Dehydrated, nauseous, sunburned Floridians flood emergency rooms when temperatures rise

Cindy Krischer Goodman, South Florida Sun Sentinel on

Published in Weather News

FORT LAUDERDALE, Fla. — Inside the emergency room at her Margate hospital, Dr. Paige Swalley orders intravenous fluids for her third patient who arrived dehydrated and suffering from a heat-related illness.

“As the heat peaks in the afternoon, they start coming in,” said Swalley, an emergency medicine physician at HCA Florida Northwest Hospital.

Last summer, emergency room visits for heat-related illnesses reached an all-time high, and if May is any indication, this year could be worse.

Florida ranked second in the U.S. for 911 calls related to heat exhaustion, heat stroke, and dangerous sunburn for the two weeks ending May 24, according to the federal government’s Heat Related EMS Activation Surveillance Dashboard. Arkansas with its blistering heat took the top spot. More than half the counties in Florida received higher-than-average EMS calls for heat-related emergencies from late April to May.

In May, not only were record-high temperatures in South Florida reported for six days of the month, but the area also experienced six days of abnormally high humidity levels, said Brian McNoldy, a senior research scientist at the University of Miami. The combination made it feel as hot as 112 degrees on the worst days. Last year was the hottest in Florida since 1985.

With traditionally hotter summer months ahead, federal health agencies want Americans to learn their heat/health risk, plan outdoor activities to avoid when danger is greatest, and take actions that lower their risk for health problems. They want employers of outside workers to use the new dashboards to guide which days might be better to tackle bigger outdoor jobs.

On Friday, the Centers for Disease Control and Prevention debuted its newest heat and health tracker that shows a person’s daily risk for heat illness based on their ZIP code.

The tracker combines historical temperature, heat-related illness, and community characteristics information with the current heat situation to gauge the resiliency of a community. The CDC hopes to encourage local leaders to put in stronger public health protections when EMS calls spike and a community has a high level of outdoor workers or few nearby hospitals. This year, however, Florida lawmakers year restricted local governing agencies from instituting heat protections for workers,

For individuals, the CDC tracker can guide someone’s behavior as excessive heat in Florida becomes more frequent.

“It is a powerful tool because, for the first time, you can go to the dashboard, type in your ZIP code, see a seven-day forecast, and understand if the temperatures are too hot for your health,” said Dr. Aaron Bernstein, director of CDC’s National Center for Environmental Health and the Agency for Toxic Substances and Disease Registry. “You hear about heat alerts, but none are based on the risk heat poses to health in that community. In Miami, a 90-degree day may affect the community differently than a 90-degree day in Tallahassee. The tracker speaks to health risk for that community.”

The heat health risk tracker also suggests precautions based on the daily risk score, which ranges from “No risk” to “Extreme” heat risk. In Broward County, for example, the tracker shows mostly moderate heat levels through June 5. It also shows air quality as moderate and advises: “If you are sensitive to air pollution, consider reducing the time you spend doing prolonged or heavy exertion.”

People sensitive to heat, such as pregnant women, kids with asthma or respiratory issues, heart disease, and seniors, should start paying attention on orange (moderate) days. Everyone should take precautions on red (major) or magenta (extreme) days.

With the projection of the heat health risk for an entire week ahead, Bernstein said, people can plan better rather than waiting for a heat advisory that offers less advanced notice. This is particularly important for people with chronic medical conditions, he said. “There are symptoms that typically show up as heat-related illness but with chronic medical problems, it may show up as more intense symptoms of their condition.”

If you see the heat health risk is high, take extra precautions like bringing an extra bottle of water with you outside, taking more breaks and making sure your clothing is suited to the heat, Bernstein advises.

Swalley said older adults are at risk when it’s hot and humid because their sense of thirst isn’t as strong and they can become dehydrated. Also, seniors and young children cannot regulate their body temperature. When someone comes to the emergency department with heat-related illness, the treatment is to cool them down with a cooling blanket and give them IV fluids to hydrate them, she said.

Symptoms to watch out for as the temperature climbs are nausea, muscle cramps, dizziness, and heart palpitations. Some people may even faint or experience a seizure.


In Florida, Monroe County, home of the Florida Keys, had the highest rate of emergency responses for heat-related illnesses for the two weeks ending May 24, a new Heat Related EMS Activation Surveillance Dashboard shows. The tracker shows heat-related emergency calls, transports to medical facilities and deaths in real-time.

The tracker reveals that over the last two weeks, about 63% of the EMS calls nationwide for heat-related illness resulted in patients being taken to a medical facility.

The risk from heat can be fatal. Heat waves kill more people in the U.S. than any other weather hazard, including hurricanes, tornadoes and floods combined, according to the CDC. The death certificates of more than 2,300 people who died in the United States last summer mention the effects of excessive heat, the highest number in 45 years of records, according to an Associated Press analysis of Centers for Disease Control and Prevention data. According to the AP analysis, nearly three-quarters of the heat deaths last summer were in five southern states that were supposed to be used to the heat and planned for it, including 84 in Florida.

Dr, Branson Collins, director of the Marcus Institute of Integrative Health at Florida Atlantic University, suggests checking weather apps to learn when the temperature peaks each day. “You want to minimize your time outside during the peak. Even a few degrees can make a difference.”

He also advises anyone doing an outdoor activity who feels their heart racing, palpitations, or shortness of breath to stop immediately and get indoors or in the shade to cool off.

Drinking water and fluids with electrolytes can be crucial for some people, he said.

“Some people don’t sweat well. Sweating helps remove heat from your body so you can cool down,” he explains. “If you can’t sweat, your body overheats, which can be dangerous.”

—A few hot tips to consider

—Using a fan when the indoor heat is 90+ degrees can do more harm than good. Fans in extreme heat can give a false sense of comfort and are less effective in cooling the body.

—Taking a cold shower or doing a cold plunge when you are sweating is not a good idea. It could trigger lightheadedness and cause you to pass out.

—The coolest time of the day in South Florida is between 6 and 8 a.m. If you are going to take a walk, do it early.

—People can improve their threshold for heat tolerance. You can build up your body’s tolerance by exposing yourself to short bouts of heat and humidity and gradually increasing the length of exposure over time,

—Caffeine can be dehydrating so you want to limit your intake when outside on a hot day.

—Mold and bacteria grow more easily in high temperatures. Change your AC filter more often during the hot summer months.

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