Health Advisory: Be vigilant for heat related illnesses during potentially dangerous heat wave

July 9, 2024

Action Requested 

• Be aware that the National Weather Service has forecast a potentially dangerous long-duration heat event for Washington State and the Western U.S., which began July 5 and has since been extended. Elevated daytime temperatures and limited cooling at night may pose a moderate to major risk for heat-related illnesses. 
  • Providers across Washington should be alert for patients presenting with heat-related illnesses and be aware that heat can worsen existing chronic health and mental health conditions. Providers should educate high-risk patient populations on how to reduce their risk for heat-related complications.
• Providers should be aware that certain groups are at elevated risk of developing heat-related illnesses or other complications during extreme heat events:
  •  People without access to Air Conditioning (AC)
  •  Older adults (65+)
  •  People who are pregnant
  •  Infants and young children
  •  People with chronic illnesses, such as asthma, heart disease, and diabetes
  •  People taking medications that can effect thermoregulation 
  •  People who are unhoused
  •  People with substance use disorder or people who consume large amounts of alcohol 
  •  People who are socially isolated or have limited mobility
  •  People who spend time outdoors, such as construction workers, agricultural workers, and outdoor athletes
• Providers should maintain a low threshold when evaluating patients for heat-related illnesses, and ask patients about their exposure to heat.
• Providers should screen patients presenting to care for heat-related illnesses, including:
• Heat Stroke (a life-threatening medical emergency)
  • Hyperthermia/High body temperature (103°F or higher)
  • Tachycardia/Elevated pulse
  • Hot, red, dry, or damp skin
  • Headache
  • Dizziness
  • Nausea
  • Mental status changes/confusion
  • Syncope/Fainting
• Heat Exhaustion
  • Heavy sweating
  • Tachycardia/Elevated pulse
  • Cold, pale, and clammy skin
  • Nausea or vomiting
  • Muscle cramps
  • Tiredness or weakness
  • Dizziness
  • Headache
  • Syncope/Fainting
• Flyers with guidance for keeping cool and knowing signs of heat-related illness can be downloaded and printed in the following languages: English, Amharic, Arabic, Chinese, Hindi, Japanese, Khmer, Korean, Marshallese, Punjabi, Russian, Spanish, Tagalog, Ukrainian, Vietnamese
• Inform patients, family members, and patient care teams about 
  • Signs and symptoms of heat illness; when to call 9-1-1 or seek urgent care
  • The potential impact of heat on medications, including proper storage and safe administration 
  • When clinically appropriate, encourage patients to maintain hydration or increase fluid intake
  • How to find Cooling Centers. The Snohomish County Public Safety Hub has a list and map of cooling centers in the county at www.snoco.org/cooling. Statewide, people can dial 2-1-1 during business hours, or visit wa211.org any time for lists of Extreme Weather Shelters and Cooling Centers.  
• Develop medication plans following CDC’s Heat and Medication – Guidance for Clinicians (cdc.gov). Some medications interfere with thermoregulation and/or fluid balance, amplifying the risk of harm from hot weather (e.g. diruetics, some antipsycotic medications, some antidepressants, some antihypertensive agents). 

Background

Extreme heat is the deadliest weather-related hazard in the United States. Washington summers are getting longer, hotter, and potentially more dangerous. Extreme heat events (heat waves) are predicted to happen more often and last longer due to climate change. Heat-related deaths are 100% preventable.

Resources

• Snohomish County Public Safety Hub: www.snoco.org/cooling 
• Snohomish County Health Department Weather and Health page: www.snohd.org/weather 
• WA DOH Hot Weather Safety Page: Extreme Heat | Washington State Department of Health
• WA DOH Seasonal Hazard Dashboard: Seasonal Hazards Dashboards 
• National Weather Service (NWS): National Weather Service
• NWS/NOAA Heat Risk Map: NWS HeatRisk 
• CDC HeatRisk Tool: HeatRisk | Tracking | NCEH | CDC
• Washington 2-1-1 List of Cooling Centers: Extreme Heat Cooling Centers
• Heat.gov resources: National Integrated Heat Health Information System