The sudden heat wave, which came after weeks of unstable weather, and especially its persistence, creates problems for everyone but particularly affects the vulnerable, namely the elderly and people with chronic diseases. The Health Directorate, starting in July, had activated the “heat code”, introduced by the Ministry of Health, to deal with the increase in visits to the Emergency Room due to high temperatures. The actions activated concerned all the Emergency Rooms in the area, with particular attention to those of Sondrio, Sondalo and Chiavenna. The numbers found in the first fifteen days of August frame a real heat emergency that is pouring into the provincial health system with heat strokes that are added to the occurrence of ischemic attacks or cardiac problems. In the Emergency Rooms, an increase of 10% in visits was recorded, if compared with the same period in 2023.
Upon access to the emergency room, in triagethe nurse assigns the heat code with particular attention to fragile patients, such as the elderly, disabled people and children. The patient is accompanied to a dedicated examination room, maintained at a suitable temperature, where he is reached by the doctor on duty who manages him based on the clinical needs detected and the emergency needs. The measures adopted by the Health Management to deal with the heat emergency also concern patients hospitalized for other types of interventions or scheduled ones and have been activated in all the hospital facilities of the company.
Heat stroke is a form of hypothermia associated with a systemic inflammatory response, resulting in dysfunction that can involve various organs. In its classic form, it occurs within two or three days of exposure, especially in children and frail people. There is a form related to physical exercise that occurs more quickly and affects healthy active people. Symptoms include an altered state of consciousness, ataxia, or movement disorders, tachycardia, shortness of breath and temperature above 40 degrees, but also asthenia, drowsiness, paleness, dizziness, fainting, muscle cramps, intense thirst, nausea and vomiting. Children can become restless and irritable. “The heat – explains the medical director Anna Maria Maestronia doctor with a specialization in Geriatrics – causes health problems when it alters the body’s temperature regulation system. Normally, the body cools itself by sweating, but in certain physical and environmental conditions this is not enough. If, for example, humidity is very high, sweat does not evaporate quickly and body heat is not eliminated effectively. The body temperature, therefore, increases rapidly and can damage various vital organs and the brain itself. Prolonged exposure to high temperatures – continues Dr. Maestroni – can cause mild disorders, such as cramps, fainting, edema, or more serious ones, such as congestion, heat stroke, dehydration. Extreme heat conditions can also cause a worsening of the health conditions of people with pre-existing chronic diseases». The effect of heat waves is relatively immediate, with a latency of 1-3 days between the occurrence of a rapid increase in temperature and the consequent increase in the number of deaths. Furthermore, the heat waves associated with a more serious effect on health are the most intense and prolonged ones and those that occur at the beginning of the summer season, when the population has not yet activated adequate physiological adaptation mechanisms to the heat. The elderly, especially if chronically ill, heart patients, diabetics or others, are the people most at risk of complications due to a greater sensitivity to heat, a reduction in thirst stimulation and a lower efficiency of thermoregulation mechanisms. They may have a lower ability to defend themselves from the heat, especially if they are in a state of reduced mobility and if they live alone. In elderly people, an alarm bell is the reduction in some daily activities, such as moving around the house, dressing, eating, going to the bathroom regularly or washing, which may indicate a worsening of the state of health.
Some general advice
- Avoid exposure to heat and direct sunlight during the hottest hours of the day, between 11 a.m. and 6 p.m.: high temperatures and humidity can cause heat-related symptoms and burns. Go out during the cooler hours, such as early in the morning or in the evening.
- Avoid areas with heavy traffic, especially for very young children, the elderly, people with asthma and other respiratory diseases, people who are not self-sufficient or convalescent. Prefer public places such as parks and gardens during the cooler hours of the day.
- Ensuring adequate air exchange: natural ventilation of domestic environments determines a better air exchange.
- Ensure a proper daily intake of liquids, especially water, moderating the intake of carbonated or sugary drinks, tea and coffee. Be careful not to drink too cold drinks and alcoholic beverages. Water is not always appreciated if taken alone, therefore encourage the elderly to also take liquids in the form of fruit and vegetables: it is very important to always consume fresh vegetables and fruit in adequate quantities, but especially during periods of intense heat.
- It is necessary to follow a light and not too elaborate diet, preferring pasta and fish to meat, avoiding elaborate and spicy foods.
- When taking medications, especially diuretics to control blood pressure, it is necessary to monitor the values periodically and in the presence of drops in blood pressure, it is necessary to be careful not to independently suspend ongoing therapies but always do so under the instructions of your doctor.