ER doctors say we need to pay more attention to heat

In southern California, emergency workers are ready for the wave of patients who pour like heat waves such as current trail in their second, third and fourth days. The heat makes an accumulated toll on the body, especially when people cannot cool at night with air conditioning.

DRE Jennifer Roh, medical director of the Harbor-UCLA Medical Center emergency medicine department, said preparation means hydration supplies, ice packs and other ready cooling devices.

Doctors, nurses and emergency technicians see the obvious cases of heat disease and heat exhaustion, of course, with fainting and cramps among symptoms. A heat stroke is the most serious version of heat -related disease and can live life.

But some doctors say that their profession is less skillful to recognize that heat can be the reason why some patients present themselves with other diseases.

Football players take a training break to hydrate and cool off in the middle of high temperatures and a heat wave on Wednesday at Santa Margarita High School in Rancho Santa Margarita.

(Allen J. Schaben / Los Angeles Times)

Heat waves are like an “invisible tsunami,” said Dr. Marc Futerck, an emergency doctor in Los Angeles. They can exacerbate heart disease, kidney problems and respiratory diseases.

A patient with diabetes who cannot keep insulin refrigerated during a power failure, for example, could land in emergencies in critical condition without anyone making the link.

Upon their arrival, they can also be confused due to the effects of composition of heat exposure, letting doctors try to reconstruct what happened. That, says Roh, makes it difficult to be sure of the role that the heat has played in the symptoms of a patient Er.

The most vulnerable patients during heat waves are the elderly, people with chronic diseases and those who take medication that alter the way their body regulates when it is hot.

“There are so many diseases beyond heat disease that even doctors who take care of these patients do not recognize him,” said Fuerternick.

A runner goes near the center of the city center to Echo Park Lake in the middle of a heat wave Thursday in Los Angeles.

(CARLIN STIEHL / LOS Angeles Times)

Dr. Sam Torbati, head of the emergency department of Cedars-Sinai Medical Center, said most of the conditions he sees in the emergency room during heat waves is largely avoidable.

Health problems are disproportionately fall on communities with fewer resources.

“The heat in Los Angeles affects everyone, but that does not affect everyone too, and some of the most affected people are the most vulnerable people in our community,” said Dr. Alex Gregor, who works at ERS in Los Angeles General Medical Center and the University of South California.

“Skid Row is a heat island, many of our patients come from the row of slippage or [other] The communities of the city where they do not have access to the shade, cooling, nature – there is therefore an unfair distribution of the burden of the disease caused by heat and climate change around our city. »»

“This is a huge problem of equity in terms of health and racial justice,” he said.

Most doctors generally do not take climate change into account. Those who say it must change.

Dr. Stefan Wheat, an emergency doctor and assistant professor at the University of Washington Medicine School, is a wider training defender linked to the climate that would teach climateers how heat acts as a “threat multiplier”.

Gregor also suggests that emergency medical service providers should be trained to recognize subtle signs of heat disease, and that social workers could be brought to connect patients to resources such as cooling centers, or to help patients establish a friend’s system, as some cities have done, so someone remarks if it is in difficulty.

A construction worker takes a break in the water while working on new houses in the middle of a heat wave on Wednesday in Irvine.

(Allen J. Schaben / Los Angeles Times)

The climate-health connection is not new. There are more than a dozen books on the subject, and some medical schools already include climate health training.

Some Los Angeles hospitals and elsewhere distribute heat preparation materials, and awareness efforts to uninformed doctors and patients have widened.

But awareness raising is always lagging behind and heat -related mortality increases, according to some. “We do a good job not to do it as bad as possible,” said Fuerterck. “But it gets worse.”

Nurses, technicians and doctors could play a more important role.

“We can use our voices as health professionals to put pressure on policies that help better protect patients on a larger scale in the community,” said Wheat.

This could mean supporting the building codes which ensure adequate cooling or workers’ protections for those working outside at extreme temperatures.

“The exhaustion of heat or heat stroke … It is not capturing the complete image,” said Wheat. “It is an increasingly urgent challenge.”

In southern California, he should remain Intensely hot well in September.