Summer brings high temperatures. Without exercising caution, extreme heat can prompt health difficulties.
Dr. Andrew Repasy discusses signs of heatstroke, how to address it, and tips for avoiding it.
Selected Podcast
How to Avoid Heatstroke
Featuring:
Andrew B. Repasy, MD
Andrew B. Repasy, MD is a board-certified doctor specializing in internal medicine. He is also the Clinical Assistant Professor of Medicine, at the Feinberg School of Medicine at Northwestern University. Transcription:
Bill Klaproth (Host): Summer brings high temperatures. Without exercising caution, extreme heat can prompt health difficulties. Here to talk with us about signs of heat stroke, how to address it and tips for avoiding it is Dr. Andrew Repasy, a physician specializing in geriatric medicine who works with older adults at Chicago Methodist Senior Services. Dr. Repasy, thanks for your time. Why are older adults more prone to heat related health problems?
Andrew Repasy, MD (Guest): Well there’s several reasons. One is they don’t perceive the heat as well as younger folks. So, your temperature can go up and old folks just don’t feel the heat and so the temperature rises, the central body temperature rises and before you know it, they can actually be in critical condition and that can be a real concern for them.
Bill: Dr. Repasy, do they sweat like a younger person does? I know sweat helps cool the body down. For an older person, do they sweat as much as a younger person?
Dr. Repasy: Actually, no, they don’t. So, that’s one of the physiologic mechanisms that leads to heat stroke in the elderly. So, there are changes in temperature perception, there is limited mobility with consequent inability to take appropriate measures such as removing heavy clothing and moving to a cooler environment and increasing fluid intake and that sort of thing. And old folks are on a bunch of medications too, so congestive heart failure, COPD, emphysema; all those things can affect the heat stroke burden on the elderly.
Bill: Those people then would have a higher risk of heat stroke than others due to illness, being overweight and being on certain medications.
Dr. Repasy: Absolutely. In fact, when you look at studies that have been done on heat stroke; the vast majority of people who die are over the age of 65. It is something like 80% of people over the age of 65 that die of heat stroke and so, it’s a real issue for them.
Bill: So, Dr. Repasy, what are the signs of heat stroke?
Dr. Repasy: Well, that’s a good question. First of all, heat stroke happens during as you said, elevated temperatures and usually that means daytime temperature readings of over 90 degrees Fahrenheit during the day and evening temperatures over 80-81. What will happen is the elderly will become confused essentially. And the important thing for other folks to recognize is if the elderly are confused in high temperatures, that can very likely be a sign of heat stroke. And the very important thing about that is if they don’t get treatment very quickly; that could lead to death in 12-24 hours.
Bill: So, it’s really important to monitor this closely and watch out for this in your loved ones.
Dr. Repasy: Exactly. And really the elderly don’t know it. Half the time or most of the time, they really don’t recognize it. So, they can become confused and die and nobody will know what happened. But if you check on them periodically, if you look at the weather report, you know they are going – you know there is going to be a heat wave coming, especially if they are in a high rise in cities, actually they are worse. The higher you are in a building, the worse the temperature gets. There’s the heat island effect of cities, the lack of trees, the lack of vegetation; it increases the temperature in the cities especially. And folks that don’t have air conditioning, are really at risk for this. Especially if they live alone. Because they just don’t recognize what’s going on with them. If they are alone; that’s a problem.
Bill: If you recognize heat stroke in a loved one; how should you address it?
Dr. Repasy: I mean really the best thing to do is to call 9-1-1. That’s really about the only thing. It’s interesting, fans and evaporative cooling like alcohol baths and stuff; don’t really help these folks. They really need to be immersed in cold water and cold packs and that has to happen pretty quickly. So, really 9-1-1 is the important thing and hopefully the 9-1-1 folks will recognize that this could be heat stroke and can take appropriate action as well because again, if they don’t, there’s a very high chance these folks can die.
Bill: So, try to get them into a cool place if possible or like you said, a cold washcloth on the head or something call 9-1-1 to try to get that temperature down as quickly as you can and obviously the medical professionals, the ambulance paramedics, I mean if it’s hot in there, hopefully they will figure that out. So, that makes sense. Call 9-1-1 if you suspect heat stroke and get help as soon as possible so you can take those measures to try to get that body temperature down. So, Dr. Repasy, can you share with us some tips, how to avoid heat stroke?
Dr. Repasy: Well, certainly knowing what the weather is going to bring is an important factor. Getting into a cool environment as you pointed out, makes a big difference. Aid conditioning does make a difference. It’s interesting that in the past, right around I like somewhere around 1980 or so, nursing homes were required to have air conditioning and so it’s – people in nursing homes used to die of heat stroke but subsequently, as waves hit the cities, nursing home residents were fairly protected, and it was the people in the communities that heat. So, air conditioning does make a difference. Increasing fluid intake. Even if you don’t think you need to; fluid intake is very important, making sure people have access to water, juice, and not alcohol, that is actually opposite because that causes diuresis and actually exacerbates the heat stroke. But water and juice and milk and tea and stuff like that can really help. And they have to be encouraged to eat and drink because as I said before, they don’t really recognize that they are having a problem. So, those are really the main things.
Bill: Well, that would make it very difficult for a senior not being able to recognize the symptoms. Now I know you mentioned earlier watch out for daytime temps over 90, nighttime temps over 80. What’s your best advice for children who may have an older parent living alone as you have been talking about, how often should they check on them during extreme heat and again, what should they closely look out for?
Dr. Repasy: I would say that they should probably call them at least two or three times a day if not more frequently. If they know the person is living in a situation where they might experience heat stroke, they should call them frequently. If they have access to bringing them into their own house where they have air conditioning that would be great. If they live out of town; that’s a problem. Calling them and making sure that the person does have access to fluids and really talk to them as you would just normally talk to them and make sure that they are making sense because just not making sense is one of the first things that can happen. So, those are really the main things.
Bill: Okay Dr. Repasy. Well thank you for sharing that with us so, most importantly if they don’t have air conditioning; bring them to your house or get them in a location where there is air conditioning and make sure that they keep drinking water, juice etc. and make sure they keep eating as well. Alright Dr. Repasy, thank you so much for your tips today. We appreciate it. To learn more or to book a tour, please visit www.cmsschicago.org, that’s www.cmsschicago.org. This is Living Well with Chicago Methodist Senior Services. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): Summer brings high temperatures. Without exercising caution, extreme heat can prompt health difficulties. Here to talk with us about signs of heat stroke, how to address it and tips for avoiding it is Dr. Andrew Repasy, a physician specializing in geriatric medicine who works with older adults at Chicago Methodist Senior Services. Dr. Repasy, thanks for your time. Why are older adults more prone to heat related health problems?
Andrew Repasy, MD (Guest): Well there’s several reasons. One is they don’t perceive the heat as well as younger folks. So, your temperature can go up and old folks just don’t feel the heat and so the temperature rises, the central body temperature rises and before you know it, they can actually be in critical condition and that can be a real concern for them.
Bill: Dr. Repasy, do they sweat like a younger person does? I know sweat helps cool the body down. For an older person, do they sweat as much as a younger person?
Dr. Repasy: Actually, no, they don’t. So, that’s one of the physiologic mechanisms that leads to heat stroke in the elderly. So, there are changes in temperature perception, there is limited mobility with consequent inability to take appropriate measures such as removing heavy clothing and moving to a cooler environment and increasing fluid intake and that sort of thing. And old folks are on a bunch of medications too, so congestive heart failure, COPD, emphysema; all those things can affect the heat stroke burden on the elderly.
Bill: Those people then would have a higher risk of heat stroke than others due to illness, being overweight and being on certain medications.
Dr. Repasy: Absolutely. In fact, when you look at studies that have been done on heat stroke; the vast majority of people who die are over the age of 65. It is something like 80% of people over the age of 65 that die of heat stroke and so, it’s a real issue for them.
Bill: So, Dr. Repasy, what are the signs of heat stroke?
Dr. Repasy: Well, that’s a good question. First of all, heat stroke happens during as you said, elevated temperatures and usually that means daytime temperature readings of over 90 degrees Fahrenheit during the day and evening temperatures over 80-81. What will happen is the elderly will become confused essentially. And the important thing for other folks to recognize is if the elderly are confused in high temperatures, that can very likely be a sign of heat stroke. And the very important thing about that is if they don’t get treatment very quickly; that could lead to death in 12-24 hours.
Bill: So, it’s really important to monitor this closely and watch out for this in your loved ones.
Dr. Repasy: Exactly. And really the elderly don’t know it. Half the time or most of the time, they really don’t recognize it. So, they can become confused and die and nobody will know what happened. But if you check on them periodically, if you look at the weather report, you know they are going – you know there is going to be a heat wave coming, especially if they are in a high rise in cities, actually they are worse. The higher you are in a building, the worse the temperature gets. There’s the heat island effect of cities, the lack of trees, the lack of vegetation; it increases the temperature in the cities especially. And folks that don’t have air conditioning, are really at risk for this. Especially if they live alone. Because they just don’t recognize what’s going on with them. If they are alone; that’s a problem.
Bill: If you recognize heat stroke in a loved one; how should you address it?
Dr. Repasy: I mean really the best thing to do is to call 9-1-1. That’s really about the only thing. It’s interesting, fans and evaporative cooling like alcohol baths and stuff; don’t really help these folks. They really need to be immersed in cold water and cold packs and that has to happen pretty quickly. So, really 9-1-1 is the important thing and hopefully the 9-1-1 folks will recognize that this could be heat stroke and can take appropriate action as well because again, if they don’t, there’s a very high chance these folks can die.
Bill: So, try to get them into a cool place if possible or like you said, a cold washcloth on the head or something call 9-1-1 to try to get that temperature down as quickly as you can and obviously the medical professionals, the ambulance paramedics, I mean if it’s hot in there, hopefully they will figure that out. So, that makes sense. Call 9-1-1 if you suspect heat stroke and get help as soon as possible so you can take those measures to try to get that body temperature down. So, Dr. Repasy, can you share with us some tips, how to avoid heat stroke?
Dr. Repasy: Well, certainly knowing what the weather is going to bring is an important factor. Getting into a cool environment as you pointed out, makes a big difference. Aid conditioning does make a difference. It’s interesting that in the past, right around I like somewhere around 1980 or so, nursing homes were required to have air conditioning and so it’s – people in nursing homes used to die of heat stroke but subsequently, as waves hit the cities, nursing home residents were fairly protected, and it was the people in the communities that heat. So, air conditioning does make a difference. Increasing fluid intake. Even if you don’t think you need to; fluid intake is very important, making sure people have access to water, juice, and not alcohol, that is actually opposite because that causes diuresis and actually exacerbates the heat stroke. But water and juice and milk and tea and stuff like that can really help. And they have to be encouraged to eat and drink because as I said before, they don’t really recognize that they are having a problem. So, those are really the main things.
Bill: Well, that would make it very difficult for a senior not being able to recognize the symptoms. Now I know you mentioned earlier watch out for daytime temps over 90, nighttime temps over 80. What’s your best advice for children who may have an older parent living alone as you have been talking about, how often should they check on them during extreme heat and again, what should they closely look out for?
Dr. Repasy: I would say that they should probably call them at least two or three times a day if not more frequently. If they know the person is living in a situation where they might experience heat stroke, they should call them frequently. If they have access to bringing them into their own house where they have air conditioning that would be great. If they live out of town; that’s a problem. Calling them and making sure that the person does have access to fluids and really talk to them as you would just normally talk to them and make sure that they are making sense because just not making sense is one of the first things that can happen. So, those are really the main things.
Bill: Okay Dr. Repasy. Well thank you for sharing that with us so, most importantly if they don’t have air conditioning; bring them to your house or get them in a location where there is air conditioning and make sure that they keep drinking water, juice etc. and make sure they keep eating as well. Alright Dr. Repasy, thank you so much for your tips today. We appreciate it. To learn more or to book a tour, please visit www.cmsschicago.org, that’s www.cmsschicago.org. This is Living Well with Chicago Methodist Senior Services. I’m Bill Klaproth. Thanks for listening.