Burns, delirium, deaths: in the United States, repeated heat waves and saturated emergency services

In June 2024, the city of Phoenix, Arizona, recorded average temperatures of 36°C, and is about to experience its hottest summer on record. The heatwaves are such that the city’s emergency services have been seeing waves of patients suffering from sunstroke, dehydration, burns from contact with hot asphalt, and episodes of heat-related delirium for several months.

When body temperatures exceed 40°C, caregivers sometimes place patients in body bags filled with ice to bring the temperature down and prevent internal organ failure: “Since they are unconscious, they do not really feel the pain of the cold. The main thing is to cool them down quickly.”says David Sklar, an emergency room doctor in the city.

In Maricopa County, where he works, at least 27 people have died from heat so far this year, and hundreds more deaths are under investigation. Those numbers are likely undercounts because, as the Guardian notes, heat-related deaths, particularly among outdoor workers, are often underreported.

Last year, in 2023, authorities recorded 120,000 heat-related emergency room visits, while the climate crisis only intensifies.

Vulnerable people

People most vulnerable to heat stress, or excessive heat buildup beyond what the human body can release, are children, the elderly, pregnant, homeless, people with chronic diseases such as diabetes and high blood pressure, and outdoor workers.

Some medications, such as amphetamines, often used to treat ADHD, or some antidepressants, antihistamines and beta blockers, can impair the body’s ability to cool itself, increasing the risk of heatstroke. Some medications themselves can change when exposed to extreme heat and become less effective, warns Gredia Huerta-Montañez, a pediatrician and environmental health researcher at Northeastern University.

Treatment for people hospitalized due to heat varies, but health care providers tend to apply ice packs to the neck and groin, areas where blood flow is high and the body tends to sweat. Cold intravenous fluids can also help lower body temperature and treat dehydration.

While extreme heat, unlike hurricanes, tornadoes and earthquakes, is not recognized by the federal government as a major natural disaster, it is the deadliest weather-related disaster, and many health care workers are advocating for it to be recognized as such. A request has been filed with the Federal Emergency Management Agency to have it recognized.