Dear Nursing Home Administrator Letter: Heat Advisory
July 6, 2010
DAL: DRS-NH 10-05
With the arrival of extended periods of high temperatures and humidity, you are encouraged to take the necessary precautions to prevent heat related illnesses. Residents with a history of dehydration, cardiovascular and/or pulmonary disease are particularly susceptible to heat related illnesses and complications. To assist in preventing heat illness among your residents during the hot and humid weather, it is recommended that all staff be especially alert to the signs, symptoms and consequences of heat prostration, heat stroke and heat cramps.
- Warning Signals: Gradual weakness, nausea, anxiety, excess sweating, syncope (fainting).
- Appearance and Signs: Skin is pale, grayish and clammy.
- Management: For syncope: Place head down and administer cool, slightly salty fluids immediately.
Heat Stroke (Serious Emergency)
- Warning Signals: Headache, weakness and sudden loss of consciousness.
- Appearance and Signs: Hot, red, dry skin, little sweating, very high temperature and hard, rapid pulse.
- Management: Immediately cool skin by wrapping or immersing in cold water or ice. Call 911 or paramedics.
- Warning Signals: Severe cramps and spasms in the arms, legs and/or abdomen.
- Appearance and Signs: Skin may be hot and dry, or cool and clammy, depending on the humidity. The muscles feel like hard knots.
- Management: Provide cool fluids and foods containing sodium chloride (table salt).
The following measures should also be taken to prevent heat related illnesses:
- Alert staff to monitor residents for the signs and symptoms of heat illness (listed above). Notify the physician of such observations and obtain medical services, if needed.
- Review resident medications and identify those that may cause residents to become more susceptible to heat and sunlight.
- Assure that facility policies and procedures for heat emergency situations are current, complete and known to all staff.
- Monitor temperatures on nursing units, particularly on hot, humid days.
- Use air circulating and air cooling equipment (window fans, floor fans, mechanical ventilation systems and air conditioners) to achieve and maintain air movement and air cooling within the facility, especially in resident rooms and resident use areas.
- Monitor choice of residents' clothing to ensure they are appropriate in extreme temperatures and are not too heavy or vapor-impermeable.
- Protect against temperature elevations within the facility by closing window blinds and shades on sun exposed walls; opening windows on shaded walls; and turning off heat generating devices, such as lights in the daytime.
- Assure, through active encouragement and assistance when necessary, that residents maintain adequate fluid intake, e.g., water and fruit juices. Alcohol should be avoided.
- Adjust menus as needed, incorporating items such as cold plates, salads, etc. Consult with your dietician.
- Encourage residents not to lie or sit in direct sunlight, e.g., if outside, encourage residents to sit in shaded areas. Use sunscreen, as necessary.
- Monitor residents engaging in physical activities. Discourage strenuous physical activity as appropriate.
Thank you in advance for your efforts to provide our residents with a safe environment that allows them to enjoy a meaningful and satisfying quality of life. If you have any questions, please call the Bureau of Quality Assurance and Surveillance for Nursing Homes at (518) 408-1282.
Jacqueline Pappalardi, Director
Division of Residential Services