“Excessive exposure to heat or the sun is underdiagnosed because no patient goes to the emergency room and says they are hot,” says Dr. Elisenda Gómez-Angelats, assistant in the emergency department at Clínic de Barcelona. That is why, according to this doctor, the recorded data on excessive sun exposure from previous years are not very reliable.
However, Gomez-Angelates stresses that there is a growing awareness that heat may be the reason why so many patients go to the hospital these days with headaches, a feeling of suffocation, shortness of breath, irritability, tremors, low blood pressure … and even with some fevers that we are facing what she considers a “heat epidemic”. On the health level, it will accompany us every summer: “The heat is like colds in the winter, filling hospitals in the summer,” says the doctor.
Symptoms may vary according to the population group and the presence of previous diseases
For this reason, the fact that doctors are increasingly aware that high temperatures may be the cause of more and more patients arriving these days with these symptoms and without any source of infection, will increase the diagnosis due to excessive heat exposure, explains Gomez-Angeláts. Not only because this panoramic picture of high temperatures increases the incidence, but also because “there is a greater sensitivity when it comes to diagnosis on the part of doctors,” notes the doctor.
In addition, it is important to keep in mind that “heatstroke, in and of itself, consists of being in a deep coma and at 40 degrees of body temperature,” explains Gómez-Angeláts, adding that this is only “the tip of the iceberg”, The case is more extreme.” Before reaching this point, he goes through other phases, which lead to symptoms that appear frequently these days in the hospital.
In young people who have been exposed to a high level of heat or solar radiation, these general symptoms may present with leg cramps, abdominal pain, diarrhoea, tremors, seizures or syncope (loss of consciousness). In the elderly, the range is further expanded. In many cases its symptoms are subtle: clumsiness, falls, weakness and drowsiness, which complicate detection.
“In bedridden people, for example, they usually realize why they are so sleepy, try to wake them up and cannot wake them up,” explains the doctor, and stresses that it is not necessary to be in the sun to suffer the effects of heat. Added to this is less autonomy to express their exposure to heat and their perception that their thermoregulation is less effective.
What happens to the body?
High temperatures cause an imbalance. The body enters a state of stress, known as heat stress or exhaustion, from which all symptoms associated with the effects of heat derive.
The body temperature increases, which translates into a specific type of fever, which does not respond to any source of infection, but is simply due to heat.
The body then displays symptoms associated with the effects of heat, although these symptoms can vary greatly depending on which population it refers to, warns Dr. Gomez-Angelates.
The most common ones are tiredness, fatigue, headache, nausea and dizziness. It can also work by intensifying previous conditions, especially cardiovascular and respiratory conditions.
For this reason, it advocates the need for close monitoring of at-risk populations, both from families and from public health services. The latter are specialized in prevention: it is recommended to avoid peak exposure and aggressive physical activity, encourage high water consumption and use cooling systems – wet cloths, create drafts with windows, fans or air conditioners. However, these measures are not equally accessible to the entire population.
“There are people who combine advanced age with not having the resources or the independence to operate a fan; and if they live alone, no one can help them put a washcloth of cold water on their forehead,” Gomez-Angelates gushes. There are also those who cannot seek refuge for work-related reasons; For them, the medical recommendation is nothing more than hydration, taking breaks, and wearing a hat.
“We work on mortality for many reasons and in the summer the peaks are usually low, but we’ve had a few years now, especially the past, where the excess mortality rate in the summer was very high and the vast majority of those deaths were attributable to heat,” concludes Dr. Boras, From the University Hospital of Val d’Ebron in Barcelona, which participates in the Committee on Health and the Environment, that this health center started before