27 June 2018

Complex care: How to 'heatwave'

This week, Public Health England and the Met Office have issued joint safety guidance for healthcare staff, as a result of a 'blowtorch' air plume from Africa prompting a heatwave alert across the country. Those among the highest at risk are the elderly, disabled and those living in residential care homes.

The warning, issued by the Met Office, says there is an 80% chance of temperatures being a risk to health.

While the sunshine might be a welcome change from our typically dreary British weather, when temperatures are abnormally high for a sustained period, such weather can prove fatal to vulnerable people. According to Public Health England, during a ten-day heatwave in August 2013, there were nearly two-thousand additional deaths.

How can this happen? The truth is, very easily if the appropriate precautions aren’t taken. Prolonged or intense exposure to higher temperatures can lead to a variety of heat-induced illnesses.

What illnesses are caused by hot weather conditions?

Heat rash

Small, red, itchy papules.

Heat oedema

Heat oedema occurs predominantly in the ankles, due to vasodilation and retention of fluid.

Heat syncope

 Passing out due to dehydration.

Heat exhaustion

 A result of water or sodium depletion. Heat exhaustion occurs when the core temperature is between 37ºC and 40ºC. If left untreated, heat exhaustion may evolve into heatstroke.

Heat cramps

Caused by dehydration and loss of electrolytes, often following exercise.

Heatstroke

Heatstroke is a serious condition, whereby the body’s thermoregulation mechanism fails – this leads to a medical emergency, with symptoms of confusion; disorientation; convulsions; unconsciousness; hot dry skin; and core body temperature exceeding 40ºC for between 45 minutes and eight hours.

So, what can you do to prevent service-users from developing conditions such as these? 

  • Identify high-risk residents/patients and move them to a cooler area, 26ºC or below. If you are unable to move a service-user, take appropriate actions to cool them down. e.g. Locate a fan.
  •  Indoor temperatures need to be recorded regularly during the hottest periods in all areas where patients reside so that they can be monitored. 
  •  Prepare cool areas and provide regular wet towels and cool foot baths.
  •  Ensure sufficient staffing so that the overall task is manageable for the team as a whole. 
  • Keep curtains and windows closed while the temperature outside is higher than it is inside.
  • Discourage residents from physical activity and going out during the hottest part of the day (11am to 3pm).
  • Check indoor temperatures are recorded regularly during the hottest periods for all areas where patients reside.
  • Ensure staff can help and advise clients and patients.
  • Consider moving visiting hours to mornings and evenings to reduce afternoon heat from increased numbers of people.
  • Provide regular cold drinks, particularly if they are not always able to drink unaided; remember the importance of increasing fluid intake during periods of high temperature to reduce the risk of blood stream infections caused by Gram-negative bacteria. Oral re-hydration salts may be suggested for those on high doses of diuretics; bananas, orange juice and occasional salty snacks can also help replace salts lost due to sweating.

A Lead Nurse from our Bristol branch offered the following advice...

"Hot weather may be lovely, but it is also dangerous . As a care-giver, you are ultimately responsible for service-users, making sure they are kept both cool and hydrated when the weather is on the warmer side. Remember, if someone appears to be suffering from heatstroke and the signs do not waver after half an hour of taking the appropriate steps to cool them down, dial 999, especially if they are experiencing severe symptoms such as fitting or losing consciousness. Do not give them paracetamol or aspirin." 

If you're a Newcross HCA and you have any pressing questions regarding service-users and their care amid the ongoing heatwave, feel free to contact our Clinical Governance team for direction on 0117 911 9677 between 8 am and 8 pm. 

 

 

Source: NHS England