Takeaway
When caring for patients during heat waves, healthcare professionals should be aware of social determinants of health—like no air conditioning at home. Clinicians should know the available resources to recommend, such as cooling centers within the communities they serve.
Lifelong Learning in Clinical Excellence | July 11, 2024 | 2 min read
By Joanna Cohen, MD, Johns Hopkins Medicine
In the bustling pediatric emergency department, a young boy sat quietly on the exam table, his cheeks flushed, and his breathing labored. He lived in an old public housing unit without air conditioning, a luxury his single mother couldn’t afford. With a heatwave in full force, the sweltering conditions at home had driven him and his siblings outside in search of relief. They spent hours playing in the sun, but when the boy began to feel dizzy and nauseous, his mother rushed him to the ED. He was diagnosed with heat exhaustion and as we rehydrated him with IV fluids, his mother sat nearby, holding his hand, her face etched with worry and guilt over their circumstances.
What are heat-related illnesses?
As temperatures rise globally, avoiding heat-related illnesses is a critical concern, especially for our most disadvantaged patients. Heat-related illnesses vary in severity, ranging from mild conditions like heat cramps to life-threatening emergencies such as heatstroke.
1. Heat cramps are painful muscle spasms and can be an early warning sign.
2. Heat exhaustion from excess fluid and electrolyte loss presents with heavy sweating, weakness, dizziness, nausea, and fainting.
3. Heatstroke is a dangerous, potentially lethal, medical emergency where the core body temperature rises, causing confusion, loss of consciousness, rapid pulse, and hot, dry skin.
Why are people living in poverty more at risk?
Healthcare disparities exacerbate the risks associated with heat-related illnesses in disadvantaged communities. These communities often have higher rates of chronic conditions such as diabetes, heart disease, and respiratory issues that increase vulnerability to heat stress. Additionally, people living in poverty may have limited access to resources that can help prevent heat-related illnesses. For instance, many low-income households lack air conditioning, making it difficult to maintain safe indoor temperatures during heat waves. Additionally, people living in urban areas with a high concentration of heat-absorbing surfaces, such as concrete and asphalt, can experience an “urban heat island” effect. This phenomenon increases ambient temperatures, making heat waves even more dangerous.
What can you do?
1. One of the most important discussions to have with patients during a heat wave is to advise them to never leave pets and children in cars during hot weather. On a warm day, the temperature inside a parked car can rise rapidly, reaching life-threatening levels within minutes, even if the windows are cracked open.
2. Ask patients about their access to cool environments during heat waves. Public pools and cooling centers can be a vital resource. Publicizing these resources to patients and assisting vulnerable patients with barriers to access, such as providing help with transportation, can be lifesaving.
3. Raise awareness about the importance of staying hydrated and recognizing early symptoms of heat-related illnesses may also be an effective prevention strategy.
Heat-related illnesses can be life-threatening, but they are preventable with proper awareness and intervention.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.