CATES: Summer heat has begun

By Carol A. Cates, MSN, MBA, RN

Chief Nursing Officer

Odessa Regional Medical Center

It’s the second week of May and the thermometer is hitting the triple digits. I don’t know why that first heat wave of the summer always seems to sneak up on me, but it does. That first time it hits 100 just seems to happen up so quickly, that I just never feel prepared for it. And it’s important to prepare for the summer heat because heat can kill and kill quickly.

According to the National Safety Council, in the US in 2019, 884 people died and another 2,061 people were injured seriously enough to require hospitalization related to excessive heat. People who are at highest risk for heat related injury or death are those that work outside in hot weather, infants and young children, people 65 and older, people who have chronic health conditions, and people who are overweight.

If you work in the heat, the National Institute for Occupational Safety and Health (NIOSH) recommends, frequent rest periods away from the heat to cool down, especially as people are adjusting to hot conditions. Stay hydrated and drink before you get thirsty. Avoid caffeinated and alcoholic beverages, water and electrolyte replacement beverages are best. Finally, watch co-workers for signs of heat exhaustion or heat stroke and intervene. Often people do not recognize the symptoms in themselves, so its important to keep our eyes on our colleagues and friends in hot weather.

The biggest risk to infants and children for heat stroke and heat exhaustion is being left in hot cars. According to Kids and Cars an organization dedicated to child safety in vehicles, an average of 37 kids die every year because they are left in a hot car. It’s probably not surprising but Texas leads the nation in deaths related to kids in cars. We have a large population in this state, plus we have very hot weather much of the year. From 1998 to 2015, 100 kids died in Texas related to heat in cars. 87% of all child deaths from being left in cars are in kids 3 or younger, 55% are under age 1. Experts believe this is largely related to backwards facing car seats in the rear seats of vehicles, and their inability to communicate beyond cries and babbling.

Some things to remember. Never leave a child in a car unattended, even if you are only going to be away “for a minute.” Seconds count when a kid is left alone in a car, temperatures can rise as quickly as 20 degrees in the first 10 minutes. Kids have a very different ratio of body weight to height than adults do. Because of that, their body temperature can rise 3 to 5 times faster than an adults can with the same heat exposure. It doesn’t have to be hot outside for a car to get too hot for a child inside. There are recorded cases of child deaths from heat exposure in cars in the shade, with windows down, and with temperatures as low as 57 degrees. Most accidental deaths with kids and cars happen when people vary their routines or are tired. In those circumstances, do something where you are forced to remember you have your child with you—like put one of your shoes in the car seat. I know it sounds silly, but it can save a life.

Symptoms of heat exhaustion include: pale, ashen, or moist skin, muscle cramps, fatigue, weakness or exhaustion, headache, dizziness, or fainting, nausea or vomiting, and rapid heart rate. If someone is showing those symptoms, quickly get them to a cooler area, give them water or cool non-alcoholic, non-caffeinated beverages, apply wet towels or have them take a cool shower. It’s important to get heat exhaustion victims treated quickly, because heat exhaustion can turn into heat stroke, and heat stroke can be fatal. Symptoms of heat stroke are a body temperature of above 103 degrees, loss of ability to sweat, rapid breathing, flushed, hot, dry skin, altered mental status, irrational behavior, convulsions, or unresponsiveness. In the case of heat stroke, call 911, move the victim to a cool place, remove unnecessary clothing, cool the person as quickly as possible, preferably by immersing them up to the neck in cool water. If you cannot do that, place them in a cool shower, or covering as much of the body as possible with cool, wet towels. If they stop breathing, be prepared to start CPR. Do not force someone in heat stroke to drink, don’t use alcohol to cool their skin, and don’t give them pain relievers or salt tablets.

Remember with heat, the best medicine is prevention. Stay as cool as you can, drink lots of water, and never leave a child, a pet, or anyone else in a hot car.