Hot weather resource kit for service providers

Information for service providers to the homeless

The City of Ottawa has developed a plan to respond to the needs of homeless people during extreme heat conditions. The response is organized in partnership with a network of community agencies and groups that provide relevant services.

Purpose

The Extreme Hot-Weather Initiative is a preventive mechanism to deal with hazardous situations for homeless individuals during extreme heat conditions. The following resources are available to respond to this need.

II. Community Agencies - Resources

Salvation Army Van
The Salvation Army operates a Mobile Outreach Van which travels a route in the inner city, providing assistance, water and other supplies. Dial 613-580-2626 if assistance is needed.

Emergency Shelters
The following emergency shelters have agreed to open their air-conditioned lounge spaces for homeless / at-risk individuals on days when Extreme Heat Alerts or Emergencies have been declared.

Salvation Army: 171 George St. Tel: 613-241-1573; Fax: 613-241-2818
Shepherds of Good Hope: 230 Murray St. Tel: 613-241-6494; Fax: 613-789-0888
Union Mission for Men: 35 Waller St. Tel: 613-234-1144; Fax: 613-234-2813

Some signs of heat-related illness include:

  • Rapid breathing
  • Weakness, dizziness or fainting
  • More fatigue than usual
  • Headache
  • Confusion
  • Muscle cramps
  • Nausea or vomiting

People taking any medications regularly should ask their doctor, nurse or pharmacist if they need to take extra precautions during hot weather.

You can help someone with heat-related illness by doing these things:

  • Move the person to a cooler place
  • Call for help as necessary
  • Take extra clothing off the person
  • Cool the person with lukewarm water, by sponging or bathing
  • Give the person sips of cool water, not ice cold water.

Important Information

Extreme heat waves are associated with elevated morbidity and mortality in urban centres. They can directly cause heat stroke, heat exhaustion, and heat cramps, and they can exacerbate other health conditions such as heart disease, respiratory problems and kidney disease. The elderly, children and the homeless are particularly at risk for heat-related illness because of the body's reduced ability to deal with heat, restricted mobility, or lack of access to cool indoor areas. People taking certain psychiatric and anti-Parkinson medications are also more vulnerable to heat and sun.

Ottawa Public Health will respond to extreme hot weather conditions by activating one of three levels of heat warnings based on forecasted humidex:

  • Heat Alerts: are in effect when the humidex is forecast to be 36 or greater for two consecutive days.
  • Heat Warnings: will be issued when the humidex is forecast to be 40 or greater for two consecutive days.
  • Heat Emergency: will be declared in the event that extreme weather / situational conditions will result in significant health consequences.

Service providers will receive Heat Warnings and Heat Emergency notifications by fax. If your agency has not been receiving these faxes please contact us at 613-580-2424 ext. 44185.

Media backgrounder heat alert

Heat:

Heat-related illness is becoming an important public health issue. Many environmental factors are expected to increase the number of heat waves, so it is important to be informed and prepared. The combination of heat, people at risk and lack of protective factors can create serious health effects, even death.

Who is at risk:

  • Seniors, and young children
    • Due to lack of the body's ability to regulate temperature
  • People who are not acclimatized (when your body has not adapted to the climate)
    • First heat wave is the hardest
    • Takes 3- 12 days to adjust
  • People taking certain medications such as anti-Parkinson medication and antidepressants. *
  • People with chronic illness including cardiac and respiratory conditions, dementia or mental illness

Lack of protective factors:

Heat becomes especially difficult for people at risk when there is a "lack of protective factors". These include:

  • No access to air conditioning
  • Poor fluid intake (need a minimum of 6-8 glasses, 250 ml = 1 glass)
  • Use of caffeine-containing drinks (including coffee, tea, colas)
  • Drinking alcohol (as it is dehydrating)
  • Living on the third floor or higher
  • Social isolation

Remember that anyone can suffer from heat related illness, especially early in the season when people are not yet acclimatized.

The more protective factors you have, the less likely you are to suffer from a heat-related illness.

A lack of protective factors is the most likely reason to suffer from dehydration, heat exhaustion and heat stroke.

To beat the heat, be sure to protect yourself and others:

  • Drink plenty of water
  • Stay out of the sun and heat
  • Find a cool place to spend the day, i.e. libraries, community centres or shopping malls
  • Avoid strenuous physical activity outdoors
  • Check in on neighbours and friends who are particularly vulnerable

Get help from a friend or seek medical attention if you been in the heat and have these signs:

  • Rapid breathing
  • Weakness, dizziness or fainting
  • More tiredness than usual
  • Headache
  • Confusion
  • Muscle cramps
  • Nausea or vomiting

*Consult your doctor, nurse or pharmacist if you are concerned about any medication you are taking.

You can help someone with heat illness by doing these things:

  • Call for help
  • Take extra clothing off the person
  • Cool the person with lukewarm water, by sponging or bathing
  • Move the person to a cooler place
  • Give the person sips of cool water, not ice cold water.
Medications and heat-related illness

Some medications make it harder for your body to control its temperature. If you are taking any of the medications listed below, you are at higher risk for heat-related illness, especially if you are doing lots of exercise or heavy work and may not be drinking enough water. On very warm days, you may need to drink more than the normal 8 glasses of water. This is especially true if you are taking two or more medications.

The list below is not complete. There may be others because new drugs are being developed all the time. Also, some drugs have different brand names so check with your doctor, nurse or pharmacist to be sure.

Antidepressants such as:

  • Amitriptyline (Elavil)
  • Doxepine (Sinequan)
  • Clomipramine (Anafranil)
  • Protriptyline (Vivactil)
  • Imipramine (Tofranil)
  • Desipramine (Norpramin)
  • Nortriptyline (Pamelor)
  • Fluoxetine (Prozac)
  • Fluvoxetine (Luvox)
  • Sertaline (Zoloft)
  • Paroxetine (Paxil)

Antiparkinson drugs such as:

  • Benztropine (Cogentin)
  • Biperiden (Akineton)
  • Ethopropazine (Parsitan, Parsidol)
  • Procyclidine (Kemadrin, Procyclid)
  • Trihexyphenidyl (Artane, Trihexane)
  • Levodopa (Dopar)
  • Selegiline (Eldepryl)
  • Amantadine (Symmetrel, Symadine)

Drugs that can alter your mood, thought processes or sleeping patterns such as:

  • Chlorpromazine (Thorazine, Largactil)***
  • Thioridazine (Mellaril)***
  • Perphenazine (Trilafon)***
  • Fluphenazine (Modecate, Moditen)***
  • Thiothixene (Navane)***
  • Trifluoperazine (Stelazine)
  • Prochloperazine (Stemetil)
  • Haloperidol (Haldol)
  • Clozapine (Clozaril)
  • Risperidone (Risperdal)
  • Loxapine (Loxapac, Loxitane)
  • Fluspirilene (IMAP)
  • Pimozide (Orap)
  • Olanzapine
  • Flupenthixol (Fluanxol)
  • Zuclopenthixol (Clopixol)
  • Reserpine (Serpasil, Serpalan)
  • Lithium - heavy exercise or heavy sweating in hot weather may change lithium levels, so that you may have too much or too little in your system

***The medicines starred here may make it easier for your skin to burn. Many other medicines may also cause your skin to burn more easily. To be sure, ask your doctor, nurse or pharmacist. Try to stay out of the sun and if you can't, use sunscreen and wear a hat and long sleeves.

If you take the medicines below, you further increase your risk for heat-illness:

  • Some antihistamines (e.g. Benadryl, Chlortripolon)
  • Over-the counter sleeping pills (e.g. Nytol)
  • Anti-diarrhea pills (e.g. Lomotil)

If you are taking any medications regularly, ask your doctor, nurse or pharmacist if you need to be extra careful during hot weather.

Screening tool for heat illness

*For consideration when Humidex is 36 or greater. Be on alert if you have any of these risk factors or see any of the symptoms of heat illness

Risk Factors

Personal

Environmental

Medical

Elderly over the age of 65

Surrounding temperature over 28oC

Chronic Illness (e.g. Cardiac, Respiratory, Renal, Diabetic Disease)

Infants under the age of 12mos.

No access to an air-conditioned space

Cognitive Impairment (e.g. Dementia, Alzheimer's, Mental illness)

Lives alone/ isolated/limited social support

Live on the 3rd story or above

Obesity

Dependant on others for assistance with daily living activities

Strenuous exercise outside

Malnutrition/ reduced fluid intake

Doesn't cope well in hot weather

Outside work

Medication use

Unaware of preventive measures

   

Use of street drugs (cocaine, LSD, heroin)

   

Homeless

   

Alcohol abuse

   

Drinks under 8 glasses of fluid/day

   
Symptoms

Dehydration

Heat exhaustion

Heat stroke

Thirst

Headache

Headaches dizziness

Dry skin

Blurred vision

Disorientation, agitation or confusion

Fatigue

Nausea or upset stomach

Sluggishness or fatigue

Light headedness

Vomiting

Seizures

Confusion

Sluggishness or fatigue

Hot dry skin

Dry mouth

Thirst

Increase body (Inner) temperature

Increased heart rate

Profuse sweating

Loss of Consciousness

Increased breathing

Moderate increase in body temperature

Rapid heart beat

Less frequent urination

 

Hallucinations

Action

Dehydration

Heat exhaustion

Heat stroke

Move the person to a cool and dry place

Move the person to a cool and dry place

CALL 911

Have the person lie down and rest

Have the person lie down and rest

Or bring patient to nearest emergency room for immediate medical attention

Have the person drink fluids such as water, or juice

Apply cool water to skin and reapply often

While waiting for help: 
Move the person to a cool and dry place

Monitor the person periodically until stabilized

Fan the wet skin.

While waiting for help:
Apply cool water to the skin

 

Have person drink fluids such as water, juice or sports drink (Gatorade™)

While waiting for help:
Apply ice to the head, neck, armpits and groin areas

 

Apply ice to head, neck, armpits and groin areas.

While waiting for help:
Fan the wet skin

 

If the person is showing signs of heat stroke call 911 immediately

 

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