Dealing with the Heat

Heat-related deaths and illness are preventable yet annually many people succumb to extreme heat. Historically, from 1979-2003, excessive heat exposure caused 8,015 deaths in the United States. During this period, more people in this country died from extreme heat than from hurricanes, lightning, tornadoes, floods, and earthquakes combined. In 2001, 300 deaths were caused by excessive heat exposure.

People suffer heat-related illness when their bodies are unable to compensate and properly cool themselves. The body normally cools itself by sweating. But under some conditions, sweating just isn't enough. In such cases, a person's body temperature rises rapidly. Very high body temperatures may damage the brain or other vital organs.

Several factors affect the body's ability to cool itself during extremely hot weather. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Other conditions related to risk include age, obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug and alcohol use.

Because heat-related deaths are preventable, people need to be aware of who is at greatest risk and what actions can be taken to prevent a heat-related illness or death. The elderly, the very young, and people with mental illness and chronic diseases are at highest risk. However, even young and healthy individuals can succumb to heat if they participate in strenuous physical activities during hot weather. Air-conditioning is the number one protective factor against heat-related illness and death. If a home is not air-conditioned, people can reduce their risk for heat-related illness by spending time in public facilities that are air-conditioned.

Summertime activity, whether on the playing field or the construction site, must be balanced with measures that aid the body's cooling mechanisms and prevent heat-related illness. This pamphlet tells how you can prevent, recognize, and cope with heat-related health problems.

During Hot Weather
To protect your health when temperatures are extremely high, remember to keep cool and use common sense. The following tips are important.

Drink Plenty of Fluids
During hot weather you will need to increase your fluid intake, regardless of your activity level. Don't wait until you're thirsty to drink. During heavy exercise in a hot environment, drink two to four glasses (16-32 ounces) of cool fluids each hour.

Warning: If your doctor generally limits the amount of fluid you drink or has you on water pills, ask how much you should drink while the weather is hot.

Don't drink liquids that contain alcohol, or large amounts of sugar—these actually cause you to lose more body fluid. Also avoid very cold drinks, because they can cause stomach cramps.

Replace Salt and Minerals
Heavy sweating removes salt and minerals from the body. These are necessary for your body and must be replaced. If you must exercise, drink two to four glasses of cool, non-alcoholic fluids each hour. A sports beverage can replace the salt and minerals you lose in sweat. However, if you are on a low-salt diet, talk with your doctor before drinking a sports beverage or taking salt tablets.

Wear Appropriate Clothing and Sunscreen
Wear as little clothing as possible when you are at home. Choose lightweight, light-colored, loose-fitting clothing. Sunburn affects your body's ability to cool itself and causes a loss of body fluids. It also causes pain and damages the skin. If you must go outdoors, protect yourself from the sun by wearing a wide-brimmed hat (also keeps you cooler) along with sunglasses, and by putting on sunscreen of SPF 15 or higher (the most effective products say "broad spectrum" or "UVA/UVB protection" on their labels) 30 minutes prior to going out. Continue to reapply it according to the package directions.

Schedule Outdoor Activities Carefully
If you must be outdoors, try to limit your outdoor activity to morning and evening hours. Try to rest often in shady areas so that your body's thermostat will have a chance to recover.

Pace Yourself
If you are not accustomed to working or exercising in a hot environment, start slowly and pick up the pace gradually. If exertion in the heat makes your heart pound and leaves you gasping for breath, STOP all activity. Get into a cool area or at least into the shade, and rest, especially if you become lightheaded, confused, weak, or faint.

Stay Cool Indoors
Stay indoors and, if at all possible, stay in an air-conditioned place. If your home does not have air conditioning, go to the shopping mall or public library—even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat. Call your local health department to see if there are any heat-relief shelters in your area. Electric fans may provide comfort, but when the temperature is in the high 90s, fans will not prevent heat-related illness. Taking a cool shower or bath or moving to an air-conditioned place is a much better way to cool off. Use your stove and oven less to maintain a cooler temperature in your home.

Use a Buddy System
When working in the heat, monitor the condition of your co-workers and have someone do the same for you. Heat-induced illness can cause a person to become confused or lose consciousness. If you are 65 years of age or older, have a friend or relative call to check on you twice a day during a heat wave. If you know someone in this age group, check on them at least twice a day.

Monitor Those at High Risk
Although anyone at any time can suffer from heat-related illness, some people are at greater risk than others.

Infants and young children are sensitive to the effects of high temperatures and rely on others to regulate their environments and provide adequate liquids.

People 65 years of age or older may not compensate for heat stress efficiently and are less likely to sense and respond to change in temperature.

People who are overweight may be prone to heat sickness because of their tendency to retain more body heat.

People who overexert during work or exercise may become dehydrated and susceptible to heat sickness.

People who are physically ill, especially with heart disease or high blood pressure, or who take certain medications, such as for depression, insomnia, or poor circulation, may be affected by extreme heat.

Visit adults at risk at least twice a day and closely watch them for signs of heat exhaustion or heat stroke. Infants and young children, of course, need much more frequent watching.

Adjust to the Environment
Be aware that any sudden change in temperature, such as an early summer heat wave, will be stressful to your body. You will have a greater tolerance for heat if you limit your physical activity until you become accustomed to the heat. If you travel to a hotter climate, allow several days to become acclimated before attempting any vigorous exercise, and work up to it gradually.

Do Not Leave Children in Cars
Even in cool temperatures, cars can heat up to dangerous temperatures very quickly. Even with the windows cracked open, interior temperatures can rise almost 20 degrees Fahrenheit within the first 10 minutes. Anyone left inside is at risk for serious heat-related illnesses or even death. Children who are left unattended in parked cars are at greatest risk for heat stroke, and possibly death. Never leave infants, children or pets in a parked car, even if the windows are cracked open.

Thanks to all The Survivors!

We'd like to thank all the breast cancer survivors that stopped by the station, flagged us down along the roadside or joined us at the Awareness Walks in order to sign the ambulances. We hope their signatures serve as a reminder to anyone diagnosed with breast cancer that the diagnosis isn't a death sentence. In fact, at one of the walks we met an 85 year old lady who was a 25 year survivor.

H1N1 and respiratory epidemics training video

With all of the confusion and concern regarding the H1N1 virus, our training director, Major Todd Early created a very thorough, informative, and up-to- date presentation on the subject. You can watch the 49 minute video here.

Since it's such an important topic, we wanted to make sure we get the message out to as many EMS personnel and first responders as possible.

Please feel free to send this link to any agency that you feel might benefit from the presentation. The video is located at http://www.oldhamcountyems.com/h1n1.shtml.

OCEMS becomes first Kentucky Ambulance Service to become a Drug Free Workplace

A new Kentucky League of Cities program is giving municipalities the lead in proactive substance abuse education and intervention for employees. Oldham County Emergency Medical Services became the first ambulance service in the state of Kentucky to receive this certification.

The facts speak for themselves.

According to the U.S. Department of Health and Mental Services Substance Abuse and Mental Health Services Administration, more than 70 percent of all substance abusers are employed.

With the support of the Kentucky League of Cities (KLC) in 2007, the Kentucky General Assembly enacted HB-267, better known as the Kentucky Drug Free Workplace Program. As a result of rampant drug use and abuse throughout Kentucky, this legislation was designed to encourage employers to implement a program to identify drug and alcohol use in the workplace, educate workers on the dangers of drug and alcohol abuse and to assist in treatment if drug use is detected.

OCEMS is now certified through the Kentucky Department of Workers' Claims as 'drug free.' Although the program is voluntary for employers, the benefits certification improve the quality of work life for employees, reduces workplace accidents, tardiness and absenteeism, and improves the quality of life and the general safety of all citizens throughout the community.

To find out more about the Drug Free Workplace program, visit the Kentucky Labor Cabinet's web site.

iStan is Here!

The department is now the proud owner of iStan, a sophisticated cutting-edge medical simulator designed specifically for EMS and emergency room personnel. Made possible through the generosity of the Baptist Hospital Northeast, The Baptist Foundation, and the Hospital Emergency Response Association, the iStan simulator will allow the service to add realistic scenarios to our training. At this point we are the only EMS service in the state to have such a state-of-the-art training aid.

It's very amazing technology...a sophisticated blend between a Resusci Annie and a robot. The simulator is controlled wirelessly by a computer and includes on-board fluid, pneumatic and electrical systems. It can cry, drool, bleed, seize, and breath at the click of a mouse. You can read more about iStan here.

The technology behind the simulators was originally developed for the U.S. Army to help train their doctors, nurses and medics. Their studies indicated that exposure to realistic and intense human life or death scenarios successfully provided thousands of medics with critical thinking and life-saving skills, confidence and the ability to put learned theories to use before exposure to real life situations. We intend to do the same at Oldham County EMS.

Saving heart muscle just became easier

Blocked arteries deprive the heart muscle of much-needed oxygen. That's the basic concept of a heart attack. If the blockage persists, the heart muscle will die. Preferred treatment is the placement of a stint or balloon angioplasty which effectively reopens the vessel—a procedure called percutaneous coronary intervention (PCI). In the past, when a person would present to the ER with a heart attack, it could sometimes take an hour or two to confirm the heart attack and assemble the cardiac catheterization team—depleting precious minutes and precious heart muscle as well. Now, there's a better way.

Using specially-designed cellular modems generously provided by Norton Hospital, paramedics from Oldham County EMS can now transmit the EKGs directly to the awaiting hospital, allowing the ER time to assemble the PCI team and prepare for the patient. The medics can then bypass the ER and take the patient to a waiting cardiac catheterization table where treatment can begin immediately. The gold standard adopted by the American Heart Association is treatment within 90 minutes of hitting the door of the hospital (referred to as Door-to-Balloon time). With advanced notification, Oldham County EMS can greatly reduce even the gold standard. The end result is that we can help more people survive a heart attack that would have been fatal in the past.

Oldham County EMS introduces new protocols

As of July 1, 2009, Oldham County EMS will be operating off a new, more progressive set of protocols than ever before. The new protocols include EZ-IO-drills, Drug Assisted Intubation (DAI) and Rapid Sequence Intubation (RSI) medications, and advanced pain management. BLS members will be able to administer epinephrine for anaphylaxis, provide Albuterol treatments for asthmatic patients, and give aspirin for initial treatment of heart attacks.

Also, as noted above, the medics will be able to transmit 12-lead EKGs directly to hospitals, thus expediting the activation of cardiac catheterization labs. In doing so, valuable time — and heart muscle — can be saved.

Expanded training section

While our primary training goal is to provide high-quality classroom instruction, we're in the process of moving those trainings to DVDs and the web as well. This not only makes the training more accessible to our employees, but the general public as well.

We're also in the final stages of designing what we're calling Life Trainings. While medical training is important, factors outside of the workplace also effect the lives of our employees. The topic for these classes will include nutrition, budgeting/home finance and conflict resolution to name but a few.