– Please distribute widely –
Heat wave throughout New England
High heat and humidity for three days or more make for hazardous conditions, especially when experienced by people who are most susceptible to heat-related illnesses. Heat-related illnesses include heat cramps, heat syncope, heat exhaustion and heat stroke, and result from the body’s failure to thermoregulate and maintain normal core body temperature.
Getting susceptible people to air-conditioned space is the single most important strategy to prevent heat illness. Those who are especially susceptible include the young, the elderly, pregnant women, and people with chronic or serious health conditions.
Air quality alert for Greater Burlington area
Today an air quality alert has also been issued by the Vermont Department of Environmental Conservation for the greater Burlington area. This is because ozone pollution concentrations are expected to be unhealthy for sensitive populations. Particle pollution is expected to reach the moderate range as well. People with lung disease such as asthma, children and older adults, and people who are active outdoors should limit prolonged outdoor exertion, and stay tuned to weather and air quality alerts.
During a heat wave, health care providers should:
- Know the risk factors for heat-related illness and death (see below).
- Advise at-risk patients to use air conditioning, or to go to an air-conditioned place if at all possible. Otherwise, draw curtains or shades, turn off lights, don’t use the oven, etc. to keep cool.
- Be alert that extreme heat can make chronic conditions such as heart or lung disease worse.
- Ask family members or other support networks to check on high-risk patients often.
- Recognize the signs and symptoms of heat stroke – a medical emergency – and other heat-related illnesses.
- Start treatment and transfer for emergency care as appropriate.
Risk factors for heat-related illness and death:
- Adults age 65 and older, and children age 4 and younger
- Lack of air conditioning at home
- Use of medications that impede thermoregulation (see following for a list)
- Limited mobility or confinement to bed
- Social isolation
- One or more chronic medical or mental health conditions, such as:
- congestive heart failure and other cardiovascular diseases
- diabetes and other endocrine diseases
- emphysema and other respiratory diseases
- liver disease
- renal failure
- cognitive and psychiatric disorders
- cerebrovascular diseases and sequelae
Some signs and symptoms of heat exhaustion and heat stroke:
- Dizziness or fainting
- Muscle cramps
- Cool, moist skin or dry, hot skin
- Nausea or vomiting
- Rapid, shallow breathing
- Impaired judgment, bizarre behavior, hallucinations, altered mental status, confusion, disorientation, and coma
- Key features of heat stroke are hyperthermia above 104º F and central nervous system dysfunction.
Drugs that impair response to heat:
Drug and Drug Effect:
- Anticholinergic drugs
- Antiparkinsonian drugs
- Antipsychotic drugs
Impaired cardiovascular responsiveness
Increased metabolic rate
- Sympathomimetic drugs
Source: The Merck Manual of Geriatrics, 3rd Edition, edited by Mark H. Beers, and Robert Berkow. Copyright 2000 by Merck & Col, Inc., Whitehouse Station. www.merck.com/mkgr/mmg/tables/67t1.isp
Treatment for heat exhaustion and heat stroke
Basic treatment for heat-related illnesses:
- Cooling of core body temperature
- Fluid replacement
Heat stroke is a medical emergency and patients require hospitalization.
Health care providers should advise patients to:
- Use an air conditioner or go to an air-conditioned place.
- Encourage at-risk patients who have air conditioners to use them during hot weather.
- Encourage those who do not have air conditioners to go to a neighbor’s house, library, shopping mall or other public place with air conditioning.
- Advise at-risk patients to use a fan only when the air conditioner is on or the windows are open.
- Protect yourself from the sun.
- Limit outdoor activity to early morning and evening.
- Wear light-colored and lightweight clothing.
- Wear sunscreen.
- Drink more fluids and avoid foods high in salt.
- Avoid drinks with caffeine, sugar or alcohol.
- Don’t wait until you’re thirsty to drink fluids.
Call a doctor if they or someone else experiences early signs of heat-related illness.
Call 9-1-1 if they or someone else experiences signs of heat stroke.
- Vermont Department of Health: www.healthvermont.gov
- Vermont Department of Environmental Conservation - air quality alerts: http://www.anr.state.vt.us/air/Monitoring/cfm/RealTimeData.cfm
- Centers for Disease Control & Prevention: www.bt.cdc.gov/disasters/extremeheat/