Global warming and more intense heat-wave periods have a significant impact on the health of human beings. Heat illness during heat waves remains a subject to be explored within the prehospital setting of a low- and middle-income country (LMIC). Early intervention of the heat illness within the community and within the prehospital setting can improve outcomes. 

A paper described the characteristics of heat illness patients utilizing the ambulance service in Telangana state, India with the aim of optimizing public prevention and aid strategies and prehospital response to the current growing problem.

It was a retrospective observational study that reviewed patients presenting to Telangana’s prehospital emergency care system with heat illness symptoms during the heatwave period from March through June in 2018 and 2019. 

The investigators performed descriptive analysis on the prehospital, dispatch, and environmental data observing the patients’ characteristics and prehospital intervention.

They found-

295 cases in 2018 and 230 cases in 2019 from March-June. 

The overall incidence of calls with heat illness symptoms to be 1.5 cases per 100,000 people. 

The Scheduled Tribes (ST) showed the highest incidence, with 4.5 per 100,000 people. 

Over 96% belonged to the white income group (below the poverty line) 

2% belonged to the pink income group (above poverty line)

Geospatial mapping of the cases revealed, the highest incidence of calls coming from the rural, tribal areas. However, the time to respond in rural areas remained longer than that in urban areas. 

Males with a mean age of 47 were most likely affected vomiting (44.4%), general weakness (28.7%), and diarrhea (15.9%)were the  three most typical symptoms recorded by the primary responders 

Oxygen therapy (35.1%), oral rehydration salt (ORS) solution administration (26.9%), and intravenous fluid administration (27.0%), with infrequent mentioning of cold sponging, were the three commonest medical interventions on scene.

This descriptive study provided a quick look at the regions and groups of individuals most stricken by heat illness during heat waves. It also described the heterogeneous symptom presentation and challenges with the management of those people within the prehospital setting. These data could also be further helpful in planning prehospital resources and preparation of community first responders during heatwave periods.

Source: Prehospital and Disaster Medicine, 36(4), 385-392. doi:10.1017/S1049023X21000583