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Summer Planning Toolkit modules

Module 3: Chronic disease and heat

Heat related disease

Heat related disease

Extreme heat events are estimated to have caused more deaths in the past 100 years than all natural disasters and other emergencies combined. This data is difficult to quantify as only a small proportion of these deaths can be directly attributed to heat (eg heat stroke); whereas others are indirect consequences of extreme heat such as exacerbation of cardiovascular disease 21

Heat related illness places significant burden on the Australian health system as it can cause increased all-cause mortality, increases in ambulance emergency caseload and increases in home-visit GP services 21

The RACGP’s Guidelines for preventive activities in general practice (the Red Book) is an essential resource for GPs managing patients with communicable and chronic illnesses, and can be used in conjunction with other specific resources mentioned throughout this toolkit when treating patients during extreme heat. The Australian Journal of General Practitioners (AJGP) has also published a useful article on Preventing heat-related disease in general practice.

Visit the RACGP’s Clinical guidelines webpage for further information on a range of chronic diseases.

Symptoms of heat-related disease

There are a variety of heat-related symptoms and associated diseases, including:

  • heat rash
  • cramps
  • fatigue
  • dizziness and fainting
  • heat exhaustion
  • heat stroke 21
  • dehydration.

Heat stroke can cause additional symptoms such as a rapid pulse and shallow breathing, trouble speaking, difficulty concentrating, sudden rise in body temperature, aggressive or strange behaviour, dry or swollen tongue, headache, nausea or vomiting and intense thirst 22.

Partaking in higher intensity exercise and other excessive activities in the heat can elevate the risks of heat stress 21

Vulnerable populations

There are some circumstances that may make a person more vulnerable to heat-related disease and heat waves. People may have chronic illness, take multiple medications, or have a disability which makes them vulnerable; while others may be susceptible to heat as they lack resources to control their environment.  Social isolation also may increase vulnerability if a patient does not have friends or family to check in on them. 

The following populations may be more vulnerable to heat-related disease and heat waves:

  • children and infants
  • older people
  • people who are experiencing homelessness
  • people who are socially isolated 21
  • people with chronic illnesses who are taking daily medications 23
  • people with low incomes
  • people with disabilities
  • pregnant patients
  • athletes and
  • people who work outside 24.

Preventing heat related disease

During heat waves, practices may wish to keep a list of their most vulnerable patients and set up protocols for checking in on them by phone, via an appointment in the clinic, or through home visits 21. Protocols may include use of flagging systems in patient records, correct coding in patient histories, up to date health summaries and building a list of vulnerable patients who may need checking during extreme heat. 

GPs can help to prevent heat-related diseases in vulnerable populations by providing education on the following, ensuring the advice is appropriate for each patient’s personal situation:

  • providing specific heat wave advice to patients in advance, ie sick day plans
  • maintaining hydration
  • avoiding unnecessary physical activity
  • avoiding going outside during the hottest parts of the day
  • wearing light coloured, loose-fitted clothing
  • using light-coloured curtains in the home
  • closing internal doors
  • moving to the eastern side of the house in the afternoon
  • using air conditioning and/or fans (if these aren’t available, going to publicly available spaces such as libraries where possible)
  • having battery operated equipment, including radios and charged mobile phones, in case there is a power outage
  • ensuring power banks are fully charged
  • stocking up on food that requires no cooking
  • having a back-up plan if the patient is reliant on electricity for medical equipment 21.

Community engagement

Your general practice may choose to engage with other organisations within your community to develop a heat plan for the purpose of supporting vulnerable populations. These organisations may already have plans in place to accommodate vulnerable people needing a cool place to rest during the day. Organisations your practice may wish to engage with include:

  • libraries
  • schools
  • after-school care centres
  • public pools and other sporting organisations
  • non-governmental organisations such as church groups, refugee organisations or homeless shelters
  • shopping centres.

If your practice has space, you could consider setting up a communal area for vulnerable patients to keep cool.

The following factors should be considered when developing a heat plan in conjunction with community organisations:

  • Does the organisation already have a heat action plan in place?
  • Are the organisation’s staff trained to deal with heat related emergencies?
  • Is there a specific area people are encouraged to go to (ie in a shopping centre there may be a dedicated resting area)?
  • How does the organisation plan to communicate the heat plan with members of the public?
  • Does the practice’s local council have a community heatwave response plan?  

Each state/territory has their own resources to help you plan for extreme heat. These resources can be found in the State/territory disaster management page of the summer planning toolkit.