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Summer Planning Toolkit modules
Module 3: Chronic disease and heat
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.
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.
There are a variety of heat-related symptoms and associated diseases, including:
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.
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:
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:
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:
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:
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.
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