Heat-related illnesses are getting worse

Since the 1960s, heat waves across 50 major U.S. cities have become more frequent, intense, and longer lasting on average. As extreme heat becomes more prevalent around the country, more people are becoming sick with heat-related illnesses.

High temperatures can lead to heat exhaustion, and in more extreme cases, heatstroke. While heat exhaustion can lead to headaches, nausea, or dizziness, heatstroke can cause hallucinations, seizures, organ failure, and coma.

Heat-related deaths have also increased every year for the past three years, reaching 1,708 deaths in 2022, according to CDC data. Even areas that are historically temperate, like the Pacific Northwest, have seen a sharp increase in heat-related deaths, with 650 deaths recorded in the United States and British Columbia in 2021.

Christopher Tedeschi, director of emergency preparedness at NYP-CUMC Emergency Medicine, noted that extreme heat, especially in areas not used to it, could potentially lead to a "mass casualty event," especially when temperatures stay high for several days or there are power outages.

"There's a domino effect," Tedeschi said. "When it gets that hot, more people present with cardiovascular events, more people present with respiratory problems, more people present with strokes. … Our emergency departments are dangerously overcrowded and that overcrowding is our biggest threat when dealing with a disaster. Hands down."

Overall, "[h]eat is just something we know we need to be really worried about," said Geoff Comp, an emergency medicine physician at Valleywise Health Medical Center.

How doctors are treating patients affected by extreme heat

As temperatures continue to rise across the United States, more people are coming into EDs with sunburns, heatstroke, and other heat-related conditions.

To treat patients affected by the heat, doctors must bring their temperature down quickly before more severe consequences, such as organ failure, set in. Some cooling methods include ice baths, keeping patients in wet clothes or gowns, or even body bags filled with ice.

According to Comp, body bags are ideal for treating patients with heatstroke since they are waterproof, can cool a person twice as fast, and can easily contain both a person being cooled and melting ice. The bag also has room for IV tubing, temperature probs, and intubation if necessary.

Although doctors say their EDs are not yet overwhelmed with patients, they are concerned that there will be a greater influx as temperatures stay high across different regions.

"In general, we're doing OK but during the heat of the day, it can often become overwhelming with the number of patients that are coming in," said Brian Hess, an ED medical director at multiple EDs at Abrazo Health in Arizona. "We're having to accommodate higher volumes of EMS traffic during those high heat periods."

Prevention is key

To prepare for extreme heat ahead of time, some hospitals have developed heat alert systems tied to heat-related warnings from the National Weather Service. These alerts help staff stock up on ice and other supplies needed to take care of heat patients.

Some clinics also have similar warning systems, which provide both physicians and patients with toolkits to help them understand heat-related health consequences and how to avoid them in the first place.

There are also community-based efforts to help people protect themselves against extreme heat. For example, Americares and the Harvard T.H. Chan School of Public Health's Center for Climate, Health, and the Global Environment partnered to create a toolkit called "Climate Resilience for Frontline Clinics" for community health centers and free clinics. So far, the toolkit has been downloaded more than 10,000 times, and 54 clinics have participated in training sessions for the resources.

Some cities, including New York and Portland, are also providing cooling assistance for eligible residents to get a portable air conditioner or fans if they don't already have them in their homes. Several localities are also offering low-income home energy assistance programs to help residents reduce their energy bills.

On an individual level, people can also protect themselves when they're out in the heat with these eight tips:

1.       Make sure to acclimate to the heat before you spend a long time outside

2.       Get hydrated and stay hydrated

3.       Remember that cars heat up quickly

4.       Remember that certain medications, such as blood pressure drugs and sedatives, don't mix well with heat

5.       Don't ignore signs of heat-related illness, including sweating, dizziness, and fatigue

6.       Know when medical attention is necessary

7.       Wear loose, light clothing when you're outside

8.       Avoid alcohol, which can dehydrate you more quickly in the heat

(Evans, Wall Street Journal, 7/18; Pennar, STAT, 7/18; Syal, NBC News, 7/14)

We know that climate change is a public health problem—and now, health care leaders are getting a better understanding of how their own organizations are contributing to the problem. Radio Advisory's Rachel Woods sat down with  Advisory Board's Miles Cottier to discuss the state of climate change and why health care leaders shouldn't wait for government action to start making progress.  Read a lightly edited excerpt from the interview and listen to the episode below.