We’d barely entered the month of June when the first heat wave of 2021 hit, bringing with it conditions ripe for heat-related illnesses to appear earlier than in past years.
With the summer’s hottest days traditionally ahead of us, Prime reached out to Dr. Mark Kenton, chief of the Emergency Department at Mercy Medical Center in Springfield, MA. for tips on how to identify heat illnesses, some basic heat illness first aid, and most importantly, when to call for help. Here’s what he said:
“With older adults, you’re dealing with a population that often already has other health conditions that can predispose them
to more heat-related illnesses. For example, if the person has kidney disease and gets dehydrated, they can go into kidney failure, if they are on diuretics for congestive heart failure it is easier for them to become dehydrated, and if someone is on dialysis and is trying to drink more fluids to stay cool, it can cause them to go into heart failure due to too much fluids for the body to process.
“Older individuals sometimes have other issues that can make the heat more of a problem as well – they may be on a limited budget and not able to afford an air conditioner, or to run any air conditioning long enough to provide relief. They may have mobility issues that make it difficult to leave a hot home or apartment and go to visit family members with air conditioning - or a cooling center. And there are often
issues with eating and drinking as people age. Some older individuals may say they don’t feel the heat, or feel thirsty. Individuals with mild dementia who are still able to function at home may forget to drink and eat properly in hot weather, which makes them more susceptible.
“Heat exhaustion can be mild or severe. With mild heat exhaustion, a person may start to feel fatigued and/or dizzy after a short exposure to hot conditions.
“More severe heat exhaustion usually comes with chronic exposure – we see it when EMTs bring in an older patient who’s been in a 90-plus degree home with no relief. They will exhibit more pronounced fatigue and dizziness, muscle cramping, nausea and vomiting, and diminished urine output if they have not been drinking enough.” The individual may also have a weak pulse.*
“Heat stroke is the most severe heat-related illness. We see patients in the Emergency Department suffering from heat stroke who have an altered mental state. They will frequently present as confused, their skin will be hot and dry, and they won’t be sweating despite having been in a very hot environment. Heat stroke can quickly turn into a life-threatening condition, particularly if the patient has other health issues.” *The individual’s temperature can reach 105 degrees Fahrenheit or higher.
“Look at the environment – is it hot? Is it humid? How long has the person been in these conditions and what are their symptoms? If they’ve been in the heat at an event, or exposed to high humidity, and/or have been doing strenuous activity, start by getting them to somewhere cool, and getting them to drink fluids. Heat illnesses can manifest very quickly under those conditions.
“Then look at their medical factors - do they have a comorbidity that could exacerbate the effects of heat? Do they take medications – such as a diuretic - that could cause dehydration to take over quickly? If possible check their pulse. A rapid pulse can be a sign of dehydration, and they need to be seen in the ER.
Also try to do an assessment of their mental state - if the individual seems confused, they need to be seen in an ER”
“Bottom line, if you walk into an individuals’ home and it’s 90 degrees, he or she is sweating profusely, complaining of being weak and dizzy and isn’t drinking, they need to be seen because the next step is heat stroke.”
*According to the Cleveland Clinic. It also recommends cool washcloths and loosening clothing to cool individuals.
