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At least 68 people are suspected of dying in Palia, Uttar Pradesh amid an ongoing heat wave, and as the Union Health Minister, Dr Mansukh Mandavia, reviews public health preparations and action plans, there are questions as to whether these deaths are heat-related. or not. Authorities said the deaths occurred in the preexisting and co-morbid patients, and while a strong link to temperatures could not be proven, experts believe vulnerable groups are more likely to feel the effect of the heat.
For comparison, there were 30 heat-related deaths reported in 2022 according to IMD. While the deaths were reported in Uttar Pradesh, it was parts of Jharkhand, Chhattisgarh, Bihar, Odisha, coastal Andhra Pradesh, and some places in eastern Madhya Pradesh and West Bengal that saw temperatures more than 5 degrees Celsius above normal. Eastern Uttar Pradesh saw temperatures 3 to 5 degrees Celsius above normal, according to the Indian Meteorological Department. So let’s understand what a heat wave is and most importantly what it does to the human body.
According to the Ministry of Health, a heat wave condition includes a maximum temperature of at least 40°C or more for plains, 37°C or more for coastal stations, and at least 30°C or more for mountainous areas. The following criteria are used to declare a heat wave:
Based on a departure from Plain
Heat Wave: Temperature ranges from 4.5°C to 6.4°C
Extreme heat wave: departure from the normal range > 6.4 ° C
Based on actual maximum temperature (plains only)
Heatwave: When the actual maximum temperature is ≥ 45°C
Extreme heat wave: When the actual maximum temperature is ≥47°C
What are the different heat-related illnesses? Why do you happen?
Heat-related illnesses include a range of disorders from muscle cramps and heat exhaustion to a more serious medical emergency such as heatstroke. These diseases occur when there is a disturbance in the regulation of body temperature due to an increase in heat input from the environment and metabolism in the body compared to the output from the skin – through radiation, evaporation and convection.
“First and foremost, we must understand the advantages of sweating or cooling the surface of the skin when the environment temperature exceeds the temperature of the human body. That is when the blood vessels close to the skin open up to absorb the cold. But when sweating does not occur and when you are exposed to high heat, the body temperature increases.” This is when it begins to affect our organs.As blood flow increases to the skin cells, there is increased pressure on the heart, causing it to beat rapidly, up to 10 beats per minute for every 0.5°C rise in core temperature. This is when you have a rapid pulse and a feeling of restlessness. In an effort to calm the body down, muscle and nerve tissues slow down, causing fatigue, headache, nausea and even vomiting. The worst is a complete electrolyte imbalance, which can overwhelm elderly patients in particular. If the degree persists If the core body temperature rises beyond 40°C, the organs begin to shut down as the body becomes more inflamed.The heart may go into shutdown and kidney function may be impaired.This means that toxins cannot be adequately eliminated by the malfunctioning kidneys and they build up in the body. body,” says Dr. Tarun Sahani, Senior Consultant, Internal Medicine, Indraprastha Apollo Hospitals, New Delhi.
There are different phases of a heat wave that affect your body.
Heat stress and thermoregulation: “When exposed to high temperatures, the body’s natural response is to maintain its core temperature through a process called thermoregulation. Under normal circumstances, the body cools itself through sweating and evaporation, allowing excess heat to dissipate. However, prolonged exposure to heat High temperatures can overwhelm these mechanisms, causing dry skin, which leads to heat stress,” explains Dr. Sahani.
Dehydration and electrolyte imbalance: When the body sweats excessively to cool down, it loses vital fluids and electrolytes. Dehydration can upset the balance of electrolytes such as sodium, potassium and magnesium, which are essential for the proper functioning of muscles, nerves and body systems. Electrolyte imbalances can lead to muscle cramps, weakness, dizziness, and even heart complications.”
heat exhaustion If the body’s thermoregulatory mechanisms fail to keep up with the excess heat, heat exhaustion can occur. This condition is characterized by symptoms such as excessive sweating, fatigue, nausea, dizziness, headache, and rapid heartbeat. Dr. Sahani explains that heat exhaustion is a warning sign that the body is struggling to deal with the heat, and immediate intervention is essential to prevent it from progressing to heatstroke.
sunstroke: This occurs when prolonged exposure to high heat raises the core body temperature to 40°C (104°F). Heatstroke can lead to failure and damage to many organs, affecting the brain, heart, liver, and kidneys. Symptoms include confusion, seizures, loss of consciousness, hot and dry skin, and a rapid and strong pulse. Heatstroke requires immediate medical attention because it can be fatal if not treated promptly.
What are the signs and recommended treatment for heat cramps?
During heat cramps, patients experience spasmodic, involuntary, painful contractions of skeletal muscles – the muscles of the calves, thighs, and shoulders. The patient is advised to rest in a comfortable environment. The Department of Health also recommends fluid and salt replacement (oral).
What is the clinical presentation of heat stress? What is the recommended treatment?
The patient may experience one or more of the following symptoms:
Headache, nausea, vomiting
tiredness and dizziness
muscle cramps
It may progress to heatstroke if it fails to improve with treatment
The Ministry of Health recommends the following:
Remove the patient from the heat stress area.
If there is no response to treatment within 30 minutes, vigorously cool the patient to a core temperature of 39°C
What are the symptoms of heatstroke and what treatment is recommended?
The patient presents with one of the following:
Core body temperature over 40°C
Signs of central nervous system impairment with confusion, delirium, seizures, and coma
The Ministry of Health recommends the following:
Remove the patient from the heat stress area.
If there is no response to treatment within 30 minutes, cool the patient vigorously to a core temperature of 39°C.
What are the commands and prohibitions
The Department of Health has a comprehensive set of guidelines that can protect everyone.
(1) Stay indoors and in shady places.
(2) Use an umbrella/hat/cap/towel when you are outside.
(3) Wear thin, loose cotton clothing and light-colored clothing.
(4) Drink water and salty drinks frequently – lassi, lemon water, fruit juices, ORS (oral rehydration solution). Eat fruits such as watermelon, cucumber, lemon, orange and others.
(5) Take frequent cold showers and reduce room temperature: use window blinds/blinds, fan, cooler, air conditioner, cross-ventilate room, spray water, and keep indoor plants.
(6) Those who feel unwell, especially the elderly, children, pregnant women, those with pre-existing medical conditions, and those working outdoors, should be immediately moved to a cooler place, wear minimal clothing, sponge them with cold water, and apply ice packs. Wrapped in a piece of cloth and taken to the nearest health facility.
Caveats:
Do not go out in the sun, especially between 12 noon and 3 pm
Avoid strenuous activities when you are outside in the afternoon.
Avoid drinking alcohol, tea, coffee and soft drinks
Do not leave children or pets in parked cars.
Avoid wearing dark, synthetic and tight clothes.
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