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Characteristics of Prehospital Heat Illness Cases During the Annual Heat Wave Period in Telangana, India

Published online by Cambridge University Press:  09 July 2021

Gayathri Devi Nadarajan Open the ORCID record for Gayathri Devi Nadarajan [Opens in a new window] ,
GV Ramana Rao ,
Keshav Reddy ,
Aruna Gimkala ,
Rani Janumpally ,
Yukai Ang ,
Cheryl Ting Zhen Woo ,
Theng Hong Neo ,
Xiang Yi Wong  and
Marcus Eng Hock Ong
Gayathri Devi Nadarajan*
Affiliation:
Department of Emergency Medicine, Singapore General Hospital, Singapore Unit for Prehospital Emergency Care, Singapore General Hospital, Singapore SingHealth Duke Global Health Institute, Singapore
GV Ramana Rao
Affiliation:
Department of Emergency Medicine Learning Centre (EMLC) & Research, GVK Emergency Management and Research Institute (GVK EMRI), Telangana, India
Keshav Reddy
Affiliation:
Department of Emergency Medicine Learning Centre (EMLC) & Research, GVK Emergency Management and Research Institute (GVK EMRI), Telangana, India
Aruna Gimkala
Affiliation:
Department of Emergency Medicine Learning Centre (EMLC) & Research, GVK Emergency Management and Research Institute (GVK EMRI), Telangana, India
Rani Janumpally
Affiliation:
Department of Emergency Medicine Learning Centre (EMLC) & Research, GVK Emergency Management and Research Institute (GVK EMRI), Telangana, India
Yukai Ang
Affiliation:
Duke-NUS Medical School, Singapore
Cheryl Ting Zhen Woo
Affiliation:
Duke-NUS Medical School, Singapore
Theng Hong Neo
Affiliation:
Duke-NUS Medical School, Singapore
Xiang Yi Wong
Affiliation:
Duke-NUS Medical School, Singapore
Marcus Eng Hock Ong
Affiliation:
Department of Emergency Medicine, Singapore General Hospital, Singapore Unit for Prehospital Emergency Care, Singapore General Hospital, Singapore Health Services & Systems Research, Duke-NUS Medical School, Singapore
*
Correspondence: Gayathri Devi Nadarajan, MBBS, MRCEM, MMed (EM)Department of Emergency Medicine Singapore General Hospital, Singapore E-mail: gayathri.devi.nadarajan@singhealth.com.sg
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Abstract

Objectives:

Global warming and more intense heat wave periods impact health. Heat illness during heat waves has not been studied in the prehospital setting of a low- and middle-income country (LMIC). Early intervention in the community and in the prehospital setting can improve outcomes. Hence, this paper aims to describe the characteristics of heat illness patients utilizing the ambulance service in Telangana state, India with the aim of optimizing public prevention and first aid strategies and prehospital response to this growing problem.

Methods:

This retrospective observational study reviewed patients presenting to Telangana’s prehospital emergency care system with heat illness symptoms during the heat wave period from March through June in 2018 and 2019. Descriptive analysis was done on the prehospital, dispatch, and environmental data looking at the patients’ characteristics and prehospital intervention.

Results:

There were 295 cases in 2018 and 230 cases in 2019 from March-June. The overall incidence of calls with heat illness symptoms was 1.5 cases per 100,000 people. The Scheduled Tribes (ST) had the highest incidence of 4.5 per 100,000 people. Over 96% were from the white income group (below poverty line) while two percent were from the pink income group (above poverty line). From geospatial mapping of the cases, the highest incidence of calls came from the rural, tribal areas. However, the time to response in rural areas was longer than that in an urban area. Males with an average age of 47 were more likely to be affected. The three most common symptoms recorded by the first responders were vomiting (44.4%), general weakness (28.7%), and diarrhea (15.9%). The three most common medical interventions on scene were oxygen therapy (35.1%), oral rehydration salt (ORS) solution administration (26.9%), and intravenous fluid administration (27.0%), with cold sponging infrequently mentioned.

Conclusion:

This descriptive study provides a snapshot of the regions and groups of people most affected by heat illness during heat waves and the heterogeneous symptom presentation and challenges with management in the prehospital setting. These data may aid planning of prehospital resources and preparation of community first responders during heat wave periods.

Keywords

climate changeemergency medicineEMSglobal health heatwaveheat illnessheatstrokeprehospital
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 4 , August 2021 , pp. 385 - 392
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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