First Aid for Victims of Heat

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            As Earth is in a condition of runaway climate change, – as feedback effects from warming oceans unleash dramatic temperature extremes on Earth, – there are more and more people who need first aid to save them from the negative effects of heat during the hot season. In some regions the hot season may be becoming longer and longer.

In the Northern hemisphere where there is more inhabited landmass than in the Southern hemisphere, the impacts from warming oceans and an ever earlier ice free Arctic are felt by millions of humans.

Of course southern part of Indonesia, Australia, southern Africa and southern part of Latin America are also affected.

In Pakistan and India and in Oman, Qatar, Iraq, Yemen and China to name just some most populous or hottest countries in the Northern hemisphere, temperatures of upto 50 degrees C are now common in summer in many places.

Exposure to such a temperature for more than an hour or two for a human let alone many species of animals leads to sure death.  More and more elderly and young people and adults weakened by poverty are dying from heat across the Earth. War compounds the devastating effect of heat of course and some of the hottest places such as Yemen are additionally being attacked by  coalitions of armies that live from destroying others: and the people in such war zones  are in specially urgent need of first aid of course.

Other regions where people will suffer more than others is where the patients are already weakened by other diseases, such as in regions where people are suffering from cancer from arsenic poisoning from groundwater  in the regions from the Indus valley in Pakistan to the Indo Gangetic plains of Bihar, Uttar Pradesh and West Bengal and Bangladesh.

The heat being put into the atmosphere by people operating and using cars, factories, power stations, oil rigs, aeroplanes, nuclear power stations, armaments including bombs, and more recently the internet and the web-based storage system for information known as the cloud is rising every year. The atmosphere, the oceans and the land are the main sinks that absorb heat but as the concentrations of greenhouse gases in these sinks rise the heat is being retained and returning more feedback effects into the system.

Governments have reneged from taking responsibility to outlaw capitalism and corporations are going into overdrive adding new greenhouse gases into the sinks.

Smart city technology and other energy intense life style products for rich urban consumers are on the rise. Consumers, producers and distributors think nothing about sweating and complaining on the one hand but using more and more fossil fuel energy for communication, transportation, food production and all aspects of daily life on the other. Workers such as factory workers in the informal sector and agriculturists outside of these air-conditioned gated compounds for living and working are all the more affected by the heat generated inside these upper caste zones.

As oceans absorb more and more heat, ocean temperatures are rising, and this in turn completely overthrows the normal weather patterns Earth had experienced for the last five thousand years or so.

Unlike the waves of warming in the ten thousand years after the last ice age, the warming wave now is not followed by a cooling one as in that Holocene epoch. It is all on the upward trajectory for the foreseeable future because it is being driven by capitalism to the extent that the present geological age is now called the Anthropocene epoch, after the fact that the Earth’s major geological and biological changes are being driven by capitalist man. The effects of the heat that is already in the system will cause temperature rise lasting many thousands of years with compensatory mechanisms some time down the line that humans will never know anything about.

Being in a situation of runaway climate change means that many living things on an Earth will find Earth uninhabitable in the lifetime of my two grandchildren and yours and there will no generations of humans much beyond those.

It is  simply impossible to know how many phyla if any or all of the six kingdoms of living things will continue. Trees may be one of the phyla from the plant kingdom to survive. But humans, of the animal kingdom, phylum chordata, class of mammals, the order of primates, the family of hominidae, the genus homo and the species homo sapiens sapiens, will not survive, because they die when their body temperature is above 40 degrees C unless treated, and most regions on Earth are going to be experiencing more and more days of temperatures above 40 degrees C.  When immediate first aid treatment is not be found  because the patient does not have access to sufficient ice or to an air conditioned room she dies.

In this scenario it is highly likely that in the coming years more and more of us will ourselves die or/and meet more and more people who are suffering from a life threatening condition of being too hot because they are burning up from the inside due to exposure to Earth’s inhuman temperatures. In the coming years we should expect more and more humans to die from heat.

So what do we do. From ourselves we should and must expect  in relation to ourselves frugality, austerity, simple living, minimal use of commercial energy, cheerful scepticism and sceptical self-mockery, as well as equanimity, perseverance, and courage. Towards others we must act with pity, charity and compassion by selflessly dedicating ourselves to mitigating their suffering.

The human body copes with heat by perspiring and breathing to cool down. In many countries including Nigeria and India temperatures are now causing what one author called “wild unthinkable conditions”. (1) To protect the body from overheating during hot weather it is important to stay in the shade, drink plenty of water, wear loose white clothes and avoid exertion. If this advice is followed the body can keep itself cool by perspiring and from the intake of cool air. Any greater exertion for some hours in direct sun, – such as what agriculturists and labourers expose themselves to due to poverty,  and all workers expose themselves to because working is not an option, – causes heat exhaustion with dizziness, headache and fainting.

In a lesser heat emergency, such as heat cramps or heat exhaustion, the following steps may lower your body temperature: get to a shady or air-conditioned place such as the mall, movie theatre or public library. Cool off with damp sheets and a fan. If you’re with someone who is experiencing heat-related symptoms, cool the person by covering him or her with damp sheets or by spraying with cool water. Direct air onto the person with a fan. Take a cool shower or bath. If you’re outdoors and not near shelter, soaking in a cool pond or stream can help bring your temperature down. Rehydrate. Drink plenty of fluids. Also, because you lose salt through sweating, you can replenish salt and water with some lemon and salt water.  Don’t drink sugary or alcoholic beverages to rehydrate. These drinks may interfere with your body’s ability to control your temperature. Also, very cold drinks can cause stomach cramps.

Humidity increases the apparent temperature. If the temperature remains high at night and humidity does not come down at night the body does not have the chance to loose excess body heat. In moist conditions we do not get the cooling effect of rapid evaporation. Thus it is important to be extra vigilant when it is hot and humid.

Heat exhaustion if caught early can usually be treated with rest, a cool environment and hydration which should include refuelling of electrolytes, which are necessary for muscle and other body functions.  Lemon water and salt is an important drink to replenish lost salts from sweating. In the period before overheating the body adapts to heat by reducing the salt concentration of sweat progressively and increasing the volume of sweat; by reducing the volume of urine and by bringing blood close to the surface where it can be dissipated easily into the environment by radiation. So when we are getting hotter and hotter we get red.

Heat exhaustion is caused by loss of body water and salt through excessive sweating. Symptoms of heat exhaustion may start suddenly, and include high body temperature, heavy sweating, weakness, dizziness, visual disturbances, feeling faint, fatigue, intense thirst, nausea or irritability, headache, vomiting, diarrhoea, muscle cramps or weakness, breathlessness, palpitations, tingling and numbness of the hands and feet.

Recovery occurs after resting in a cool area and consuming cool drinks like water, clear juice, or lemon water with salt. First aid for heat exhaustion includes getting medical help and staying with the person until help arrives; moving her to a cooler, shaded location; removing as many clothes as possible (including socks and shoes); applying cool, wet cloths or ice to head, face or neck; spraying with cool water.

Heat oedema is swelling which generally occurs among people who are not acclimatised to working in hot conditions. Swelling is often most noticeable in the ankles. Recovery occurs after a day or two in a cool environment. Heat rashes are tiny red spots on the skin which cause a prickling sensation during heat exposure. The spots are the result of inflammation caused when the ducts of sweat glands become plugged. Heat cramps are sharp pains in the muscles that may occur alone or be combined with one of the other heat stress disorders. The cause is salt imbalance resulting from the failure to replace salt lost with sweat. Cramps most often occur when people drink large amounts of water without sufficient salt (electrolyte) replacement.

Heat syncope is heat-induced dizziness and fainting induced by temporarily insufficient flow of blood to the brain while a person is standing. It occurs mostly among unacclimatised people. It is caused by the loss of body fluids through sweating, and by lowered blood pressure due to pooling of blood in the legs. Recovery is rapid after rest in a cool area.

Heat exhaustion may quickly develop into heat stroke. Symptoms of heat stroke include: hot, dry skin or profuse sweating, confusion, loss of consciousness, seizures, very high body temperature. When the patient is suffering from heat exhaustion or heat stroke her heart rate increases. If she heats up to 39-40 C, fatigue sets in. At 40-41C, heat exhaustion is likely and above 41C, the body starts to shut down. Chemical processes start to be affected, the cells inside the body deteriorate and there is a risk of multiple organ failure. The body cannot even sweat at this point because blood flow to the skin stops, making it feel cold and clammy.

If the skin is dry, the body temperature above 39°C, if the patient is suffering from confusion and is unconsciousness  she is suffering from heat stroke. Heatstroke can occur at any temperature over 40 C and, if not treated immediately, chances of survival can be slim. The best method of cooling people down is to immerse them in ice water or apply ice packs to the groin and armpits where crucial arteries are located – but it all depends on how long the body has been at an elevated temperature and whether they can be brought to a place of lower humidity in time.

Heat stroke is the most serious type of heat illness. Signs of heat stroke include body temperature often greater than 39°C, and complete or partial loss of consciousness. Sweating is not a good sign of heat stress as there are two types of heat stroke – “classical” where there is little or no sweating (usually occurs in children, persons who are chronically ill, and the elderly), and “exertional” where body temperature rises because of strenuous exercise or work and sweating is usually present. Heat stroke requires immediate first aid and medical attention. Delayed treatment may result in death. First aid for heat stroke as for heat exhaustion includes: stay with the person until help arrives, move to a cooler, shaded location, remove as many clothes as possible (including socks and shoes), immerse in cold water, in a bath of cold or ice water to quickly lower the patients core body temperature. The quicker she can receive cold water immersion, the less risk of death and organ damage.  If cold water immersion is unavailable,  her body temperature can be lowered using an evaporation method. Cool water is misted on the body while warm air is fanned over her, causing the water to evaporate and cool the skin. Another technique is to pack the patient with ice and cooling blankets if available. Another method is to wrap her in a special cooling blanket and apply ice packs to her groin, neck, back and armpits to lower her temperature. If available she should be given  medications to stop her shivering. Shivering increases body temperature, making treatment less effective. A muscle relaxant, such as a benzodiazepine stops the shivering. The patient should not be forced to drink any fluids.

References:

(1) Nseobong Okon -Ekong, https://www.thisdaylive.com/index.php/2017/12/09/effects-of-hot-temperature-on-the-body/

Anandi Sharan was born in Switzerland, lives in Bangalore and last year worked in Araria District Bihar, India. She works on trying to find the best money system to help people adapt to climate change especially in India.

 

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