With triple-digit temperatures in the southern and southwestern areas of the United States, it makes sense that hospital emergency departments are reporting increased patient census figures associated with heat-induced conditions like heat stroke.
But, in Houston, the triple digits come with a triple healthcare threat to patients with chronic illnesses. The combination of extreme heat, high humidity and Sahara dust storms, R. Benjamin Saldaña, DO, medical director of Houston Methodist's emergency care centers, told Becker's, has created a "life-threatening" situation.
Similar to the way areas of the U.S. Northeast and Midwest are always ready to manage snowstorms with heavy equipment in the winter, southern hospitals are prepared for long periods of time when the thermometer stays pinned over 100 degrees.
However, this July has proven to be especially difficult, according to both Dr. Saldaña and Marjorie Bessel, MD, chief clinical officer at Phoenix-based Banner Health.
"Saharan dust particles, combined with humidity, will bring on small micron viruses," Dr. Saldaña said. "Having this knowledge prepares us; we know we are going to be dealing with more COPD and asthma patients and others with chronic illnesses at risk of further problems during this time."
Dr. Saldaña is advising his clinicians and patients to don their masks again to prevent complications that can arise from breathing in dust particles during the hot, humid conditions.
Dr. Bessel said her healthcare system's EDs are reporting well over 100 heat stroke patients a day. That's in addition to the patients coming in with chronic illnesses who are also affected by the extreme heat.
Additionally, Dr. Bessel said the sidewalks and pavement are so hot that fall victims, who otherwise might have only presented with fractures, now need to be treated for severe burns caused by possibly having to stay on the ground after a fall for a long period of time.
Banner Health EDs are equipped with multiple ways to rapidly cool patients while managing symptoms including confusion, which can add a new dimension to patient management.
Advice for ED leaders
In addition to providing expeditious care, Dr. Saldaña said ED leaders should remind their clinicians they are in the best position to educate patients — especially those who are treated and released back into the sweltering heat.
He said ED healthcare workers should take all opportunities to talk with patients about the safest times to be outside, the importance of wearing sunscreen, staying hydrated and taking advantage of air conditioning and public cooling stations when possible, to avoid the need to return to the hospital for additional heat-related care.
"Patients present with cramps, exhaustion, nausea, weakness and dizziness. These are very nonspecific complaints," Dr. Saldaña said. "Providers have to be aware that these signs could be heat exposure or something else. Tell patients they should be wearing masks if they are outside. Educate them about changing filters in their home more often in the summer to prevent those dust particles from getting into the air they breathe," Dr. Saldaña said.
These issues are obvious and apparent to doctors and nurses, but not to patients.
Banner Health, while not yet back at pre-COVID-19 staffing levels, has focused on making sure its EDs are fully staffed whenever possible. With a major focus on being a high reliability organization, she said, Banner Health is always looking to plan for whatever is coming next while also improving processes, including managing heat-related illnesses.
"There's always something. Whether it's an outbreak of an infection or extreme heat, we focus on serving our community with staff who are very skilled at what they do," Dr. Bessel said.
"My job is to create an environment where it's not hard for our frontline team to do the work that they need to do and to make sure they've got the equipment that they need to do it," she said.