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 heat-related 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 Symptom(s) Causes Safety Tips

Heat rash • Red cluster of pimples

• Blisters • Itching • Red rash on the skin

that usually occur on the neck, chest, breast and/or groin

• 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.

Heat edema • Swelling in the ankles, feet and hands

• Body temperature normal or elevated core temperature up to 104° F

• 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.

Heat tetany • 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

• Hyperventilation • Respiratory

alkalosis

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

Heat cramps • Muscle spasms • Muscles usually

affected include the abdomen, calf, thighs and shoulder muscles

• Body temperature normal or elevated core temperature up to 104° F

• 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.

Heat syncope • Dizziness • Fainting • Body temperature

normal or elevated

• 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

flow to the central nervous system

medical attention.

Heat exhaustion • Profuse sweating • Weakness • Rapid breathing • Dizziness • Nausea/vomiting • Muscle cramps • Normal mentation • Body temperature

normal or elevated core temperature up to 104° F

• Drinking liquid without electrolytes

• Dehydration • Electrolyte

deficiency

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.

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.

• 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

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.

1 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

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 • COOLING CENTER HOURS •

Vineland Public Library 1058 East Landis Avenue

Vineland, NJ 08360

Gloria Urban, Director, or Anita Lupcho, Public Relations

(856) 794-4244

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

Vineland (Fiorilli) Senior Center 6th & Elmer Streets Vineland, NJ 08360

Mary Barner, Director

(856) 794-4074

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

Vineland Sharing Center (Nutrition Program for the

Elderly) Tarkiln Acres Community Hall

Tarkiln Drive Vineland, NJ 08360

Carol Wilson, Site Manager

(856) 692-8289

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

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.htm

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-county-

democrat/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/