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The heat index reached 44 degrees Celsius in Miami this week. In Mexico monkeys fall dead due to the scorching heat. India is experiencing its most recent heat crisis.
Warmer temperatures increase the chances of heat-related illnesses. According to the Centers for Disease Control and Prevention, emergency room visits for heat-related conditions increased sharply last summer in many parts of the United States. And weather experts are once again predicting above-normal temperatures for much of the country this summer.
We asked emergency doctors across the United States what the public should know about extreme heat.
Heat-related illnesses range from mild to life-threatening
Mild heat conditions include rashes, swelling of the hands and feet, muscle cramps, and heat syncope, which is fainting after standing for a long time or getting up suddenly. People with heat exhaustion have more severe symptoms, such as headache, nausea, vomiting, and dizziness.
Hany Atallah, an emergency physician and chief medical officer at Jackson Memorial Hospital in Miami, says heat exhaustion is the most common heat-related illness he sees in the ER. Doctors can usually help patients cool down and hydrate properly and discharge them within a few hours, he says.
Heat stroke, caused by exposure to extreme heat or strenuous exertion at high temperatures, is less common but much more dangerous. The hallmark signs of heatstroke are a core body temperature above 40 degrees Celsius and confusion, seizures, or other mental status changes in the context of exposure to extreme heat.
“The body loses the ability to cool itself,” explains Atallah. This condition can lead to brain damage, muscle breakdown, and kidney failure.
“When these patients arrive at the emergency department, you have to get to work removing all their clothing, cooling them as quickly as possible, giving them intravenous fluids and any other type of help,” explains Atallah.
In extreme cases, patients suffering from heat stroke may need the support of a machine that takes over the functioning of the heart and lungs, said Jacquelyn Bowers, director of emergency services at the Ochsner-LSU Health System in Northern California. Louisiana.
Looking for low temperatures and drinking fluids is essential
If you show any symptoms of heat-related illness, the best thing you can do is go to a cool place and hydrate quickly. This can be as simple as getting into a car, turning on the air conditioning, and drinking some cool liquid. “All this will help you,” Atallah said.
Remove layers of clothing or any restrictive clothing. If you’re hiking or at the beach, find some shade or get in the water.
“If you immerse yourself in cold water, you will cool down faster,” said José Burgos, a hospitalist at University Medical Center in El Paso.
If you’re at home, take a cold shower or a cold bath and turn on a fan. Blowing air onto damp skin will help sweat evaporate and help your body cool, said Ronna Campbell, an emergency medicine doctor at the Mayo Clinic in Rochester, Minnesota.
If you are very dehydrated and feel unwell, sports drinks or water with salt tablets will help you recover the electrolytes, such as sodium, that you lose when you sweat and are necessary to maintain fluid balance.
Every minute matters
If you’ve tried cooling down and drinking fluids, but your symptoms haven’t improved within half an hour or are getting worse, go to the emergency room, Bowers said.
Experts also recommend seeking immediate care if you or someone you know has heat-related symptoms and is unable to get out of the heat, appears disoriented, or is having seizures.
If heat stroke is not recognized and treated quickly, “it can cause rapid deterioration, within minutes,” Bowers said. “We really have to address it as the emergency that it is.”
Children and older people are more susceptible
Children are particularly at risk in extreme heat, doctors said. They tend to heat up faster, but they lack mechanisms to compensate for this because their systems are immature. For example, they sweat less, explains Campbell. And they may not be hydrated enough. “They have fun and forget that they have to drink water,” she explains.
Older people are also at high risk. They are more likely to suffer from chronic diseases such as diabetes, kidney and heart failure, which interfere with the body’s ability to regulate temperature and balance fluids, explains Burgos. And treatments for some of these diseases, such as blood pressure medications that keep the heart rate low or diuretics that remove fluid from the body, can impair the body’s ability to compensate for extreme heat. People with depression or dementia may also not realize they are thirsty and forget to drink water, Burgos said.
Patients with these conditions should talk to their primary care doctor, cardiologist or nephrologist about how to adapt to extreme heat, Burgos said. “We have to educate them about how to deal with their fluid and medication restrictions and watch for symptoms,” she said.
Adjust your routine during extreme heat
When temperatures rise, smart decisions can make a big difference, doctors say. If you can, avoid outdoor physical activity during the hottest hours of the day. (Check your local weather forecast to make your plans.) Go to a cooling station or a shopping center, even if it’s just for a couple of hours, if your house doesn’t have air conditioning.
When you go out or exercise in the heat, wear loose, light-colored clothing, which will absorb less heat and help keep your body cool. Stay hydrated, even if you’re not thirsty. Avoid alcohol, which can dehydrate you and impair your ability to recognize when something is wrong.
Pay attention to time. In very humid places like South Florida or Louisiana, the heat is more dangerous even at lower temperatures. Sweat evaporates less quickly from the skin, “so it takes longer for the body to cool down,” Campbell explained.
On the contrary, in the desert, where Burgos practices, the dry conditions, the lack of natural shade and the strong direct exposure to the sun will make you feel “like in an oven,” he said. People can get hot easily.
If you know you will be in extreme heat and performing strenuous work or exercise, it is important to have a plan to safely acclimatize your body over time. Research suggests that you can get your body used to the temperature by gradually increasing your activity in a hot environment over a week or two, and taking breaks to cool down and hydrate properly.