Unrelenting heat and humidity are combining to send people to hospital emergency rooms with heat-related illnesses, and the worst may be yet to come, according to an informal survey of several Massachusetts hospitals.
“Today is going to be the day that it spikes. It’s really oppressive out there,” said Dr. Marc Restuccia of UMass Memorial Medical Center in Worcester.
Most of the people seeking urgent care are suffering from heat exhaustion. They have muscle cramps or feel light-headed; some are nauseous and vomiting. Others have racing pulses or feel faint. In these cases, dehydration has taken a serious toll that infusing intravenous fluids can reverse. But untreated heat exhaustion can progress to heat stroke, a life-threatening condition in which dangerously high body temperatures can have toxic effects on organs such as the kidneys or the brain.
One patient at Massachusetts General Hospital is suffering from heat stroke, Dr. Alasdair Conn, chief of emergency medicine at MGH, said today.
Only two patients with heat illnesses came to the ER yesterday, he said, but “the fact that we had four today by midday seems to indicate that it will continue to rise.”
Today’s humidity is to blame, not just the scorching heat, Dr. John Benanti, chief of emergency medicine at South Shore Hospital in Weymouth, said.
“The humidity makes it difficult for everyone,” he said. “When you sweat as a way to cool yourself, you can’t cool off if the humidity is so high the sweat doesn’t evaporate.”
Certain people are more vulnerable to heat and humidity. Dr. Jonathan Olshaker, who heads emergency medicine at Boston Medical Center, said over the past few days people who have been working in the sun too long have needed help after feeling faint or nauseous, but it’s more common to see patients whose asthma, heart disease, or other chronic illnesses have been aggravated by the hot weather.
“Heat really is a stress on the system,” he said. “It makes your body work harder. Consequently people who don’t have the ability to respond as well to a stressor, like the very young or the very old or those with chronic diseases, are probably more likely to be affected.”
Very young children’s bodies are not as good at dissipating heat as they will be when they are older. Emergency doctors beg parents not to leave children of any age alone in a car, where they can overheat and die.
Older people are vulnerable for a variety of reasons, said Dr. Erin O’Fallon of Hebrew SeniorLife. They have impaired thirst sensors, so they are much less likely to drink adequately or to be aware that they are getting dehydrated. Many medical conditions, and the medications they take to control them, also contribute. Diuretics to treat blood pressure, for example, can be dehydrating.
“[Older] people should try to drink beverages during the day even if they don’t feel thirsty, and every four to six hours they should be passing urine,” O’Fallon said.
Older people may also be more dependent on others to bring them meals or drinks, which can lead to less than ideal hydration. Family members or others caregivers should check in on older people more often and be alert to signs of confusion or labored breathing, both of which can be a sign of impending heat stroke.
Symptoms of heat illnesses may be hard to recognize. Fatigue, slurring of speech, and dizziness can be just as serious as chest pain, specialist say. If you see someone pass out, call an ambulance, Benanti of South Shore Hospital said. Paramedics can give fluids and make an assessment on the person’s condition. If you have a fever and stomach pain, it’s probably not a virus and Tylenol won’t help, he said, so call for help.
Restuccia of UMass Memorial, who is also medical director of the air ambulance service Life Flight and Worcester Emergency Medical Services, is worried about the paramedics themselves, along with flight doctors and nurses, and firefighters whose jobs put them at risk of heat exhaustion on a day like today. Extra water is on board in ambulances and crews are reminded to look out for one another.
Neighbors should look in on older people, especially those who may be living alone. City cooling centers are an important resource for those whose homes aren’t cooled by fans or air conditioning.
Other people should limit their time in direct sunlight and drink up.
“The message for everyone is drink enough fluids,” Dr. Assaad Sayah, emergency chief at Cambridge Health Alliance said.
But be sure you’re drinking the right thing. Alcohol is not going to help, nor is coffee or an energy drink spiked with caffeine. Both substances make you lose more fluid.
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|White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at firstname.lastname@example.org. Follow her on Twitter: @cconaboy.|
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