Heat Illnesses: Nursing Essentials from a NYC Emergency Department

As complex as health care may be in an emergency department (ED) setting, the weather and seasonality have added additional variables to that complexity. It is critical that registered nurses in the ED understand the health care trends associated with the weather and seasons. As in many other places, the summer here in New York City is a time when people are more active, spending time outdoors and traveling. This summer we have experienced several stretches with temperature in the high 90 degrees. July recently had a seven-day stretch with temperatures nearing and exceeding 100 degrees in New York. These heat waves can become physiologically unbearable.

Jonathan Nover, MBA, RN

Who is most vulnerable to heat illness?

During these heat waves, it is important to recognize the pockets of vulnerability among us. Older adults are often the most vulnerable because of decreased capacity to thermoregulate in response to changes in temperature. It is also important to consider the effects of heat on the homeless community and people without access to air-conditioned environments. Children are more susceptible to heat illness than adults. Some medications, such as diuretics, and consumption of alcohol and illicit drugs can increase a person’s risk of heat exhaustion. Additionally, individuals who perform strenuous […]

Heatstroke in Older Adults: A Short Step from Heat Exhaustion

Signs and Symptoms of Heat Illness Signs and Symptoms of Heat Illness

Older adults tend to be more vulnerable than younger adults in a number of ways, one of which is in their reaction to intense heat.

Given the increase in extreme weather events in recent years, an article that we published a few years back, “Heatstroke in Older Adults” (free until September 1), is as timely now as ever. A high percentage of heat-related deaths in the U.S. occur among people who are 65 or older. Here are some of the reasons:

Older adults’ normal temperature-regulating processes may be impaired by illnesses such as diabetes or cardiovascular disease or by medications such as vasoconstrictors or diuretics, leaving them more vulnerable to heat exhaustion, which can progress to heatstroke, a far more dangerous condition. Those who are immobilized or suffer from disorientation secondary to dementia may fail to recognize dangerous symptoms or to drink appropriate types and amounts of fluids or move to a cooler location. Isolation, which is also frequently associated with heat injury, is common among older adults, particularly in cities, which are more susceptible to extreme heat waves because they create ‘heat islands,’ where surface and air temperatures are as much as 10°F higher than those in surrounding areas.

This short article gives nurses essential information on:

Can School Nurses Help Prevent Heat Stroke Fatalities in High School Football?

Shawn Kennedy, MA, RN, AJN editorial director & interim editor-in-chief

by Bludgeoner86, via Flickr

Earlier this month, Diana Mason, AJN’s editor-in-chief emeritus, wrote here about head injuries in soccer. A related news story about high school sports should make all school nurses, coaches, and parents take notice: student athletes suffer—and sometimes die—from heat stroke during intense workouts in hot weather.

According to an Associated Press report, Fred Mueller, director of the National Center for Catastrophic Sports Injury Research at the University of North Carolina, attributes 39 deaths since 1995 to heat-related causes. And that doesn’t count three deaths this past summer that he notes may also be associated with heat stroke.

Most of the deaths are associated with football preseason training in August. My middle son played high school football and every August he went to “preseason camp.” He and his teammates slept on air mattresses in the non-air-conditioned high school gym, and spent the last week of summer vacation in grueling drills and practices, wearing shorts, T-shirts, shoulder pads, and helmets. One year he arrived home looking thin and gaunt. He related stories of teammates vomiting on the sidelines during practices and of restricted water breaks. It took a player fainting during one session and an onslaught of parent complaints and pressure […]

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