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For many nonprofit agencies, the summer season brings outdoor field trips, picnics, summer camps, and other outdoor activities. Along with all the fun also comes increased risk to heat related illness (HRI). For individuals such as children and elderly who may have disabilities and illnesses, the risk can be higher. They may not fully understand the dangers and may not be able to effectively communicate when symptoms occur. Medical conditions may also increase their risk. To help mitigate this exposure, consider the following.

Training

Train staff to understand the stages of heat stress symptoms and how to respond. According to the Center for Disease Control (CDC), the top three heat related illness are:

CDC chart of Heat-Related Illnesses and What To Look For vs. What To Do

Heat Stroke

Heat stroke 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 heat stroke occurs, the body temperature can rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not given.

Symptoms

  • Confusion, altered mental status, slurred speech
  • Loss of consciousness (coma)
  • Hot, dry skin or profuse sweating
  • Seizures
  • Very high body temperature
  • Fatal if treatment delayed

First Aid

  • Call 911 for emergency medical care.
  • Stay with person until emergency medical services arrive.
  • Move the person to a shaded, cool area and remove outer clothing.
  • Cool the person quickly with cold water or ice bath if possible; wet the skin, place cold wet cloths on skin, or soak clothing with cool water.
  • Circulate the air around the person to speed cooling.
  • Place cold wet cloths or ice on head, neck, armpits, and groin; or soak the clothing with cool water.

Chart from: https://www.cdc.gov/disasters/extremeheat/warning.html

Heat Exhaustion

Heat exhaustion is the body’s response to an excessive loss of the water and salt, usually through excessive sweating. Workers most prone to heat exhaustion are those that are elderly, have high blood pressure, and those working in a hot environment.

Symptoms

  • Headache
  • Nausea
  • Dizziness
  • Weakness
  • Irritability
  • Thirst
  • Heavy sweating
  • Elevated body temperature
  • Decreased urine output

First Aid

  • Take person to a clinic or emergency room for medical evaluation and treatment.
  • If medical care is unavailable, call 911.
  • Someone should stay with person until help arrives.
  • Remove person from hot area and give liquids to drink.
  • Remove unnecessary clothing, including shoes and socks.
  • Cool the person with cold compresses or have the person wash head, face, and neck with cold water.
  • Encourage frequent sips of cool water.

Heat Cramps

Heat cramps usually affect workers who sweat a lot during strenuous activity. This sweating depletes the body’s salt and moisture levels. Low salt levels in muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion.

Symptoms

  • Muscle cramps, pain, or spasms in the abdomen, arms, or legs

First Aid

  • Drink water and have a snack and/or carbohydrate-electrolyte replacement liquid (e.g., sports drinks) every 15 to 20 minutes.
  • Avoid salt tablets.
  • Get medical help if the person has heart problems, is on a low sodium diet, or if cramps do not subside within 1 hour.

Training Resources

There are a variety of resources online for training staff. These include:

Understand the Heat Index

The Heat Index is a measure of how hot it really feels when relative humidity is factored in with the actual air temperature. The chart below from the National Weather Service (NWS) can be used to determine the heat index. As an example, if the air temperature is 96°F and the relative humidity is 65%, the heat index–how hot it feels–is 121°F. The red area without numbers indicates extreme danger. The National Weather Service will initiate alert procedures when the Heat Index is expected to exceed 105°-110°F (depending on local climate) for at least 2 consecutive days.

NWS also offers a Heat Index chart for area with high heat but low relative humidity. Since heat index values were devised for shady, light wind conditions, exposure to full sunshine can increase heat index values by up to 15°F.   Also, strong winds, particularly with very hot, dry air, can be extremely hazardous.

digital display of cell phone with heat index app

OSHA and NIOSH have developed a free Heat Safety Tool for planning outdoor activities based on how hot it feels throughout the day.  This provides Featuring real-time heat index and hourly forecasts, specific to your location, as well as occupational safety and health recommendations from OSHA and NIOSH.  Available on Apple App Store and Google Play, features include:

  • A visual indicator of the current heat index and associated risk levels specific to your current geographical location
  • Precautionary recommendations specific to heat index-associated risk levels
  • An interactive, hourly forecast of heat index values, risk level, and recommendations for planning outdoor work activities in advance
  • Editable location, temperature, and humidity controls for calculation of variable conditions
  • Signs and symptoms and first aid information for heat-related illnesses

Image from: https://www.cdc.gov/niosh/topics/heatstress/heatapp.html

Prevention Tips

Provide protection from the sun by using sunscreen properly and wearing appropriate clothing.  The CDC recommends lightweight, light colored, loose-fitting clothing. 

Erect shade canopies or provide misting tents as a place to cool down. 

Schedule outdoor activities carefully.  Try to limit your outdoor activity to when it’s coolest, like morning and evening hours. Provide rest breaks often in shady areas.  

Monitor the heat index closely.  If needed, cancel or reschedule events to avoid excessive heat warnings.

For camps with a lot of physical activity, gradually increase the activity over several days. Campers and staff may require several days to get used to hot weather.

Maintain adequate supplies of cool water readily available in activity areas.  Give campers their own water bottles and encourage them to drink frequently.  Monitor water supplies frequently.

Avoid hot and heavy meals as they add heat to the body.

Persons with chronic conditions such as obesity may be at higher risk for heat related illness. Camp medical staff should review medical forms carefully to identify any conditions or medications that may require limitation or modification of outdoor activities. 

Closely monitor those individuals that may be more susceptible to heat related illness. 

Never leave children or other vulnerable individuals in vehicles.  Vehicles can quickly heat up to dangerous temperatures, even with a window cracked open. While anyone left in a parked car is at risk, children are especially at risk of getting a heat stroke or dying. Remember to check the vehicle when leaving to be sure everyone is out. Do not overlook anyone who has fallen asleep in the vehicle. 

If you have any questions, view Berkley Human Services’ risk control resources.

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