Heat stress, heat exhaustion and heatstroke are potentially serious health risks for people during a heatwave.
- In heatwaves, significant increases in mortality can occur due especially in those >65years old and more vulnerable groups
- Deaths have occurred at home, in residential care facilities and in hospitals.
Who is particularly vulnerable?
Heatwaves can affect any of us, but those most at risk are:
- Older people – especially those over 75
- Those who live on their own or in a residential care facility
- People who have a serious or long term illness – including heart or lung conditions, diabetes, kidney disease, Parkinson's disease or some mental health conditions
- Those who may find it hard to keep cool – babies and the very young, the bed bound, those with drug or alcohol addictions or with Alzheimer's disease, homeless people
Advice for health services during heatwaves
Heatwaves are known to result in increased deaths or serious illness and no part of the population may be considered protected from the risks associated with heatwaves. However, those at most risk include the elderly, the sick, infants and small children.
Health services need to ensure that a safe, temperature-controlled environment exists for the delivery of care to their patients or service users.
Target temperatures
- Room temperature should be about 20 degrees Centigrade.
- HSE Sustainability Office indicates the temperature of 18 – 23 degrees is the comfortable range.
- Ideally, all patients and particularly those who are most vulnerable should be cared for in cool areas unless there is a clinical reason for this not to be the case.
Assessment
The environmental temperature experienced by each patient should be considered – if there are differences, each individual situation needs to be risk assessed and managed. In the absence of automatic temperature control that maintains an ideal temperature at all times, the following are recommended:
- Draw up a plan for monitoring temperatures
- Measure the temperature, taking into account variability over the day and night
- Identify places that are cool/comfortable temperatures throughout the day and night (<26 degrees)
- Identify places that have temperature problems that need to be addressed.
Respond immediately to uncomfortable ambient temperatures to ensure they return to comfortable temperatures quickly or move the patient to a suitable environment.
Actions
Continue comprehensive temperature assessing as above (1-4)
Ensure cool areas are kept below 26 degrees
Review and prioritise high-risk patients
Ensure sufficient cold water and ice
Consider weighing patients regularly to identify dehydration and rescheduling physiotherapy to cooler hours
Communicate alerts to staff and ensure they are aware of heatwave plans
Ensure sufficient staffing
Activate plans to maintain business continuity - including a possible surge in demand. Balance business continuity with the ability to provide safe service in a comfortable environment.
Ensure staff help and advise patients, including providing access to cool rooms, close monitoring of vulnerable individuals, and reducing initial temperatures through measures including:
- Shading
- Turning off unnecessary lights/ equipment
- Cooling building at night
- Ensuring discharge planning takes home temperature and support into account
- Fans and air conditioning while ensuring compliance with infection prevention and control
- Report the emergence of challenges to senior management
- Continuously monitor and evaluate climate control to ensure the achievement of safe ambient temperatures in patient care spaces with reporting on success and issues arising.
