John: With no end in sight to
the extreme heat gripping much
of the nation, the sizzling
temperatures can quickly become
hazardous, and in some cases,
deadly.
Ali rogin reports on how
emergency rooms are dealing with
an influx of patients with
heat-related issues.
Ali: Sweltering temperatures
continue to scorch parts of the
U.S., with millions under heat
alerts coast to coast.
In Phoenix, Arizona, the heat
has reached 110 degrees for more
than 20 consecutive days,
inspiring some creative
challenges on social media.
>> Only eating foods I cook
outside in Arizona for a day.
>> Into the oven you go.
See you tonight.
5 hours later.
Wow.
Real cookies.
Warm out of the oven.
Ow. Cheers.
Ali: But the record highs can be
dangerous for anyone exposed to
the heat for too long.
In the past week, there have
been thousands of heat related
emergency room visits across the
country.
Dr. Aneesh narang is an
emergency medicine physician at
banner university medical center
in Phoenix.
Dr. Narang, thank you so much
for joining us.
Tell me about what you're seeing
from patients who come in
because of heat related
conditions.
Dr. Narang: Yeah, thanks for
having me.
So we're seeing quite a spectrum
of heat related illnesses, as we
normally do this time of the
year.
And it really exists on a
continuum.
So we have some that have mild,
I would say, heat related
illnesses such as dehydration,
cramps, heat rash, swelling.
And then unfortunately, now
we're seeing several cases of
patients presenting with the
most severe form of heat related
illnesses, which is a heat
stroke. And unfortunately, we
are seeing many, many patients
every day with us.
Ali: Is it more than you've seen
in previous years since you've
been doing this work, or has it
been about the same?
Dr. Narang: Yeah, I mean, I
think we're still waiting for
the sort of official numbers to
come in, but I think there's
some indication that prehospital
calls for heat related illnesses
are definitely up compared to
last year.
And I would certainly say over
the last several years, we're
seeing a lot more of this.
No question.
I think last year, it was marked
in the numbers we saw in,
unfortunately, you know, 425
people in our community died of
heat related illnesses.
And now we're seeing numbers, I
think, that are very similar, if
not more to this point. And we
still have a long way to go.
Ali: Walk us through how high
temperatures affect the body.
I think we all know inherently
that that's the case.
But I'm curious if you can take
us through how it works.
Dr. Narang: Yeah, I mean, I
think at the sort of microscopic
level, it is damaging cells and
it's inactivating proteins and
harming DNA.
So things that we need to live,
to breathe, to function, how
that manifests it for symptoms
is varied, of course, but I
would say heat exhaustion is the
first clue that something is
wrong.
If heat exhaustion, you start to
feel lightheaded, dizzy, you
have headaches, you may be
vomiting, you may feel that
you're going to pass out.
And if you don't get into a cool
environment quickly, get
undressed, cool down as fast as
you can, then you're really at
risk of developing heat stroke.
And really, what's happening
here is, our body's ability to
thermoregulate is impaired.
We are no longer able to do that
when you reach temperatures that
high.
And certainly, there's a lot of
factors to that.
Your ability to sweat, dilating
your blood vessels, all those
things help promote heat loss.
And now, you can't do that when
you get to such high
temperatures, and you can't get
help right away.
And then, heat stroke is the
most severe form, unfortunately,
heat-related illness.
By that time, patients are
confused, and they may not be
able to talk to you.
They may have seizures.
So that is what we're seeing,
unfortunately, right now every
day.
Ali: And what are the methods
you use to treat these various
things?
I would imagine that by the time
you're coming to the E.R., it's
not simply about cooling people
down.
Dr. Narang: Yeah.
So certainly, rapid cooling,
though, is a huge intervention
for us, and what we focus on.
But while we're doing that, we
also have to support their
breathing.
We've got to replace the fluid
losses, and we have to treat any
complications that come along
the way.
So patients who have heatstroke,
usually that's above 104
degrees, we are rapidly cooling
them.
There's many ways to do this.
I would say the most effective
way that we can do in a hospital
setting is really what we call
ice immersion therapy.
We are putting them in a bag. We
are pouring ice with some water
that can rapidly cool their
temperature back to normal or
-- core temperatures within
minutes.
If we don't do that quickly,
there's a greater chance of
short term mortality, long term
effects on your organs and your
brain.
So that is our focus.
There are many other ways to
cool patients down.
Ice packs in the groin, the
axilla, the neck, fans, spraying
with lukewarm water just promote
evaporative cooling.
But I would say the most
effective and quickest way is
ice immersion therapy.
Ali: How do you think emergency
rooms should adjust their
protocols for these sorts of
emergencies given that they seem
to be on the rise?
Dr. Narang: Yeah, I think the
most important thing, and
luckily, in the valley here in
Phoenix, I think we're all very
prepared for the summer season,
is, you have to have protocols
in place for this to be
effective.
You have to have everything in
sort of one drawer, one area,
the emergency room that you
know, you can reach to with the
appropriate monitoring, with the
ice, with the appropriate bags
and equipment.
And you have to have protocol in
place before hypothermia season
kicks in. And your staff -- it
takes a total team effort to
make this effective.
Everybody has to be on board and
understand the steps we have to
do.
If you have any delay in rapidly
cooling these patients, any
delay of 20 or 30 minutes or
more, now we become -- now we're
behind the eight ball, and now
we're talking about severe long
term effects, as well.
Or they may not make it,
unfortunately.
So if we protocolize things, and
have everyone in our staff
understanding how this works, we
are set up for success.
Ali: And these record
temperatures are expected to
last through the rest of the
summer. So how can people stay
safe?
Dr. Narang: Well, I think we
always advise patients.
You know, I think it's important
for us in the medical community
and the public health community
to continue to educate the
public.
If you need to be outdoors, go
early in the morning -- 4:00 in
the morning, 5:00 in the
morning, when temperatures
aren't so hot anymore.
But if you can't, stay indoors.
If you don't have an air
conditioning unit, go to the
mall, go to the free public
library.
As much as time is spent in the
air conditioned indoor space,
the better off you will be.
You need to start off the day
drinking water.
If you enjoy a cup of coffee,
have a glass of water with it.
You've got to continue to
maintain your hydration
throughout the day. You know,
wear loose fitting clothes,
apply sunscreen, do everything
you can, though, to not be
outside during the peak peak
hours in the day when we see the
temperatures scorching here.
Ali: Dr. Aneesh narang with
banner university medical center
in Phoenix, thank you so much
for your time.
Dr. Narang: Thank you.
♪♪