index days. Listen to weather forecasts for high heat stress days, and plan events that must occur outside during times when temperatures are cooler. Ensure that older people and infants and children have adequate drinking water or fluids available and assist them as necessary. Make sure that any incapacitated or impaired person is encouraged to drink and provided with adequate fluids. Avoid alcohol consumption, especially when it is very warm, because alcohol increases water loss and impairs your ability to sense early signs associated with dehydration. Wear light-colored and loose-fitting clothing if you must be outdoors when it is hot outside. Carry a personal fan or mister to cool yourself. Break up your exposure to hot temperatures. Find air-conditioned or shady areas and allow yourself to cool between exposures. Taking someone into a cooled area for even a couple of hours each day will help prevent the cumulative effects of high heat exposure.

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