Heatstroke

Dancing for long periods of time can lead to dehydration and heatstroke. Heatstroke is a life-threatening condition. Deaths from heatstroke have occurred at raves, nightclubs and festivals even when the individual had not consumed recreational drugs. However, recreational drugs can increase the risk of heatstroke, both by masking the symptoms (when you’re altered it’s not always easy to keep track of your body, especially when it comes to determining normal and abnormal drug side effects) and by affecting the body pharmacologically (e.g., stimulants increase body temperature directly and MDMA inhibits the body’s natural thermo‐regulation).

While heatstroke is very serious, taking simple precautions can greatly reduce the risk. Knowing what it is and how to respond to it is critical for all kinds of environments, especially where dancing is taking place.

How to Prevent Heatstroke

Preventing heatstroke is basically an effort to keep your body cool. The most important factor here is staying hydrated, so remember to drink plenty of water. Be careful not to drink an excessive amount of water, though, too! Consuming too much water can upset the body’s electrolyte balance and lead to a life-threatening condition called hyponaetremia, which means that the salt in your body is too diluted. On the other hand, hypernatremia is caused when you’re dehydrated and there’s too much salt in your system. Both hyponatremia (over-hydration) and hypernatremia (dehydration) can be very dangerous.

A good rule of thumb is to drink a little less than 1L of water per hour, even if you don’t feel thirsty. This translates to around 3-4 cups of water per hour. The CDC advises against drinking more than 1.5 liters of water per hour, which can lead to hyponatremia.

Basic Tips

• Drink a bottle of water an hour (2-4 cups), and eat some salty snacks.
• Start drinking water a few hours before dancing (and keep drinking it afterwards).
• Try to stay in good physical shape to help your heart work less hard while you exert yourself.
• Wear loose-fitting or athletic clothes that wick away moisture.
• Protect yourself from the sun with a hat, sunglasses, lotion and lip balm.
• Take breaks from dancing and allow your body to cool down. (Chill out areas are perfect for this.)
• Electrolyte drinks can be helpful for replenishing salt if you’re sweating a lot, although adequate food intake usually is sufficient for this. (Be mindful of sports drinks with caffeine or loads of sugar in them.)

Note: There have been some cases of hyponatremia deaths (drinking too much water) at EDM events where the individual incorrectly believed that drinking water would reduce the unpleasant effects of a negative drug experience. Fear and panic that one’s life is in danger and the belief that drinking lots of water is the solution may have played a role in these deaths. It is therefore important to remember that water is not an antidote to any psychoactive drug and that nobody should drink more than 3-4 cups an hour.

Some People Are More Susceptible than Others

Some people are more prone to heatstroke than others. This could be a genetic trait, or it may result from certain chronic illnesses and even diseases someone has had in the past. There are anecdotal reports, for example, that patients who have survived meningitis have an increased sensitivity to heat, even years after their recovery. If you have had meningitis, a chronic illness, or a predisposition to heat sensitivity, or if members of your immediate family are heat sensitive, you may be at a higher risk of heatstroke than others.

Know the Symptoms

• Failure to sweat
• Cramps in the legs, arms and back
• Giddiness, dizziness, headache, fatigue
• Suddenly feeling really tired, irritable and confused
• Nausea or vomiting
• Fainting or loss of consciousness

If any of these things happen, stop dancing, drink some water and chill out immediately.

If Someone Collapses While Dancing

1. Call a medic first and foremost.
2. Get the person to as cool of a place as possible. This might mean taking them outside if you’re inside a venue, or to some shade if you’re outdoors.
3. Drench them with water (as cold as possible) using any means you can. Increase the cooling down process by fanning them with anything that’s handy. Focus on places where arteries are close to the skin, like the neck, wrists, armpits, and groin. You’re looking to get their body temperature down to 102F (38.9C). Once their temperature is down to this level, the person should be wrapped in a dry blanket or given some dry clothes to wear. Their temperature shouldn’t be allowed to fall much below 102F or other serious consequences might develop from cooling too rapidly.
4. When the medics come, tell them what the person has taken (if you know) and inform them that you think it’s heatstroke.
5. If the person regains consciousness, have them drink water if they’re lucid enough to do so safely. At this point the person might start sweating again – this is a good sign.
6. The person should be taken to the hospital for observation and proper treatment.
7. It may be several weeks or months before the person can dance as much again, and they will need to be extra careful in hot places for a while, too.

Tips for Promoters and Club Owners

Remember, heatstroke can also happen to people who haven’t taken any drugs. Here are some simple suggestions to prevent heatstroke emergencies from happening at your events:

1. Provide some form of easy access to cool drinking water. This can be as simple as making sure there is cool, running water in the bathrooms (shutting off access to cool water in the bathrooms is illegal and extremely dangerous). Providing free water is even better.
2. Don’t overcrowd your venues. Too many people dancing energetically in an enclosed area can raise the ambient temperature above 100 degrees! Limit your ticket sales based on the “heat capacity” of the venue.
3. Provide a chill out room. Couches, bean bag chairs and ambient music make a comfortable environment for people to relax and cool down after dancing energetically.
4. Establish proper ventilation and temperature control measures. Air conditioning may not be available, but large fans, open windows and doors can often do the job. Fans blowing hot air from the inside out through an open window are better than from the outside in. Also remember that hot air rises. The heat on the dance floor wants to go up. Ceiling vents with exhaust fans provide the best ventilation.
5. Provide safety and harm reduction information to your patrons. DanceSafe offers pamphlets (like this one) with health and safety tips for avoiding heatstroke and other risks of dancing.
6. Be prepared. Have your security trained in basic first aid, and hire onsite EMTs for events with more than 500 attendees. Always call an ambulance if somebody falls unconscious or starts having a seizure.