Healthcare facilities asked to set up heat wave response centres

Islamabad:The Islamabad District Health Office has directed all the in-charges and medical officers of the healthcare facilities serving under the health office to open ‘Emergency Heat Wave Response Centre’ seven days a week, during the heat wave period.

The letter issued by District Health Officer Islamabad Dr. Muhammad Zaeem Zia states that the months of May to July are extremely hot in Pakistan and are coupled with heat waves due to global warming and climate change. The mortality and morbidity attributable to heatstroke may increase and it is pertinent to take immediate necessary measures in this regard.

Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature. The body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. When heat stroke occurs, the body temperature can rise from 103 degree Fahrenheit to 106 degree Fahrenheit within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not given.

The DHO explains that the common clinical features of heat stroke include profuse sweating or the absence of sweating with hot red or flushed dry skin, weakness/lethargy, chills, throbbing headache, high body temperature, hallucinations, confusion, dizziness and slurred speech. The letter further states that infants, elderly persons, athletes and outdoor workers are at high risk of heat stroke and therefore all the healthcare facilities are directed to setup ‘Emergency Heat Wave Response Centres’ that will remain open seven days a week, during the heat wave period and nominate focal persons and ensure the availability of relevant staff at the centre.

The DHO directed the in-charges to hold meetings with the health facility staff regarding preparation and coordinate with the facility ambulance or Rescue Service 1122. The health facility staff should be trained by the in-charge medical officers on emergency management of heat stroke patients. Ensure availability of the essential supplies at the health facilities including

Oral fluids, ORS, IV Fluids, ice packs, emergency life saving medicines, cotton rolls and gauze pads for sponging, asked the DHO.

The DHO said that the patients must receive immediate treatment and management in case of symptoms. If a person shows symptoms of heat stroke, he or she should be immediately moved to a cooler environment. Put him or her in a horizontal position and elevate legs and hips, remove unnecessary clothing and initiate external cooling, for example, by placing cold packs on the neck, armpits and groin, fanning continuously and spraying the skin with water at 25 to 30 degree centigrade. Measure the body temperature. Do not give acetylsalicylic acid or paracetamol. Position an unconscious person on his or her side. Maintain the IV line immediately as severe cases often require intravenous rehydration. Promote sweat evaporation by placing the patient before the fan and ice packs under the armpits and groin. If the patient is able to drink liquids, he or she should be given plenty of water in sitting position, said Dr. Zaeem Zia.

The letter added that the staff must monitor the body temperature with a thermometer and continue cooling efforts until the body temperature drops to 101 to 102 degree Fahrenheit. Antipyretics may be given once the body temperature drops to 101 degree Fahrenheit or below. Health facility staff must monitor vitals including blood pressure and oxygen saturation while managing a patient, the letter states.