Heatwave Advice
Introduction
The increase in illness and mortality due to very hot weather happens within
one or two days of the temperature rising. It is therefore very important to be
ready to respond quickly if a heatwave is forecast. On 23rd June there was a
30% chance of London having a heatwave in July 2015.
Please scan the headings below and read the sections relevant to you. The
information will help you to keep your service users, and indeed yourselves,
healthy during a period of very hot weather. The material is a summary of the
NHS / Public Health England Heatwave Plan 2015.
There are links to useful websites throughout so keep an electronic copy of
these notes if possible.
Link to NHS / Public Health England Heatwave Plan 2015:https://www.gov.uk/government/publications/heatwave-plan-for-england
Link to Met Office 5 Day Forecast for London:http://www.metoffice.gov.uk/public/weather/forecast/gcpvj0v07?tab=fiveDay
The Main Health Risks of a Heatwave
The exacerbation of respiratory or cardiovascular diseases
This is the main causes of death and illness during a heatwave.
The exacerbation of other chronic or severe illnesses
eg diabetes, renal insufficiency, Parkinsons disease, severe mental illness
Heat exhaustion
The symptoms of heat exhaustion can develop rapidly. They include:
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skin feeling very hot and flushed,
heavy sweating,
dizziness,
fatigue,
nausea,
vomiting,
tachycardia (a rapid heartbeat),
mental confusion, and
urinating less often and the colour of urine being darker than usual.
Heat exhaustion can happen to anyone in hot weather and if it isn't treated it
can lead to heatstroke, which can be dangerous and even fatal.
Source: NHS / PHE Heatwave Plan for England 2015
Local contact: Tony Andrews
tandrews@westminster.gov.uk
020 7641 3637
Heatwave Advice
Main Health Risks ctd
Heatstroke
The symptoms of classic heatstroke can develop over several days if you are
spending a long time somewhere hot. The symptoms of exertional heatstroke
can appear more quickly, usually after physical activity.
Symptoms of heatstroke include:
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high body temperature: having a temperature of 40°C (104°F) or above
is a major sign of heatstroke,
heavy sweating that suddenly stops: if the body is unable to produce
any more sweat then this is a big warning sign that the body has
become over-heated and dehydrated,
tachycardia (a rapid heartbeat),
hyperventilation (rapid breathing), and
muscle cramps.
The extreme heat that causes heatstroke also affects the nervous system,
which in turn can cause other symptoms such as:
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mental confusion,
lack of co-ordination,
seizures (fits),
restlessness or anxiety,
problems understanding or speaking to others,
hallucinations (seeing or hearing things that are not real),
loss of consciousness.
Heatstroke is a medical emergency. Dial 999 immediately and ask for an
ambulance.
If you or anyone else feels unwell, drink water and go somewhere cool
to rest. If symptoms such as breathlessness, chest pain, confusion,
dizziness, weakness or cramps get worse or don't go away, seek
medical help
For more details of health effects see Chapter 1 of the “Making the
Case” paper accompanying the Heatwave Plan for England:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/310604/100882902328-TSO-Heatwave-Making_the_Case_ACCESSIBLE.pdf
Source: NHS / PHE Heatwave Plan for England 2015
Local contact: Tony Andrews
tandrews@westminster.gov.uk
020 7641 3637
Heatwave Advice
High Risk Groups
Identifying the people most at risk of suffering serious ill effects of a heatwave
is one of the most important actions. Please prepare to identify those people,
perhaps at short notice.
High temperatures can be dangerous within one or two days, especially
for:
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the elderly
infants
people with chronic or long-term medical conditions
particularly those with respiratory or cardiovascular diseases (the
main causes of death and illness during a heatwave)
homeless people
people with alcohol or drug dependence
People who cannot adapt their behaviour to keep cool (dementia or
immobility are factors here)
People who live in “Urban Heat Islands” See Chapter 3 of “Making the
Case” for an explanation. (see above link)
People living in top floor, South facing flats
NB: In an extreme, prolonged heatwave fit and active people can also be
affected
For more details of high risk groups see Chapter 1 of the “Making the
Case”:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/310604/100882902328-TSO-Heatwave-Making_the_Case_ACCESSIBLE.pdf
Generic Advice for All Staff and Service Users
This advice has been phrased for staff visiting vulnerable people in their own
homes but much of it is relevant for other settings and indeed for staff
themselves.
Advance preparations:
Help your service users to:
Stay tuned to the weather forecast on the TV or radio.
Here is a useful Met Office site:http://www.metoffice.gov.uk/public/weather/forecast/london?tab=fiveDay
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Stock up with supplies of medicines, food and non-alcoholic drinks to
avoid having to go out in the heat
Keep plenty of water to hand and stay in the shade whenever possible.
Identify the coolest room in the house, so they can go there to keep
cool.
Source: NHS / PHE Heatwave Plan for England 2015
Local contact: Tony Andrews
tandrews@westminster.gov.uk
020 7641 3637
Heatwave Advice
Advance preparations ctd:
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Check the practicality of shading and/or opening windows
Monitor temperatures frequently, prepare cool areas (below 26° C),
Ensure access to water and ice,
If temperatures become very high:
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Identify your high risk service users (see the High Risk Groups
above, including people with heart problems, breathing difficulties
or serious illnesses).
Ensure high risk people are visited or telephoned daily to check
how they are coping with the heat.
Encourage and assist them to:-
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Drink water or fruit juice regularly.
Change from hot to cold food with high water content (fruit and salads)
Avoid tea, coffee and alcohol, and if they do drink alcohol make sure
they have lots of water or other non-alcoholic drinks as well.
Wear loose cotton clothing
Keep rooms cool by using shade or reflective material external to the
glass, or if that is not possible, by closing light-coloured curtains
(metallic blinds and dark curtains can make the room hotter).
Close windows and curtains while the room is cooler than outside and,
if it's safe, open windows at night when the air outside is cooler.
Avoid going outside in the hottest part of the day (11am to 3pm).
If they do need to travel, to carry water with them (it is best to drink 15
minutes before travelling).
Spend time in the shade and avoid strenuous activity.
Splash their faces and the backs of their necks with cool water.
People with heart problems, breathing difficulties or serious illnesses
may find their symptoms become worse in hot weather, so make sure
they have enough medicines in stock and take extra care to keep cool.
Review the frequency of visits
Help others: check on neighbours, relatives and friends who are less
able to look after themselves (eg, if they have mobility problems).
If you’re planning to travel, check the forecast at your destination too
and see the tips below from TfL.
Take sensible precautions to prevent sunburn, particularly in children
See the HPA/PHE Sunsense Guide:https://www.phe-protectionservices.org.uk/cms/assets/gfx/pheradon/animations/ataglance/content/sunsense.swf
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See the NHS Heatwave Advice to the Public and if possible give it
to your service users:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/310608
/10091-2902332-TSO-Looking_after_yourself_ACCESSIBLE.pdf
See the NHS / PHE Advice for Health and Social Care Professionals:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/310605/10
089-2902329-TSO-Heatwave-Advice_for_Health_Professionals_ACCESSIBLE.pdf
Source: NHS / PHE Heatwave Plan for England 2015
Local contact: Tony Andrews
tandrews@westminster.gov.uk
020 7641 3637
Heatwave Advice
Transport for London Tips to keep cool
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Carry water with you (It is best to drink 15 minutes before travelling)
Don't board a train or bus if you feel unwell
If you feel unwell please get off at the next stop and seek help from our
staff
Avoid pulling the passenger alarm between stations
Advice for people looking after children (schools,
early years settings, youth clubs and play schemes)
The generic advice for all staff and service users above will be helpful for you
but the following specifically relates to children:Children who may be more at risk could be those who are:
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Overweight
Under 4 years old
Taking medication
With disabilities or complex health needs
Ask the school nurse to advise which children are at risk as the above is a
very simplified indication of risk factors.
See Chapter 3.3 of the Heatwave Plan for England 2014:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/310598/100872902315-TSO-Heatwave_Main_Plan_ACCESSIBLE.pdf
For practical advice see the PHE Heatwave Guidance for schools and
early years settings:
http://webarchive.nationalarchives.gov.uk/20140714084352/http:/www.hpa.org.uk/Topics/Em
ergencyResponse/ExtremeWeatherEventsAndNaturalDisasters/Heatwaves/heatwaves_teach
ers/
Action Tables (All managers)
Recommended: The action tables in the NHS Heatwave Plan, Chapter 3
and in the Annexes of NHS Advice for health and social care professionals
provide a very helpful summary of actions for managers in various settings:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/310598/100872902315-TSO-Heatwave_Main_Plan_ACCESSIBLE.pdf
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/310605/100892902329-TSO-Heatwave-Advice_for_Health_Professionals_ACCESSIBLE.pdf
Source: NHS / PHE Heatwave Plan for England 2015
Local contact: Tony Andrews
tandrews@westminster.gov.uk
020 7641 3637
Heatwave Advice
Advice for Managers of Care Homes
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Identify the high risk residents
Increase staff awareness of heat related illness.
Care homes should monitor temperatures frequently. Install
thermometers
Prepare cool areas (below 26° C),
Check that windows can be shaded (ideally externally) and opened
(security permitting)
Ensure access to water and ice,
Consider changing menus to cold food with high water content (fruit
and salads)
Check supply of fans (NB; see caution on fans on p 7 of Advice to Care
Home managers below)
Review staffing levels
See the Heatwave Plan Advice for Care Home Managers and Staff:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/310606/100902902330-TSO-Heatwave-Care_Home_Managers_ACCESSIBLE.pdf
Heat Health Advice during Ramadan
In 2015 Ramadan starts on Thursday 18th June.
See p31 of the NHS Heatwave Plan:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/201039/Heatwa
ve-Main_Plan-2013.pdf
Advice for Event Organisers
See Annexe 3 of the NHS Heatwave Plan
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/201039/
Heatwave-Main_Plan-2013.pdf
See also the HSE advice for event organisers:http://www.qub.ac.uk/safetyreps/sr_webpages/safety_downloads/event_safety_guide.pdf
Alert Levels and Met Office Heat Health Alert Service
Chapter 2 of the NHS Heatwave Plan explains the Alert Levels:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/429384/
Heatwave_Main_Plan_2015.pdf
Source: NHS / PHE Heatwave Plan for England 2015
Local contact: Tony Andrews
tandrews@westminster.gov.uk
020 7641 3637