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How to Stay Safe During a Heatwave

Thanks to climate change, heatwaves have increasingly — and regularly — become more and more intense. Just look at this month’s headlines: Record-breaking heat has brought Europe to a standstill, especially in the UK, where air conditioning isn’t usually needed. In Spain and Portugal, which are more accustomed to high heat, the death toll from heat-related causes is approaching 2,000.

In a similar year in the US, extreme heat is the top weather-related killer. Symptoms of heat exhaustion and heat stroke can be subtle at first but can quickly escalate, says Dr. Sarah Nosal, a family medicine doctor in The Bronx, New York.

“Parts of our country are getting so hot right now that it’s really getting unsafe,” she says. “The people who pass away from heat stroke are usually the ones who’ve stayed in their homes without air conditioning.” 

As temperatures climb this summer, here are 10 tips for what you should and shouldn’t do during a heatwave.

1) Understand if you’re at higher risk of heat stroke.

The central nervous system weakens with age, which puts adults over 65 at more risk, since they’re less able to handle extreme changes in body temperature. Other conditions that merit precautions include heart or lung disease and obesity. Certain medications can also make you more dehydrated or even increase your risk of heatstroke or heat exhaustion. These can include anything from over-the-counter pain relief to antidepressants and high blood pressure medicine. Check with your doctor or pharmacist to see if you should take extra care in the heat and sun.

2) Plan for where you’ll wait it out.

Pay attention to heat advisories in your area. Many cities have public cooling centers for residents; libraries or malls are also good spots to find air conditioned, ventilated spaces. In New York, fire departments can give out caps that turn fire hydrants into sprinklers. If you have AC, set it to or below 78 degrees during the hottest hours to keep your home cool. “Don’t stay in your house if you don’t have AC,” Nosal says. “That’s how people die.”


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3) Check on friends and family.

If you have elderly or disabled friends and family, plan to be with them during a heat wave, or check on them at least twice a day; they’re among the most at-risk populations during a heat wave, particularly if they’re isolated. Also, make sure they’re wearing clothing appropriate for the heat. “An older person might be wearing more layers and not realize they’re sweating and losing hydration,” Nosal says.

4) Be mindful of your fluid intake.

Arizona-based family medicine specialist Dr. Gail Guererro-Tucker tells her patients to drink at least two to three liters of water (around eight to 12 cups) during a heat wave, before walking out the door. Drink two to four cups every hour you’re outside, and more if you’re exercising. Water is best, versus sugary energy drinks. If you don’t like the taste of water, flavor it with some juice or fruit slices. To gauge your hydration, look at your urine. If it looks like apple juice or is darker than that, you’re likely dehydrated. Your urine should be odorless and pale.

5) Avoid drinks that can dehydrate you.

Alcohol and caffeine can both make heat-related illness worse because they’re dehydrating. “And then you’re less likely to perceive you’re having a problem and it can get worse,” Guererro-Tucker says. 

6) Work out early in the day.

If there’s going to be a heat wave and you’re not hitting an indoor gym, exercise outside in the early morning, before 10 a.m., or in the evening. Hydrate often before, during and after your workout. “Don’t wait until you’re thirsty,”  says Guererro-Tucker. “If you wait until you’re thirsty, you’ve waited too long.” Don’t think that because you’re young and healthy, you’re less vulnerable to the heat, says Nosal. Young football players have made tragic headlines, for instance, after becoming grievously ill or even dying after exposure. 

7) Stock your car with the right supplies.  

In extreme temperatures, cars, just like people, can have a harder time working. Make sure you have the necessary supplies handy in case your car breaks down in an isolated area. Keep water, window shades, an umbrella, a high-SPF sunscreen and some cooling towels you can wet in your car during summer months.

8) Stay alert for signs of heat stroke.

Heat exhaustion happens when your body gets too hot. If left unchecked, the exhaustion can lead to heat stroke, which occurs when your internal temperature hits at least 104 degrees Fahrenheit. Heat stroke can typically be treated if caught quickly, but delaying treatment can be fatal. Symptoms of heat exhaustion can include heavier-than-usual sweating, muscle cramps and feeling lightheaded or fatigued. Heat stroke symptoms can include red skin, trouble breathing and seizures. 

9) Be prepared to help someone in heat distress.

Someone with milder heat-related sickness should get into the shade or AC to cool off. If you’re helping someone recover, don’t immediately give them food or a sugary drink. Instead, use ice packs, cool, wet towels or a tepid shower to reduce body temperature. For more dangerous symptoms, call 911 or head to the emergency room. Someone who has severe heat stroke, with a rectal body temperature over 105, will need rapid cooling in a hospital and IV fluids to bring their temperature down. 

10) Know that if you don’t have AC, your doctor can help.

In New York, for example, Nosal often requests federal aid for her patients with eligible medical conditions who can’t pay their electricity bill or afford to buy an air conditioner. Health conditions might include heart disease or an illness that requires a medical device that needs to be plugged in. “I’ve never had an eligible patient turned down after I write a letter for them,” Nosal says. 

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