By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
2023 set a record for heat-related deaths. 2300 people died last year because of high heat. So, far, 2024 is worse. I used to think heat related deaths happened because people aren’t used to the heat. It seemed like the heat-related deaths in the headlines years ago happened when there was a heat wave in New York or some other big city in the northern states. Now heat related deaths occur most often in 5 states: Arizona, Texas, Nevada, Florida, and Louisiana. All of those are places where heat is something we experience every year and should be “used to.”
The increasing number of deaths in those 5 states in alarming. From 1979 to 1999 only 18% of heat related deaths happened in those 5 states. From 2016-2021, those states accounted for 61% of heat related deaths, and in 2023, they accounted for 75% of the heat-related deaths in the U.S. One county in Arizona, Maricopa County, which is the county for the city of Phoenix, had a terrifying 645 heat related deaths last year. I don’t think that anyone can say that people in Phoenix aren’t expecting it to get hot in the summer. That makes me wonder, what is going on?
Experts think the main reasons are two-fold. First, because we are “used to” the heat, we tend to underestimate how quickly heat related illnesses can happen. The second is that it’s getting hotter earlier in the year and average temperatures are going up in the summer months. To me those reasons mean that heat related illness and death is something that we really need to start talking about with the people we love. Even though we are used to the heat every summer, we still have to take it seriously and remember to practice prevention.
The first part of prevention is understanding risk for heat related illness. People who are at mot risk are anyone who works outdoors or in hot environments, infants and young children, people aged 65 or older, people who are ill, those who have chronic health issues, and those who are on medications that can cause dehydration or make them more sensitive to temperature changes, and/or people who are overweight.
The best prevention for heat related illness is to limit exposure to hot temperatures. In the summer, that means get into airconditioned spaces as often as possible. If you are needing to be outside or in a hot space, drink lots of fluids, even when you aren’t thirsty. Water with an occasional sports drink or fruit juice to replace salts lost to sweating is always the best option. Avoid alcohol and energy drinks, they can be dehydrating. Wear loose, lightweight, and light-colored clothing and a hat. Avoid being outside during the hottest part of the day: 11 a.m. – 3 p.m. Put on sunscreen and re-apply frequently. Sunburn affects your body’s ability to cool itself. Pace yourself during any exertion like running or manual labor. Always make sure that everyone is out of cars before you walk away, especially when you are outside of normal routines.
There are two types of heat related illnesses, heat exhaustion and heat stroke. Heat exhaustion is the least severe and easiest to treat. Symptoms of heat exhaustion are pale, ashen, or moist skin, muscle cramps, fatigue, weakness, or exhaustion, headache, dizziness, or fainting, nausea or vomiting, and a rapid heart rate. If you or someone else is experiencing these symptoms, get to a shaded or air-conditioned area, drink water or other cool, non-alcoholic beverages, apply cool, wet towels to the neck, armpits, and groin (areas where major blood vessels are close to the surface) or better, take a cool shower if possible. Untreated, heat exhaustion can quickly develop into heat stroke, so treating heat exhaustion quickly is very important. Offer but don’t force liquids, don’t apply rubbing alcohol to the skin, and don’t allow them to take pain relievers or salt tablets.
Heat stroke can lead to death if actions are not taken rapidly. Heat stroke is an emergency. Heat stroke symptoms are a body temperature over 103 degrees, and skin that is flushed, dry, and hot to the touch. Usually sweating has stopped. Rapid breathing, headache, dizziness, confusion, and other signs of altered mental status can occur. Irrational or belligerent behavior can also occur. Seizures and unresponsiveness are late and very serious signs. If you suspect someone is experiencing heat stroke, call 911, and cool them down as much as you can until help arrives. Try to get them into cool water (do not put their head under water) and remove as much clothing as you can. If that is not possible, place them in a cool shower, or cover as much of the body as possible with cold, wet towels. Keep cooling until their body temperature is less than 101 degrees. Monitor breathing and pulse, start CPR if needed.
Heat related illness and death can be prevented. Even though we are used to the heat, we still need to take it seriously. Please do everything you can to prevent heat related illness this summer.
