Sizzling Days Grip Nation; No Public Health Emergency


Quick Cooling, Lots of Fluids

Dr. Gary Hemann, co-director of Mercy Medical Center in Des Moines, said he has certainly seen an uptick in heat-related illnesses in his ED, particularly in older patients and those with chronic illness -- as well as in those with substance abuse disorders.

These patients aren't necessarily as aware of how their body is responding to the heat, making them more vulnerable, he explained.

Allin of the University of Kansas said patients with alcohol use disorders are particularly at risk because, besides diminishing awareness, booze also dehydrates.

In any case, the best way to get overheated patients back in shape is intravenous fluid and quick cooling -- which usually involves simple fans.

"It seems old school, but it's the most effective way," Allin said.

Physicians can also apply hypothermia vests, which many EDs now use to prevent poor neurological outcomes in cardiac arrest patients. They're cumbersome, though, and not as plentiful as fans, Allin explained, so most patients get the old remedy.

By the end of the week, the high-pressure system generating the massive blanket of heat will push eastward, sweeping temperatures in the 90s into the mid-Atlantic states by Friday.

Medical centers there are prepping for the potential onslaught, though some have already faced their share of heat-sick patients.

Rochester, N.Y., dealt with about 100 heat-related emergencies related to a weekend air show -- although the temperature was a more mild 85 to 92, according to Manish Shah, associate chair of the ED at the University of Rochester Medical Center: "definitely not as hot as what's coming to get us," he said.

Shah noted a recent commentary in BMJ that made significant headlines last week when it called into question the need to drink eight glasses of water a day.

"Whether that's true or not in the case of normal temperatures, it doesn't apply to extreme ones like this," Shah said. "You may need 10 glasses. You can guzzle water, but you're just going to be sweating it all out."

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