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EXTREME HEAT TOOLKIT

Vineland, New Jersey

Vineland Health Department 640 E Wood Street Vineland NJ 08360 856-794-4131


Introduction to Extreme Heat Preparedness As the temperature begin to rise over the summer, it is important for people to remember to be safe by protecting themselves from heat related injuries. The list below describes the different heat illnesses, symptoms, causes, and ways to avoid such conditions. Extreme Heating Effects on the Body In normal instances, the body cools itself off. However, when the body’s temperature control system becomes overloaded, heat related illness and mortality can occur. Very high temperatures may damage the brain and other important body organs. Other conditions that may inhibit the body from regulating temperature are old age, youth, obesity, mental illness, poor circulation, sunburn, and some prescription medications.

Heat and Outdoor Workers

People who work outdoors are more likely to become dehydrated and are more likely to get heatrelated illness.

STOP all activity and get to a cool environment if you feel faint or weak. • • • • • • • • •

Drink from two to four cups of water every hour while working. Don’t wait until you are thirsty to drink. Avoid alcohol or liquids containing large amounts of sugar. Wear and reapply sunscreen as indicated on the package. Ask if tasks can be scheduled for earlier or later in the day to avoid midday heat. Wear a brimmed hat and loose, lightweight, light-colored clothing. Spend time in air-conditioned buildings during breaks and after work. Encourage co-workers to take breaks to cool off and drink water. Seek medical care immediately if you or a co-worker has symptoms of heat-related illness. For more information, please visit: http://www.cdc.gov/niosh/topics/heatstress/.

Source: CDC


Heat Illnesses and Their Symptoms Medical Condition

Heat rash

Symptom(s)

• • • •

Heat edema

• •

Heat tetany

Heat cramps

Heat syncope

Causes

Red cluster of • pimples Blisters Itching Red rash on the skin that usually occur on the neck, chest, breast and/or groin Swelling in the • ankles, feet and hands Body temperature normal or elevated • core temperature up to 104° F

Respiratory problems, such as breathing difficulty • Muscular problems, including spasms or numbness or tingling of muscles • Body temperature normal or elevated core temperature up to 104° F • Muscle spasms • Muscles usually affected include the abdomen, calf, thighs and shoulder muscles • Body temperature normal or elevated core temperature up to 104° F • Dizziness • Fainting • Body temperature normal or elevated

Safety Tips

Blockage of sweat ducts

Remove the affected person from heat. Minimize exposure of skin to sun. Keep the affected area dry. Seek medical attention if rash does not improve.

Occurs in persons who are not acclimatized to heat Increased blood flow to the skin in limbs

Elevate and apply compressive stockings to the affected limbs.

• •

Hyperventilation Respiratory alkalosis

Remove the affected person from the heat and advise the person to breathe slowly.

Drinking liquid without electrolytes Dehydration Electrolyte deficiency

Stop all activities, relocate to a cool location, rest and drink electrolyte containing fluids. Seek medical attention if symptoms persist.

• •

• Increased blood flow to the skin resulting in decreased blood

Lay the affected person gently on the floor and provide lots of fluid. Seek


core temperature up to 104° F Heat exhaustion

• • • • • • • •

Heat stroke • This is a life threatening, adverse effect of exposure to • extreme heat, usually occurring when the body temperature is greater than 104˚F. • • • •

flow to the central nervous system

medical attention.

Profuse sweating • Drinking liquid without electrolytes Weakness • Dehydration Rapid breathing • Electrolyte Dizziness deficiency Nausea/vomiting Muscle cramps Normal mentation Body temperature normal or elevated core temperature up to 104° F

Stop all activities, relocate to a cool location, rest and drink electrolyte containing fluids. It can be difficult to determine if someone has heat stroke and not exhaustion. If symptoms do not quickly improve, or unable to oral rehydrate, seek medical attention.

Call 911 immediately if you see anyone with these symptoms and has a body temperature of 104˚F and above. While waiting for first responders, the affected person should be taken to a cool shady area. Cool the person with immersion in cool water, spraying the person with cool water while fanning the person vigorously, or placing ice packs on neck, axilla, and groin.

Oral body temperature of 104˚F and above Often sudden onset of symptoms •Confusion or loss of consciousness Rapid and strong pulse Hot, red and dry skin Headache Dizziness Nausea/vomiting

• •

Profound dehydration Profound electrolyte deficiency Body is unable to maintain heat diffusion through the skin Normal regulation of body temperature is no longer intact

Centers for Disease Control and Prevention. (2006). Frequently Asked Questions (FAQ) About Extreme Heat. Retreived April 17, 2012, from http://www.bt.cdc.gov/disasters/extremeheat/faq.asp. 2 Platt, M. and Vicario, S. (2010). Heat Illness. In Rosen’s Emergency Medicine: Concepts and Clinical Practice, 7th Ed. p1882-3. 3 Zimmerman JL, Hanania NA. (2005). Chapter 111. Hyperthermia. In: Hall JB, Schmidt GA, Wood LD, eds. Principles of Critical 1


Table 1: Definitions of Heat Watch, Advisory, and Warning1 Excessive Heat Watch In New Jersey Excessive Heat Watches are issued when conditions are favorable for an excessive heat event in the next 12 to 72 hours. A Watch is used when the risk of a heat wave has increased but its occurrence and timing is still uncertain. A watch provides enough lead time so that those who need to prepare can do so, such as city officials who have extreme heat response plans.

An excessive heat watch is issued in New Jersey when temperatures are expected to peak in the upper 90’s and could reach 100 degrees. An excessive heat watch is also issued whenever a prolonged period of hot temperatures and high humidity are expected. The following counties were under excessive heat watch in June 2012: Mercer, Gloucester, Camden, and Northwestern Burlington Counties. Urban cities are also at high risk during an excessive heat watch.

Heat Advisory in New Jersey Heat Advisories are issued when an extreme heat event is expected in the next 48 hours. These statements are issued when an extreme heat event is occurring, is imminent, or has a very high probability of occurring. An advisory is for less serious conditions that cause significant discomfort or inconvenience and, if caution is not taken, could lead to a threat to life and/or property.

Heat Advisories are issued in New Jersey when temperatures are expected to reach the low to mid 90’s. Humidity could push the heat index up to more than 100 degrees. The following counties were issued heat advisories in July 2012: Warren, Hunterdon, Middlesex, Monmouth, Gloucester, Camden, Mercer, and Ocean Counties.

Excessive Heat Warning in New Jersey Excessive Heat Warnings are issued when an extreme heat event is expected in the next 48 hours. These statements are issued when an extreme heat event is occurring, is imminent, or has a very high probability of occurring. A warning is used for conditions posing a threat to life or property.

Excessive heat warnings in New Jersey are issued when heat and humidity created heat reaches indexes of near 100-105 degrees. Cities and urban areas are under excessive heat warnings during such times.


Extreme Heat in New Jersey - July 2012- temperatures broke the 100 degree mark in Trenton, NJ. - Each year more than 1200 people are treated in New Jersey emergency departments for heat related injuries or sunburns. - Overexposure to summer heat causes between 45 and 170 hospitalizations in New Jersey annually. The major of hospitalizations are males between the ages of 65-84. Cooling Centers in Cumberland County, NJ GET OUT OF THE HEAT! Exposure to extreme heat can be life threatening. Finding a place to cool off can make all the difference. Use our Cooling Center Locator to find a place to cool off near you. AGENCY / ADDRESS CONTACT PERSON PHONE NUMBER Vineland Public Library 1058 East Landis Avenue Vineland, NJ 08360 Gloria Urban, Director, or Anita Lupcho, Public Relations (856) 794-4244 Vineland (Fiorilli) Senior Center 6th & Elmer Streets Vineland, NJ 08360 Mary Barner, Director (856) 794-4074 Vineland Sharing Center (Nutrition Program for the Elderly) Tarkiln Acres Community Hall Tarkiln Drive Vineland, NJ 08360

• COOLING CENTER HOURS •

Monday - Thursday, 9 a.m. to 9 p.m. Friday and Saturday, 9 a.m. to 5 p.m. Library Closed: July 4th, 5th, and 6th

Monday - Friday 9 a.m. to 4 p.m.

Monday - Friday, 8:30 a.m. to 1:30 p.m.

Carol Wilson, Site Manager (856) 692-8289

Information Retrieved on June 5, 2013 from http://www.co.cumberland.nj.us/content/173/251/765/1898/3106.aspx


People Most at Risk for Heat Related Complications Older adults are the most vulnerable to extreme heat complications. Young children are also vulnerable to extreme heat complications. Lack of air conditioning can also increase the risk of heat- related illnesses. Excessive heat events are prolonged periods when temperatures reach 100 degrees Fahrenheit or more above the average high temperature for a region. NEVER LEAVE YOUR CHILD ALONE IN A CAR!!! Sometimes babies are asleep so peacefully that parents may forget that they are there. Leaving a child alone in a car can cause serious injury or death. Here are some tips to help parents remember: 1. Avoid heatstroke related deaths and injuries by not leaving children in the car alone not even for one minute. 2. Remember to keep car doors locked when you are not in the car to prevent children from getting inside on their own. 3. Create reminders such as putting things such as briefcases, purses, or cell phones in the back next to your child that you will need in an effort to remember that they are back there. 4. Take action and call 9-1-1 if you see a child left alone in a car. Ways to Reduce Extreme Heat Exposure • Stay in an air conditioned environment. • Visit air conditioned places within your community such as libraries, malls, stores etc. • Take a cool shower or bath. • Drink lots of fluids while avoiding drinks with high sugar contents, caffeine, and alcohol because they can cause dehydration. • Find out if your current medications induce heat related illnesses. • Wear lightweight, light-colored, loose fitting clothing. • Wear a hat when outdoors. • Avoid outdoor activities during the hottest hours of the day. • Do not leave children, frail adults, pets, or the disabled in a car for even one minute because temperatures can rise quickly. • Listen to local weather forecast about high temperatures. • Know those in your neighborhood who are elderly, young, or sick because they are the most likely victims. • Make sure child car seats and safety belts are not too hot for children. • Call 9-1-1 immediately if medical attention is needed.


Additional Resources Here is a list of additional websites that you may visit for more information on how to avoid complications associated with extreme heat temperatures: - http://www.ready.gov/heat - http://www.bt.cdc.gov/disasters/extremeheat/ - http://www.epa.gov/naturaldisasters/extremeheat.html - http://www.nws.noaa.gov/os/heat/index.shtml REFERENCES 1. http://www.epa.gov/aging/resources/climatechange/extremeheatevents.h tm 2. http://nj.gov/counties/mercer/news/releases/approved/120529.html 3. http://www.safekids.org/heatstroke 4. http://www.michigan.gov/documents/mdch/Extreme_Heat_421812_7.pdf 5. Centers for Disease Control and Prevention. (2006). Frequently Asked Questions (FAQ) About Extreme Heat. Retrieved from http://www.bt.cdc.gov/disasters/extremeheat/faq.asp 6. http://www.nj.com/hunterdon-countydemocrat/index.ssf/2012/06/warnings_advice_issued_as_new.html 7. http://www.co.cumberland.nj.us/content/173/251/765/1898/3106.aspx 8. http://www.ggweather.com/heat/


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