ISLAMABAD: All medical health facilities under the District Health Office Islamabad have been directed to set up emergency ‘heatwave response centres’ that will remain open seven days a week.

In a letter, the District Health Office directed the centres to nominate focal persons and ensure availability of relevant staff besides training them by in-charge medical officers on the emergency management of heatstroke patients.

They were further asked to ensure availability of essential supplies at the health facilities, including ORS, fluid, icepacks, emergency life-saving medicines and cotton rolls/gauze pads for sponging.

Patients must receive immediate treatment/management, including moving them to a cooler environment which should be indoors with air conditioner or at least into the shade.

Essential supplies should be made available, training of staff on management of heatstroke patients be ensured, letter says

If a person shows symptoms of heat stroke, put them 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 25–30°C, measure the body temperature and do not give acetylsalicylic acid or paracetamol. The letter stated: “Maintain the IV line immediately as severe cases often require intravenous rehydration. Promote sweat evaporation by placing the patient before fan and icepacks under the armpits and groin. If the patient is able to drink liquids, he/she should be given plenty of water in sitting position. Monitor the body temperature with a thermometer and continue cooling efforts until the body temperature drops to 101°F to 102°F. Antipyretics may be given once the body temperature drops to 101°F or below. Monitor vitals.’

The letter said May, June and July are extremely hot in Pakistan and are coupled with heatwaves due to global warming and climate change. The mortality and morbidity attributable to heatstroke may increase. It is pertinent to take immediate necessary measures in this regard.

Heatstroke 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 heatstroke occurs, the body temperature can rise from 103°F up to 106F within 10 to 15 minutes. Heatstroke can cause death or permanent disability if emergency treatment is not given.

Common clinical features of heatstroke 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.

Infants, elderly persons, athletes and outdoor workers are at high risk for heatstroke.

The letter said heat/sunstroke is a preventable condition and common preventive measures include avoiding going outside during the hottest time of the day. If you must do strenuous activity, do it during the coolest part of the day which is usually in the morning between 4am and 7am, stay in the shade, do not leave children or animals in parked vehicles.

Besides, drink plenty of water while limiting time in direct sunlight in hot/humid weather or in places with high environmental temperatures, avoid becoming dehydrated and refrain from vigorous physical activities in hot and humid weather. Persons working under the sun should prevent dehydration and heatstroke by taking time out of the sun and drinking plenty of water/fluids. The patients should avoid use of caffeine and sugar containing soft drinks and/or tea, which may exacerbate dehydration.

Consume salty foods, use umbrella and wear hats, light colour and loose-fitting clothes. Keep the body cool and hydrated by taking cool showers or baths during a heatwave, use cold packs and wraps, towels, sponging and footbaths to keep cool.

“If you feel dizzy, weak and anxious or have intense thirst and headache during a heatwave, it is best to move to a cool place as soon as possible and measure your body temperature. Drink some water or fruit juice to rehydrate. Rest immediately in a cool place if you have painful muscular spasms (particularly in the legs, arms or abdomen), and drink oral rehydration solution (ORS) containing electrolytes. Medical attention is needed if heat cramps last more than an hour. Consult your doctor if you feel unusual symptoms or if symptoms persist and it is important to drink fluids,” the letter added.

Published in Dawn, May 18th, 2024