“Overexposure to heat or the sun is underdiagnosed because no patient goes to the emergency room saying they are hot,” says Dr. Elisenda Gómez-Angelats, assistant in the emergency department of the Hospital Clínic de Barcelona. This is the reason why, according to this doctor, the data recorded for overexposure to the sun from previous years are not very reliable.
However, Gómez-Angelats assures that there is increasing awareness that the heat can be the cause of so many patients going to the hospital these days with headaches, a feeling of suffocation, shortness of breath, irritability, tremors, hypotension… and even with some fever. And it is that we are facing what she considers a “heat epidemic” that, at the health level, will accompany us every summer: “The heat is like colds in winter, it fills hospitals in summer,” says the doctor.
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 diagnoses due to overexposure to heat, explains Gómez-Angelats. Not only because this panorama of high temperatures increases the incidence, but also because “there is a greater sensitivity when it comes to diagnosing on the part of doctors”, points out the doctor.
In addition, it is important to take into account that “heat stroke, per se, consists of being in a deep coma and at 40 degrees of body temperature,” explains Gómez-Angelats, adding that this is only “the tip of the iceberg, the most extreme case.” Before reaching that point, it goes through other phases, which produce the symptoms that are frequently seen these days in the hospital.
In young people who have been exposed to a high level of heat or solar radiation, these generic symptoms may appear accompanied by leg cramps, abdominal pain, diarrhea, tremors, seizures or fainting (loss of consciousness). In elderly people, the range widens even more. In many cases its symptoms are subtle: clumsiness, falls, weakness and drowsiness, which complicates detection.
“In people who are bedridden, for example, they usually realize why they are so drowsy, they try to wake them up and they can’t,” explains the doctor, who emphasizes that it is not necessary to have been under the sun to suffer the effects of heat. She also has less autonomy to express and recognize that they have been exposed to heat because their thermoregulation is less effective.
For this reason, it calls for the need to closely monitor the population at risk, both from families and from public health services. The latter specialize in prevention: it is recommended to avoid exposure at peak times and aggressive physical activity, and 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 being older and not having the resources, or autonomy, to turn on a fan; And if they live alone, there is no one who can help them put a cold water towel on their foreheads, ”defends Gómez-Angelats. There are also those who, for work reasons, cannot take refuge; for them the medical recommendation is not much more than to hydrate, take breaks and put on a hat.
“We work on mortality from many causes and in summer the peaks are usually low, but we have been here for a couple of years, especially the past, in which excess mortality in the summer was very high and the vast majority of these deaths are attributed to heat,” concludes Dr. Borrás, from the Vall d’Hebron University Hospital in Barcelona, ??who participates in the Health and Environment Committee that this health center started before the av
