Community Care During Extreme Heat: Heat Illness: Prevention and Preliminary Care

ISBN: 978-1-100-18177-6
Cat. No.: H128-1/11-645E
HC Pub.: 110063

This fact sheet is for Health Care Workers working outside of facilities in the community and in patient/client homes.

Heat Illness and High Risk Individuals

Recognizing Risk

Populations most at risk for heat illness and death during extreme heat:

• People who are confined to bed, or have reduced ability for self care
• People with pre-existing conditions have greater risk of heat illnesses. These include cardiovascular, pulmonary, renal and psychiatric conditions.
• People who are alone without a social support network in hot home environments.

Planning for the Summer and Extreme Heat

Knowledge Check and Action Plan for Management and Staff

• Ensure your organization has an updated extreme heat emergency plan.
• Plan to coordinate with other agencies.
• Know your partners and maintain coordination plan with other services during extreme heat.
• Educate and train staff on extreme heat and heat illnesses in the early spring.
• Inform staff about extreme heat emergency plans (e.g. staffing, response to client needs).
• Increase staff awareness of public cooling options (e.g. pools, splash pads, shaded green space, libraries, shopping centres).
• During extreme heat, review key fact sheet information with volunteers and staff.
• During extreme heat, review clinical management of patients and residents most at risk either due to reduced mobility, chronic illnesses (pulmonary, cardiovascular, renal), or certain medications. (Refer to Health Canada's Acute Care Fact Sheet.)

Community Care - Assessing for and Educating on Heat Illnesses

Checklist when Visiting Client

URGENT: If client does not answer the door for a scheduled visit:

• Notify your office / supervisor
• Attempt to call the client, if there is no answer:
  • Call the client's emergency contacts to request they check on the client
  • Follow any other steps required by your organization

On entering client's home, check how they are coping with the heat.

• Observe home environment
• Do they show physical signs of being in distress?
  • Slower than usual response to answer the door
  • Appearing unwell or complaining of not feeling well
  • Appearing disoriented

If client is not in distress, check further on how they are coping with the heat.

• Is client uncomfortable because of the heat?
• Does the client have access to fan, air conditioning, fridge, phone, social support?
• Is client at risk from exposure to extreme heat?
  • Client has mobility, mental and/or physical health issues
  • Client does not have physical and/or mental capability to escape the heat
  • Client lacks access to transportation
  • Client needs help to keep their environment cool, or move to a cooler place?

Is client showing signs of heat illness:

• extreme thirst
• unusual skin colouring
• tiredness
• weakness
• dizziness
• headache
• fainting
• nausea
• vomiting
• rapid breathing and heartbeat
• muscle cramps
• decreased urination with unusually dark yellow urine colour

Actions to Help Clients Avoid Heat Illnesses

• Provide care (or help to coordinate care)
• Educate client (and caregivers) on how to cool themselves
• Inform client of local cooling options and community services to help support the needs of the client
• Provide client with appropriate Health Canada Heat-Health Fact Sheet (for Older Adults, Physically Active and Young Children)

Keeping the Person Cool

• Use cool water to:
  • Sponge or bathe
  • Soak hands, forearms, and/or feet
  • Spray skin while fanning
  • Wet a cloth to put on neck and/or armpits.
• Have Patient/Client:
  • Dress in loose fitting, light-coloured clothing made from breathable fabric (e.g. cotton).
  • Drink liquid (especially water) regularly, even when not thirsty.
  • Eat fruits and vegetables which are high in water content.
  • Have a glass of water in reach - ensure it is beside them before leaving.

Keeping the Home Cool and Food Safe

• Close windows, blinds and curtains during the hottest part of the day.
• Open windows, blinds and curtains when temperature is cooler in the evening.
• Use electric fans, air conditioning, to cool or circulate air.
• If home gets too hot, have client go to public place to cool down (e.g. pool, shaded green space, library, shopping centre). Ideal temperature range is assessed on a case by case basis.
• Do not use the oven. Instead use the stove top or microwave to heat food, or have meals that do not require heating.
• Ensure that food is properly stored as soon as eating has finished, and discard spoiled food. This is particularly important following a power outage.

For additional information refer to Health Canada's Extreme Heat Events Guidelines: Technical Guide for Health Care Workers

For further information email: Climatinfo@hc-sc.gc.ca

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