During a heat wave, health care providers should:
Be aware of the increased risk of heat-related illness among: older adults, people with chronic physical health conditions; serious psychiatric, cognitive or developmental disorders that impair judgement or self-care; and those taking medications that can impair thermoregulation. • Instruct at-risk patients to use home air conditioners or go to air-conditioned places during hot weather, and stay well-hydrated. • Consider reaching out to your most vulnerable patients and encourage social contacts and caregivers to help them stay cool and well-hydrated. Report deaths where heat exposure was the direct cause or a contributing factor to the NYC Office of the Chief Medical Examiner 212-447-2030 immediately.
The National Weather Service has forecast very hot weather and has issued a heat advisory starting on Wednesday, July 19, 2017 and continuing through Friday, July 21, 2017. The current forecast calls for high temperatures and humidity producing heat indices in 95-97 range. These weather conditions can cause heat stroke and exacerbate chronic medical conditions, and may lead to severe complications and death. Heat waves such as this one that last for several days can be more dangerous to health. Air conditioning is the most effective protection for at-risk patients during extreme heat.
Updates on extreme weather conditions are available from the National Weather Service (www.weather.gov) and the NYC Office of Emergency Management (www.nyc.gov/oem).
Risk Factors for Heat Stroke Death
Certain individuals are at increased risk for heat-related illness and death (see checklist). In addition, most hyperthermia victims are overcome by heat in their own homes and do not have or use air conditioners; fans do not provide sufficient cooling during extremely hot weather. Fans should only be used when the air conditioning is on or windows are open, and at night to bring in cooler air from outside.
Prevent Heat-related Illness and Death
- Advise at-risk patients to use their air conditioners or go to air conditioned places and limit outdoor activity especially during the hottest part of the day. Cooling centers will be open to New Yorkers on days that the heat advisory is in effect. To find a cooling center in New York City during a heat wave, call 311 or go to www.nyc.gov/oem. • Suggest setting air conditioners to 78°F to provide comfort while keeping electricity bills lower and conserving energy. • Advise at-risk patients to increase fluid intake during hot weather. • Recommend self-monitoring, such as bodyweight measurement, to monitor hydration for patients with health conditions sensitive to fluid balance or among those using medications that can impair thermoregulation or cause dehydration. • Engage caregivers, family members and support networks to check frequently on at-risk patients, especially those who cannot care for themselves, to assist them in staying cool and well hydrated before and during hot weather. • Be alert to the signs and symptoms of heat-related illness or exacerbation of chronic medical conditions. For more information on heat illness, visit www.nyc.gov/health/heat. • Immediately report deaths where heat exposure is suspected as the direct cause or a contributing factor to the NYC Office of the Chief Medical Examiner at 212-447-2030.