Surviving a Heatwave
July 2022


The UK could have its hottest day on record on Tuesday 19th. July 2022, with temperatures forecast to hit up to 41°C. London, it was warned, could be one of the hottest places in the world, with temperatures soaring above the Western Sahara and the Caribbean. The United Kingdom is poorly prepared for extreme temperatures. UK housing was not designed to withstand high temperatures and the general population are not used to handling extreme heat. Heatwaves can be dangerous and in all countries there are deaths, especially in protracted hot weather among the young, elderly and clinically vulnerable.

How to cope with a heatwave:

• Plan your day so you stay in the shade as much as you can. Study weather forecasts and avoid going out in the hottest part of the day.
  
  
• If you have to go out in a heatwave, try to stay in shade most of the time, wear a hat and light, loose clothes and use a factor 50 sun protection cream that allows the skin to perspire. Choose clothing that is UV treated because you can burn through cotton or polyester T–shirts, for example.
  
  
• Carry plenty of water – take frequent small sips. Make your own hydration drink using 1 litre (34 fl. oz.) water, 10 tablespoons of lemon or orange juice and half a teaspoon of salt or bicarbonate of soda. Take occasional sips of your hydration mix and frequent sips of clean water
  
  
• In doors, keep rooms cool by closing curtains or shading windows, keep them closed if the room air is cooler than the outside air and open them at night when the temperature drops. Using a fan helps but do not have the airstream directed towards you.
  
  
• Take cool showers or baths. Splash yourself with cold water, particularly the face and back of your neck. If you go outdoors, keep a damp towel against the back of your neck, keep wetting the top of your head or wet your headgear.
  
  
• Eat as normal. Eat more cold food – salads and fruit. Avoid drinking tea, coffee, carbonated drinks and alcohol. If you smoke, cut down dramatically as smoking uses up water in the mouth, throat and lungs.
  
  
• Keep pets in the shade and make sure they have plenty of fresh water available.
  
  
• Pay particular attention to babies and young children, keep them calm and make sure they are comfortable and not overexerting themselves.
  
  
• Keep an eye on elderly neighbours.
  
  
• Temperatures in a car can rapidly soar. Park in the shade and shade the windscreen and other windows with screens bought for the purpose or, as a temporary measure, use baking foil with the shiny side facing outwards. At temperatures of over 40°C, tarmac road surfaces can melt, posing danger to driving and there is a risk of tyres bursting if the car is driven at speed. Never leave animals unattended in a parked car and make sure they have plenty of water to drink.
  

What can happen to you in a heatwave?

Heatstroke

Heatstroke is the most severe of the heat–related problems, often resulting from exercise or heavy work in hot environments combined with inadequate fluid intake. Heatstroke is a killer in a heatwave.

Young children, older adults, people who are obese and people born with an impaired ability to sweat are at high risk of heatstroke. Other risk factors include dehydration, alcohol use, cardio–vascular disease and certain medications.

What makes heatstroke severe and potentially life threatening is that the body's normal mechanisms for dealing with heat stress, such as sweating and temperature control, are lost. The main sign of heatstroke is a markedly elevated body temperature (generally greater than 40°C (104°F) with changes in mental status ranging from personality changes to confusion and coma. Skin may be hot and dry, although if heatstroke is caused by exertion, the skin may be moist.

Other signs and symptoms may include:

• Rapid heartbeat.
  
• Rapid and shallow breathing.
  
• Elevated or lowered blood pressure.
  
• Cessation of sweating.
  
• Irritability, confusion or unconsciousness.
  
• Feeling dizzy or light–headed.
  
• Headache.
  
• Nausea.
  
• Fainting, this may be the first sign in older adults.

If you suspect heatstroke

Move the person out of the sun and into a shady or air–conditioned space.

Dial the emergency services or call for emergency medical assistance, be prepared that in a heatwave the emergency services will be busier, so it is important you know what to do until they arrive:

Cool the person by covering him or her with damp sheets or by spraying with cool water. Direct air onto the person with a fan or newspaper.

Have the person drink cool water, if he or she is able. Only allow the person to take small sips of water at minute intervals. Drinking more than this will lead to sweating and worsening of the situation because the body loses the water and does not absorb it.


Dehydration

This is loss of water from the body. It can cause tiredness and problems with breathing and heart rates. Legs may swell slightly because the body cannot store water as such, but water is deposited in fat, muscle and tissues in the legs, as an attempt to store it; some people notice this more than others and age is a factor here. Being very thirsty is a late warning of dehydration, do not wait until you feel thirsty before drinking. The only way of preventing dehydration is to drink water in small sips. If you drink an excess of water you will sweat more and worsen your situation, a common mistake made by people when caught in a heatwave.

Signs of dehydration
Feeling a little thirsty, dry in the mouth and dry lips are early signs you do not have enough water in your body – this is mild dehydration.

Feeling very dry in the mouth, very thirsty, eyes sunken in the sockets and skin losing its elasticity are signs of moderate dehydration.

If you show all the signs of moderate dehydration but in addition have cold hands and feet, a weakened pulse of over 100 beats per minute at rest, rapid and shallow breathing, feel lethargic and confused, the body is severely dehydrated.

Mild and moderate dehydration are not usually life threatening at any age and can be treated in the home. Severe dehydration is life threatening at all ages and requires hospitalisation.

Survival tips for dealing with dehydration
Mild dehydration is common in a heatwave scenario. To treat mild dehydration, slowly build up your liquid levels by taking frequent sips of cooled, boiled water. To treat moderate dehydration you need to drink a re–hydration solution. Do not drink sports drinks that claim to re–hydrate you, these drinks can lead to vomiting and diarrhoea and are so concentrated they can limit intestinal water absorption. In a heatwave, one of the fastest routes to dehydration is to drink "sports drinks" and "energy–giving" drinks.

An emergency re–hydration solution can be made in the home consisting of one level teaspoon of salt and eight level teaspoons of sugar dissolved in one litre (quart) cooled boiled water. Drink the whole litre in small quantities. Commercially available re–hydration mix can usually be purchased from a pharmacy. Kaolectrolyte (carbohydrate and electrolyte powder packets) is the product that most closely approximates World Health Organization and American Academy of Paediatrics guidelines on oral re–hydrating solutions suitable for babies and small children. Because it comes in small, easily transportable packets and dissolves in 227 ml (8 fl. oz.) of water in seconds, Kaolectrolyte is more convenient than most pre–mixed brands if you need to carry a re–hydration mix with you. Kaolectrolyte also come in several flavours. Most countries have similar products and a pharmacy can advise you on what to use.


Sunburn

It is easy to become fatigued, lethargic and neglect sun protection in a prolonged heatwave. Sunburn is a type of burn caused by overexposure to the UV (ultraviolet) rays of the sun; people with fairer skin, containing less melanin, burn quicker in the sun than darker skinned people. Sunburn starts with an initial redness of the skin, which may be painful and cause blistering. The sunburnt area feels hot to the touch and severely sunburned people can develop fever, chills, dizziness and dehydration. After the skin has healed, the dead skin peels off as it is replaced by new skin. The level of severity of the sunburn is directly proportional to the length and the strength of the exposure.

The consequences of sunburn
As well as the immediate discomfort, repeated overexposure to the sun should be avoided, as permanent skin damage can develop. This can take the form of premature ageing and skin cancer.

Survival tips for dealing with sunburn
Sunburn should be treated as soon as it happens or as soon as you notice. After mild sunburn, a warm shower will speed up the peeling of the burned (dead) skin and so get rid of the irritation faster than if left untreated.

You can also bathe the burnt area in lukewarm water, to which you can add lavender oil, camomile, eucalyptus or baby oil. Another thing to do is to use Aloe Vera gel on the burn. These natural remedies are a good way to cool and soothe the burn and, as they all contain natural anti–inflammatory chemicals, they reduce the swelling. These remedies do not help the burn to heal more quickly. To do this, you need to use after sun lotion, a moisturiser designed specifically for this purpose, which also contains anti–inflammatory substances and will cool and soothe the burn. After–sun lotions also contain additives that help the burn to heal more rapidly. It is best to avoid oily or greasy lotions because these will trap in the heat and the pain and do not help the burn at all.

Never burst a blister caused by sunburn as this can cause serious infection. If the sunburn has blistered and covers a large area or if the person is shivering and showing signs of dehydration, seek medical help immediately.

The best thing you can do is not get sunburnt, use protection cream with the correct UV protection factor for your skin type, wear white (to reflect the UV) clothing (cotton is best), sunglasses to protect the eyes and a large hat to protect the top of the head, face and neck. Wear long trousers and long–sleeved tops (again, white cotton is best) to reduce the risk of burning larger areas of skin. It is possible to purchase UV–treated clothing and this gives greater protection.