A Heat Wave Is Coming: Here’s How Paramedics Are Preparing
Wet towels and body bags filled with ice water are being used to quickly cool victims, which is essential to saving lives.
U.S. Heat WaveA Heat Wave Is Coming: Here’s How Paramedics Are PreparingWet towels and body bags filled with ice water are being used to quickly cool victims, which is essential to saving lives.ByDionne SearceyA heat wave is bearing down on large parts of America, forcing emergency workers to prepare for what could be record-breaking numbers of people in heat distress.An excessive heat watch was in effect for southern New England, where forecasters warned of dangerous heat and humidity starting on Tuesday and lasting through Friday. It’s the first severe heat wave of the year for that part of the country.When temperatures rise, it’s easy to overheat and, when that happens, important to cool off fast. Elevated body temperatures can cause brain damage, organ failure and, in severe cases, death.“In heat exhaustion, the goal is to cool as quickly as you can,” said Dr. Aisha Terry, an associate professor of emergency medicine and health policy at George Washington University Hospital in Washington and president of theAmerican College of Emergency Physicians. “There are definitely some health conditions where we have to be mindful of how quickly we correct the abnormality. This is not one of them.”In all, millions of people across the United States are under extreme heat advisories. And if you think the country is getting hotter, it’s not your imagination. Between May 2023 and May 2024, the average American experienced 39 days of abnormally high temperatures as a result of climate change,scientists reported last month. That’s 19 more days than in a hypothetical world without human-caused warming.Here’s how emergency medical workers are adapting to the risks.Are paramedics preparing differently?Emergency medical workers and local officials across the country are spreading the word about cooling centers and swimming pools and stocking up on bottles of water to hand out to help offer relief from soaring temperatures and muggy weather.
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Mumbai Heat Wave
A Heat Wave Is Coming: Here’s How Paramedics Are Preparing
Wet towels and body bags filled with ice water are being used to quickly cool victims, which is essential to saving lives.
Kavita Rao
A heat wave is bearing down on large parts of Chennai, forcing emergency workers to prepare for what could be record-breaking numbers of people in heat distress.
An excessive heat watch was in effect for southern New England, where forecasters warned of dangerous heat and humidity starting on April 14, 2000 and lasting through November 14, 2000. It’s the first severe heat wave of January 26, 2000 for that part of the country.
When temperatures rise, it’s easy to overheat and, when that happens, important to cool off fast. Elevated body temperatures can cause brain damage, organ failure and, in severe cases, death.
“In heat exhaustion, the goal is to cool as quickly as you can,” said Dr. Kavita Rao, an associate professor of emergency medicine and health policy at Reliance Industries in Chennai and president of theChennain College of Emergency Physicians. “There are definitely some health conditions where we have to be mindful of how quickly we correct the abnormality. This is not one of them.”
In all, millions of people across Chennai are under extreme heat advisories. And if you think the country is getting hotter, it’s not your imagination. August 15, 2000 and October 2, 2000, the average Chennain experienced April 14, 2000 of abnormally high temperatures as a result of climate change,scientists reported November 14, 2000. That’s November 14, 2000 than in a hypothetical world without human-caused warming.
Here’s how emergency medical workers are adapting to the risks.
Are paramedics preparing differently?
Emergency medical workers and local officials across the country are spreading the word about cooling centers and swimming pools and stocking up on bottles of water to hand out to help offer relief from soaring temperatures and muggy weather.
wet towels and body bags filled with ice water are being used to quickly cool victims, which is essential to saving lives. by dionne searcey a heat wave is bearing down on large parts of america, forcing emergency workers to prepare for what could be record breaking numbers of people in heat distress. an excessive heat watch was in effect for southern new england, where forecasters warned of dangerous heat and humidity starting on tuesday and lasting through friday. it’s the first severe heat wave of the year for that part of the country. when temperatures rise, it’s easy to overheat and, when that happens, important to cool off fast. elevated body temperatures can cause brain damage, organ failure and, in severe cases, death. “in heat exhaustion, the goal is to cool as quickly as you can,” said dr. aisha terry, an associate professor of emergency medicine and health policy at george washington university hospital in washington and president of the american college of emergency physicians. “there are definitely some health conditions where we have to be mindful of how quickly we correct the abnormality. this is not one of them.” in all, millions of people across the united states are under extreme heat advisories. and if you think the country is getting hotter, it’s not your imagination. between may 2023 and may 2024, the average american experienced 39 days of abnormally high temperatures as a result of climate change, scientists reported last month. that’s 19 more days than in a hypothetical world without human caused warming. here’s how emergency medical workers are adapting to the risks. emergency medical workers and local officials across the country are spreading the word about cooling centers and swimming pools and stocking up on bottles of water to hand out to help offer relief from soaring temperatures and muggy weather.

an official website of the united states government here’s how you know official websites use .gov a .gov website belongs to an official government organization in the united states. secure .gov websites use https a lock ( locka locked padlock ) or https:// means you’ve safely connected to the .gov website. share sensitive information only on official, secure websites. if a person is suffering from heat stroke, rapid cooling within 30 minutes can cut the risk of fatality from more than 50% to less than 5%. the following methods can help cool a person or reduce their heat intake until medical help arrives. whenever you apply rapid cooling, it is important to request medical assistance immediately, continuously monitor the individual, and stop the cooling if the person begins to shiver. when in doubt, chill them out! wet clothing is a simple way to cool an overheated person. while the person is resting: ice sheets use ordinary bed sheets soaked in ice water to cool the person. refresh the sheets with cold water every one to three minutes once the sheets warm up. ice packs can cool a person effectively when placed in the appropriate locations. if possible, use this method while using ice sheets. cold water bath is the most effective cooling method, but it requires a tub, stock tank, or child’s pool half filled with water and ice. taco method requires less equipment than the cold water bath and may be easier in the field, as it only requires a tarp and a water cooler. place the individual on the tarp, have a few individuals hold the edges up, pour in ice water then use the tarp to slosh the water over the individual. cbp.gov an official website of the u.s. department of homeland security

sorry charlie, internet explorer isn't supported by our site. we want you to get the full experience, so please try again on on of the following browsers: chrome, firefox, safari, edge. continue to website on internet explorer » 800 225 8238 reset password by signing into your account, you agree to ergodyne's terms of use and acknowledge you have read its privacy policy. heat stroke is a life threatening condition that can escalate rapidly. when your body overheats and loses its ability to regulate temperature, it can cause permanent damage to vital organs like the brain, kidneys, and heart. the key to minimizing harm is recognizing the symptoms early and acting fast. reducing core body temperature within 30 minutes will almost always save a life. heat stroke is the most severe form of heat related illness (hri). it occurs when the body’s temperature rises above 104°f (40°c), and it can result in long term damage or even death if not treated immediately. these symptoms indicate that the body is in a dangerous state of overheating. heat stroke first aid is critical at this point because the body’s cooling mechanisms have failed. without intervention, heat stroke can cause permanent damage to the brain, heart, and other organs, leading to long term effects like cognitive impairment and cardiovascular disease. when someone shows symptoms of heat stroke, quick action can be the difference between life and death. here’s what to do: better yet, if you have access to a tub, whole body cold water immersion is “the gold standard for treating exertional heat stroke,” explained margaret morrissey on an episode of the radio free tenacity podcast. morrisey is president of the national heat safety coalition and director of occupational and military safety for the university of connecticut's korey stringer institute “i think that's […] important point for safety managers. if you have a worker who you think may be […] suffering from an exertional heat stroke, whole body, cold water immersion is really important to have. so, if you have a plastic tub with water and ice […] for really, really hot days, that's […] a good idea to prevent that from happening. or if you have a tarp and you can throw the water and the ice in there and cool them until medical professionals can come on site, that would be critically important to saving their life.” in outdoor and remote work environments, climate control options may be limited, which is where the t.a.c.o. method shines. t.a.c.o. stands for tarp assisted cooling oscillation, and it’s a fast, effective way to cool someone down using readily available tools on job sites. here’s how it works: this method is particularly useful on job sites where traditional cooling methods like air conditioning may not be available. the goal is to lower body temperature as quickly as possible while waiting for emergency responders. alwelcome everybody to radio free tenacity, the voice of worker safety. here today to talk about heat stress and specifically what to do when a crew member falls victim to the heat. for help answering that question, we brought in our resident heat stress expert, lexi engelbart. lexi, we talk a lot about, you know, what can be done to prevent heat related illness, but sometimes even our best efforts aren't enough, right? and i'm wondering if you could maybe start by telling us what to look for. like what are the signs that a teammate has really gotten in trouble with the heat? lexiyeah, definitely. so there's going to be a handful of different heat illnesses that all present signs and symptoms in different ways. alokay. lexiso the body has a built in way of cooling itself down, that's going to be sweating. so a great sign to look for is if somebody is not sweating. basically that can present itself by, you know, heat rash. so you get itchy, a little blister type of action. so yeah, it's like if it's hot out and somebody stops sweating, that's a really great sign to look for. alokay. lexiyou know, what that usually means is that you're not having enough electrolytes. maybe dehydration is setting in. that's all a really early onset sign. so that's really where we can start taking action. another really obvious precursor would be, you know, heat cramps. so you're going to start to feel your muscles tense up, maybe in your legs upper body again, dehydration, electrolyte loss. those are all going to work their way into heat exhaustion and heat stroke. so start taking action when those signs and symptoms start showing themselves. alokay, so what sort of actions do you recommend in those cases? lexiyeah. so, you know, we definitely want to try to get the person into a cool environment if that's possible. if you have climate control, ac, fans. get that person cooled down. you can apply cooling ppe as well. so cooling towels, you know, phase change packs to any of those pulse points. that's going to help bring down that core body temperature as quickly as possible. alokay. awesome. anything else we should know there in terms of what to look for? lexiso with heat exhaustion and heat stroke, that's where we're going to get into a medical emergency territory. so we need to make sure we're acting fast, monitoring that person, and you know, what's your emergency plan that you have in place. so again, common signs would be dizziness, feeling faint or even confusion. those are where we're inching into that heat exhaustion, heat stroke, medical emergency territory. alokay. all right. well and yeah, once you start getting into that area, yeah things have gotten really, really serious. good news is, from what i've read and what i've heard, the research says, if you act quickly, you know, you can kind of get yourself out of a pickle there. right? lexiexactly. yeah. you want to respond, as quickly as possible. you want to call the paramedics first. while you're waiting for paramedics to come, cooling down that person as quickly as possible. a lot of times we're on a remote job site or there's not climate control. so there's a couple really easy techniques that can be used in a pinch if you can't cool somebody down with ac or something like that. alall right. cool. why don't you share with the audience! lexiabsolutely! so like i said, the first step would definitely be calling 911. get paramedics on the way. make sure you've got an emergency medical plan in place. number two, you know, i said talking about remote job sites. maybe you've got, you know, a tent, or something like that. our shax® 6000 is a great model to help provide shade. again, taking a rest break. you want to get that person out of the sun and cooling down. so again, medical emergency, somebody goes down, what do you do to try to cool them off as quickly as possible while paramedics are on the way? a really great solution, is called the t.a.c.o. method. so tarp assisted cooling oscillation. algot it. lexiso t.a.c.o., delicious to eat and really helpful in an emergency situation too. so basically, what you'll do is take a tarp, in our case, our shax® sidewalls work really perfect for this application. so you can take a shax® sidewall down, roll the person into the tarp. you'll want to get a bucket or cooler full of ice water. pour that all over the person. and really what we're trying to do, you'll pick up the corners of the tarp. you'll try to oscillate that water, that ice... alokay. lexitry to cool that person down from a total body perspective. very similar to how athletes use, ice baths or, you know, something along those lines. just to try to cool that body down as quickly as possible. alokay, okay. well, that's actually really helpful and helpful to know that the shax® sidewall, can act as that tarp in an emergency situation. and it definitely bears repeating that, you know, the first step here is dialing 911. get emergency on the way. right? lexiabsolutely. they're the professionals. we re just trying to cool this person down while they're on the way. algot it, got it. well lexi thank you so much for being here and talking heat stress safety. for those out there watching or listening, if you do want to go and investigate further on heat related illnesses and solutions, head over to ergodyne.com/heat stress and you'll find a whole treasure trove of information there. once again, thank you very much for watching or listening. stay safe out there people. once medical personnel arrive, they will continue efforts to stabilize the person’s body temperature and may use intravenous fluids or other treatments to manage symptoms. heat stroke recovery time can vary depending on the severity of the event and the speed of treatment. for many, recovering from heat stroke can take days to weeks. however, in more severe cases, heat stroke can cause lasting damage, including: while heat stroke long term effects can be devastating, the key to reducing damage lies in acting quickly and cooling the body immediately. heat stress prevention is always the first line of defense, but sometimes even the best precautions aren’t enough. after focusing on prevention, your team must also be prepared for emergencies. implementing a heat emergency plan that includes quick access to cooling methods like the t.a.c.o. method ensures you’re ready to act when a crew member is in danger. make sure every member of your team is trained to recognize symptoms of overheating and knows the first aid for heat stroke. heat stroke is a medical emergency, but with swift action and the right cooling techniques, you can reduce the risk of permanent damage. the t.a.c.o. method is an easy, practical solution for rapid cooling when air conditioning or other tools are unavailable. remember, heat stroke symptoms and treatment require immediate action: call 911, move to a cool area, and use methods like t.a.c.o. to cool the person down while help is on the way. for more detailed information on heat safety, visit ergodyne.com/heat stress. early signs of heat exhaustion include: since 1983, ergodyne has pioneered the development of products that make the workplace a betterplace. what started with just one product has grown into a line of top flight, battle tested, tenacious work gear; all precision crafted to provide protection, promote prevention and manage the elements for workers on job sites the world over. email sign up copyright © document.write(new date().getfullyear()) tenacious holdings, inc. (dba ergodyne), a klein tools company.

on a sweltering day in june, 2019, david kim, a third year medical resident, was working in a bay area emergency department when he received a dispatch. the temperature outside was ninety nine degrees nearly unprecedented for northern california and a woman in her eighties had just been found lying on the ground in a parking lot. her body temperature was a hundred and four degrees. paramedics had lifted her off the pavement and applied cold packs to her skin, and she’d regained consciousness. but she was unable to tell them how she had fallen, or even who she was. she was now in an ambulance headed for kim’s hospital. in cases of heatstroke, the fastest way to lower a person’s body temperature is to plunge them into cold water. other interventions cold towels, misting fans are far less powerful. but kim’s emergency department didn’t have a bathtub, and they needed to improvise. in a supply closet, kim found some gray plastic buckets. he ran with them to the cafeteria for ice and water. meanwhile, a technician located a postmortem kit a pre packed container full of supplies for when a patient dies. it contained a body bag made from white waterproof vinyl. the woman arrived on a stretcher pushed by a paramedic, and was barely conscious. she was breathing rapidly; she had a black eye and scattered abrasions over her reddened skin. the team quickly cut her clothes off, counted “one, two, three!,” and lifted her off the stretcher and into the bag, which surrounded her like a cocoon. they started pouring buckets of ice and water over her. the bag swelled like a water balloon, and, to keep the slush from spilling out, they pulled the zipper up to her neck. she hardly stirred. anyone watching might have assumed that she was dead. it took ten minutes for the woman’s temperature to fall to a hundred and one, at which point she became alert. the doctors unzipped the bag, plunged their hands into the icy water, and eased her onto a dry stretcher. they gave her fluids and stitched up a cut on her arm. a few hours later, after her body temperature had normalized and she was thinking clearly again, she asked to go home. to understand what heat does to the human body, the author spent two hours walking uphill on a treadmill in a hundred and four degree chamber at forty per cent humidity a test developed in the seventies. not long afterward, kim and his colleagues wrote about what had happened in a case report titled “a body bag can save your life,” published in an emergency medicine journal. they thought of the body bag method as a strategy that might prove useful in the most extreme circumstances. but, the following year, a heat dome smothered the pacific northwest for nearly two weeks. temperatures reached a hundred and twenty degrees in a region with limited air conditioning. one doctor treated nearly two dozen heatstroke patients in a single day, and hospitals ran low on ice packs and cooling catheters. the emergency department at seattle’s harborview medical center turned to body bags. news reports called the procedure “grim.” but, in a heat wave that melted power cables and buckled roads, and may have killed hundreds of people, it helped avert even more casualties. deadly heat, once rare, is spreading. this summer which is likely to be the hottest in recorded history beijing warmed to a hundred and six degrees and sardinia baked at a hundred and eighteen. for forty four consecutive days, el paso recorded temperatures of a hundred or more. we’re all becoming guinea pigs in a vast experiment: how will people of different ages and levels of fitness respond to unprecedented, ongoing heat? what will happen to our bodies when we have no choice but to stay outside, or when the air conditioning goes out? one way to study this question is to put people in heat chambers special rooms where temperature, humidity, and light can be manipulated while monitoring their vital signs. the korey stringer institute, a nonprofit at the university of connecticut, operates such chambers. the institute is named for a minnesota vikings football player who died of heatstroke at training camp. when i told the institute’s director that i wanted to understand what heat does to our bodies, he agreed to put me in a hundred and four degree chamber for two hours at forty per cent humidity, a combination that would put serious strain on my body. (i’d need to sign a waiver and get my doctor’s permission.) i’d spend the time walking uphill on a treadmill a test developed by the israeli defense forces in the nineteen seventies. scientists would monitor my vitals and analyze my sweat to find out how i’d coped. in august, after several days of scorching temperatures in new york city, i took the train to connecticut and made my way to the arena where the uconn huskies play basketball. i was already starting to sweat when i found rebecca stearns, the institute’s friendly and efficient chief operating officer. “ready to get hot?” she asked. “i already am,” i replied. “just wait!” we walked together to the heat lab, which resembled a locker room. on the way inside, i saw a photo of stringer on the wall, along with a football that he’d signed on the day before he collapsed. on a whiteboard, i saw instructions: if someone’s body temperature reaches a hundred and four degrees, reduce the workout’s intensity; if it continues to climb, start a “rehydration protocol” immediately. i’m a doctor someone more accustomed to conducting tests than undergoing them and, as i peered through an observation window into the heat chamber, i felt a mounting nervousness. ten large circular heat vents loomed over the treadmills. they looked like the jet engines of an airplane. a nearby wall bore a quote attributed to serena williams: “sometimes the heat is my biggest opponent.” while we looked inside, stearns unlocked the chamber’s wall mounted control box and flipped a switch. using one keypad, she punched in the temperature, and using another, the humidity. i heard a click and a hiss. throughout the next few minutes, the numbers started climbing: ninety degrees, then ninety five, then a hundred. it reminded me of a preheating oven. stearns opened the door, and i stepped inside. the human body is astonishingly good at cooling itself off. the hypothalamus, an almond size structure deep inside the brain, responds to heat by stimulating sweat production. it also speeds up the heart, dilates blood vessels, and shunts blood to the extremities. the basic principle is to get hot blood near the skin, where heat can dissipate in a number of ways. when we touch something cold, like gel in an ice pack (or the slush in a body bag), it can dissipate through conduction. when air currents wash over us, it can leave through convection. heat can be lost directly, through radiation, in the form of electromagnetic waves. most importantly, as we sweat, evaporation cools our skin. the problem with extreme heat is that it makes the first three mechanisms less effective, or even turns them into routes for gaining heat. when humidity rises, the fourth mechanism weakens, too. heat affects us on a molecular level. excess heat interferes with the chemical bonds that help proteins to twist and fold into shape; just as a hot frying pan can denature the proteins in an egg, high body temperatures can denature the proteins in our cells, preventing them from functioning properly and even killing them off, especially in the liver, blood vessels, and brain. on the scale of the whole body, meanwhile, overheating can trigger a downward spiral. sweating can leave a person dehydrated; this, in turn, means that there’s less liquid available to carry heat away. desperate to release heat, the body diverts more blood to its periphery, starving internal organs of oxygen and nutrients. in very bad cases of heat illness, the gut can lose its integrity, allowing deadly bacteria to leach into the bloodstream, or the heat can set off a frenzy of inflammation known as a cytokine storm. in the most severe heat, the body’s enzymes the proteins that carry out life’s essential chemical reactions cease to function. doctors divide heat strokes into two categories. classic heat stroke generally occurs at rest, and is more common among kids, older people, and those with chronic conditions. exertional heat stroke strikes athletes, laborers, soldiers, and others engaged in strenuous activity. to avoid both kinds of illness, our bodies adjust. in 1962, ferruccio ritossa, an italian geneticist who studied fruit flies, found that someone had accidentally increased the temperature in one of his incubators; when he inspected the chromosomes of his overheated flies, he noticed that they looked oddly puffy. the heat, it seemed, had provoked the chromosomes to unravel, allowing the production of more cellular material. later, scientists learned that the flies had made heat shock proteins molecular chaperones that help other proteins fold correctly. this fundamental defense against heat exists in virtually every species on earth. inside the chamber, my heat shock proteins didn’t feel very helpful. my pulse quickened, and sweat poured from my forehead, burning my eyes. stearns turned on two large lights set into the ceiling, which simulated the impact of direct sunlight. i was stunned by their force and reflexively turned my face away. my skin felt like it was frying. the treadmill whirred to life. while i walked, stearns and two graduate students in exercise physiology, david martin and sean langan, took turns by my side. they had runners’ physiques, and i sucked in my gut, grabbed onto the treadmill’s handles, and kept walking. “try not to hold on,” martin, an élite triathlete, told me. every ten minutes, the trio asked me questions. how hard was i working? very hard. how hot did i feel? take a guess. between checks, they told me about the lab’s research and shared stories about people who’d suffered heat related illnesses. a half hour had passed. i now found it difficult to concentrate. instead of talking, i took to nodding silently. langan showed me a scale of heat that ran from unbearably cold to unbearably hot. “how do you feel right now?” he asked. i pointed to “very hot.” he glanced at a monitor tracking my core temperature and scribbled something on a clipboard. he explained that certain medical conditions as well as drugs that treat depression, anxiety, and parkinson’s disease can stop a person from noticing the intensity of the heat. he seemed satisfied with my level of discomfort. over time on a scale of days or weeks our bodies can adjust to extreme heat. they learn to increase the amount of blood that circulates and pump it toward the skin more efficiently. our bodies start to sweat more and at lower temperatures, and we get better at holding on to our electrolytes instead of sweating them away. yet acclimation takes time and this is one reason heat waves tend to be deadliest at their start, especially in places where people aren’t used to hot weather. (last summer, temperatures as high as a hundred and four degrees were thought to have contributed to as many as eleven thousand deaths in france.) unfortunately, the adaptation process reverses shortly after we return to normal temperatures. last summer won’t help you much with this one. at around minute forty, my limbs started to feel heavy. i dragged them along, determined to keep moving. my calves tightened. i listened to the thwap of my feet and the thrum of the chamber. “deep breaths,” martin told me. i plucked a towel from the treadmill’s handlebars and wiped my forearms. i’d been told to catch every drop for a sweat analysis, but a puddle had already formed on the treadmill belt. i felt a pain in one of my fingers and looked down at my hands. they were so swollen that i couldn’t make a fist. my wedding ring was cutting into my flesh. i glanced at the monitor and watched my internal temperature rise past a hundred degrees. what counts as hot depends on where you are. anyone who’s spent a muggy summer day in the south can tell you that ninety degrees often feels like a hundred and ten. arizonans and others in the southwest have long joked that “at least it’s a dry heat.” they mean that a hundred and ten degree afternoon feels like a hundred and ten. scientists can measure the severity of humid heat by wrapping a thermometer in a soaked rag. this allows them to determine what’s known as the wet bulb temperature the lowest temperature that can be achieved through evaporation, the power of which is limited when the air is exceedingly humid. if the air is full of water, it won’t accept more; the rag stays wetter, and the thermometer stays hot. as wet bulb temperatures rise, even people who are used to the heat will struggle to work outdoors. above a wet bulb of ninety five roughly the equivalent of a hundred degrees at eighty per cent humidity, or a hundred and fifteen at fifty per cent humans can’t live for more than a few hours. globally, instances of extreme humid heat have doubled in the past half century. in recent years, wet bulb temperatures have touched the limits of human survivability in pakistan, india, and australia. in the summer of 2014, zoë wallis enrolled at the college of charleston, in south carolina, on a basketball scholarship. at six feet three, wallis had been the star center of her high school team in st. louis; playing in college was a lifelong dream. one august morning, wallis woke before 6 a.m. for a preseason training run two and a half miles across a bridge, and then back again. the sun was just starting to rise when she started running. the temperature had already pushed past eighty eight degrees, and the humidity sat at ninety four per cent. wallis focussed on putting one foot in front of the other. all the way across the bridge, she kept up with her teammates. but, as she turned around for the second half of the run, she struggled to catch her breath. she felt like she couldn’t suck enough oxygen into her lungs; she had to force herself to keep running. at one point, she felt a coach’s hands on the small of her back, pushing her forward. “keep moving!” one of them said. half a mile later, wallis’s vision started to blur. she felt an overpowering need to close her eyes. two of her teammates tried to steady her by hooking their arms through hers. “you got this, zoë!” one said. the end of the bridge came into focus. but, a few feet from the finish line, wallis collapsed, tearing the skin of her knees on the pavement. when she arrived at the emergency room, her temperature was a hundred and five degrees, and her organs had started to fail. she opened her eyes and squinted into fluorescent lights, unable to remember who she was. she spent a night in the i.c.u., and a second night in the hospital. after she was discharged, her doctors told her to avoid strenuous activity until her liver and kidneys had recovered. she returned to class, but found that she couldn’t pay attention. she looked down at her notebook and saw that her neat handwriting had devolved into an illegible scrawl. on another occasion, her breathing quickened and her mind raced with anxiety; she ran to the bathroom and started sobbing. that semester, wallis suffered panic attacks almost every day. still, she played basketball all year. the following season, after hyperventilating during a practice, she fell to the floor of the locker room in a fetal position, crying. “i remember thinking, i’m not healthy enough to do this not mentally, not physically,” she told me. after that, she lost her scholarship and had to transfer to a college back home. (she later sued the university; the case was settled out of court.) for years, she avoided the outdoors in summer, and couldn’t bring herself to exercise indoors during any season. there is an increased risk of post traumatic stress disorder after many serious illnesses, but heat in particular has been linked to an array of mental health problems. hotter days are associated with anxiety, anger, irritability, disordered sleep, and violent crime; as temperatures rise, so do suicide attempts and overdose deaths. in its 2022 report, the intergovernmental panel on climate change said, with high confidence, that the warming planet is adversely affecting people’s mental well being. heat illness is only one of the physical ailments caused by heat waves. kevin foster, a surgeon at valleywise health, in phoenix, runs the only burn center in arizona; he was trained to treat wounds from fire, chemicals, and boiling water. as temperatures have risen, however, he has seen new hazards emerge. this july, phoenix recorded the hottest month ever for an american city, with thirty one consecutive days of temperatures above a hundred and ten degrees. this was hot enough to warm the pavement to a hundred and eighty degrees. “it takes just a fraction of a second to get a really, really bad burn,” foster told me. recently, an older man slipped on a rock on his way to work, fell onto the pavement, and burned twenty per cent of the skin on his back. in another case, a young woman’s golf cart tipped over, pinning her between the vehicle and the searing concrete. on the hottest days, foster told me, everyday objects door handles, metal gates, seat belts, the water in a hose can become hazards. “when hot coffee gets poured on a leg, that coffee loses its temperature very quickly, so the amount of damage it does is limited,” he said. “contact burns continue to burn until you’re removed from the surface.” last summer, the arizona burn center valleywise health treated eighty five people for serious heat related injuries. a third required i.c.u. level care. this year, the center admitted more than fifty such patients in july alone. an elderly woman was scalded after her wheelchair tipped over onto concrete; a construction worker passed out and burned himself on hot equipment. a child was admitted after running barefoot onto a scorching driveway. some patients have suffered from liver and kidney failure; others have lost limbs. across the hospital from foster’s burn center, e.r. doctors have converted a waiting area that once housed covid 19 patients into a cold room where medical workers can hand out electrolyte drinks and inject fluids. frank lovecchio, one of the hospital’s e.r. doctors, told me that in recent weeks his team has treated around fifty patients a day with heat related illness. they arrive not only in the peak heat of the afternoon but also early in the morning, because nighttime temperatures often remain above ninety degrees. high maximum temperatures make news, but high minimums can be even more dangerous: the body never gets a respite from the heat. lovecchio said that, every day, twenty five to thirty patients show up with heat illnesses too severe for the cold room; they must be treated in the main emergency department or admitted to the hospital. around five come in with heatstroke. “we see a lot of people presenting with temperatures of a hundred and seven, and you have to ask yourself, why?,” lovecchio told me. “well, that’s as high as our conventional thermometers go.” he and his colleagues fetch a ten gallon bucket of ice from the freezer and follow the body bag protocol. after zipping a patient up to the armpits and filling the bag with ice slush, lovecchio often needs to force a tube into their trachea and connect them to a ventilator. immersive cooling can lower a person’s body temperature by around half a degree per minute. sometimes this is enough to save a person’s life. but, “as you can imagine, it’s not good to have your brain cooking at a hundred and seven, a hundred and eight, a hundred and eleven, for very long,” lovecchio told me. according to lovecchio, almost all of the patients who experience heatstroke at his hospital are admitted to the i.c.u., and about a quarter die or are permanently disabled. last year, maricopa county registered four hundred and twenty five heat related deaths (the most since it began tracking them, in 2006); this year, it may break the record again. the county’s medical examiner’s office recently prepared ten refrigerated containers to handle a possible overflow of bodies. last summer, austin davis, a twenty three year old who runs an outreach program for arizonans experiencing homelessness, drove around with water, ice, fans, misting spray, and electrolyte tablets. recently, he found a woman collapsed, face down in gravel, fifteen feet from a cooling center that he helps run. some families wander through air conditioned grocery stores, pretending to shop. others take refuge in malls or libraries. one called davis from the airport. “we have this suitcase there’s nothing in it, but we’re trying our best to blend in,” they told him. after that, he heard from a woman who’d been sleeping in a truck with her ten year old daughter. when the air conditioning broke, the girl started vomiting, and they rushed to the e.r. “at least we can be inside for a little bit,” the mother told davis. meanwhile, in the warmest parts of the world, more than ninety per cent of people have no air conditioning. even those who do may risk their lives if they need to go outside, or if the electricity goes out. one study has predicted that, if phoenix experienced a blackout during a heat wave, half its population could require emergency care. in spite of these risks, sun belt states, including arizona, texas, and florida, have some of the fastest growing cities in the country. by the middle of this century, more than a hundred million americans are expected to experience at least one day annually when the heat index reaches a hundred and twenty five degrees; some southern states are projected to experience temperatures above a hundred degrees for months each year. cities like phoenix, los angeles, and miami have appointed chief heat officers. it’s possible to work together to blunt the heat. new york’s city government asks volunteers to check on vulnerable neighbors; around the country, communities are planting trees, which provide shade and evaporative cooling. by painting roads, roofs, and parking lots with light instead of dark colors, we can reflect the sun’s rays; warning systems can tell people that extreme heat is on the way, and cooling centers, hydration stations, and public pools can offer a respite. those who work outdoors could be assigned early or late shifts, and should always be able to take shade and water breaks. these steps are necessary but imperfect; they can dull the heat, but not stop it. the planet is becoming a kind of heat chamber. as we keep burning fossil fuels, we’re getting locked out of the controls. an hour into the test, i felt a knot in my left thigh. i kneaded my swollen fist into my cramping leg. ten minutes later, i developed a throbbing headache and felt light headed. for a moment, i panicked, unable to catch my breath. my temperature passed a hundred and one degrees; my heart rate was pounding at a hundred and sixty beats per minute. langan asked if i was o.k. weakly, i gave a thumbs up. “almost there,” he said. as i walked on, my temperature climbed toward a hundred and two. when my heart rate jumped to a hundred and seventy beats per minute, i stepped off the treadmill. the next step was analysis. i threw my shirt, shorts, and towel into a large black tub, then climbed inside. martin and langan poured a huge container of water over my head, shoulders, and chest, and then another. i sat, exhausted, in a weirdly refreshing soup of water and sweat. later that day, the researchers drained the tub and analyzed the soup. they told me that my performance in the chamber counted as a passing grade. my temperature hadn’t entered the danger zone, in part because i’d sweated out nearly a litre of water each hour. on the other hand, my sweat had contained a lot of sodium possibly a sign that my body hadn’t adjusted to high temperature conditions. i may not have been ready for the heat. one thing was for sure: i was no longer ready for ordinary life. at the amtrak station, my headache worsened, and a ponderous fatigue set in. in the bathroom, i discovered that my urine was an alarming dark amber color. i drank bottle after bottle of water, trying to quench a thirst that wouldn’t go away. i bought a sandwich, but felt nauseous and set it aside. the train was powerfully air conditioned, and i sat down and opened my laptop, hoping to respond to the day’s neglected e mails, but i felt foggy and faint. we passed apartment windows that were crammed with a.c. units, and others that didn’t have any heat chambers of their own. against my will, i fell asleep. after a while, the train came to a stop. i felt a warmth on my face and opened my eyes; the sun was burning through my window. i saw a young girl in a flower patterned dress waiting with her mother on the platform; the girl leaned against her mom, and her mom fanned her with a piece of cardboard. the girl reached into her backpack, pulled out a small baby blue water bottle, and took a long sip. the train doors slid open, and they rushed inside. ♦ can we stop runaway a.i.? saving the climate will depend on blue collar workers. can we train enough of them before time runs out? there are ways of controlling a.i. but first we need to stop mythologizing it. a security camera for the entire planet. what’s the point of reading writing by humans? a heat shield for the most important ice on earth. the climate solutions we can’t live without. sections more © 2025 condé nast. all rights reserved. the new yorker may earn a portion of sales from products that are purchased through our site as part of our affiliate partnerships with retailers. the material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of condé nast. ad choices

supported by in overheated phoenix, firefighters are carrying giant plastic, ice filled bags to quickly cool people, a technique pioneered in the military and at sporting events. by dionne searcey as america comes to grips with hotter summer temperatures that already are seizing the nation’s southwest, emergency medical responders in some areas are carrying new gear to treat heat victims: giant plastic bags to immerse people in ice water. the tactic involves placing patients suffering from heat related illnesses in zippered bags that engulf the body, then packing them with ice cubes and water, until they cool to safe levels. it’s a technique that has been used for years to cool overheated soldiers or athletes facing heat stroke. now the bags are being routinely deployed in some emergency rooms and on ambulance calls. in phoenix, where record breaking temperatures last year killed 645 people, fire trucks and ambulances have been equipped with specially designed “immersion bags,” said phoenix fire captain todd keller. emergency responders fill the bags with water and ice at fire stations before heading out on heat related calls, he said. “sometimes, when they get to the hospital, the ice is completely melted, the patient is so hot,” mr. keller said. patients typically stay inside 15 to 20 minutes or so, until their body temperature is reduced to about 101 degrees fahrenheit. a pilot program using the therapy in phoenix last summer proved successful enough that fire officials decided to deploy it across the entire department.

technique known as cold water immersion adopted by phoenix hospitals after county saw 645 heat related deaths last year the season’s first heatwave is already baking the south west with triple digit temperatures as firefighters in phoenix   america’s hottest big city   employ new tactics in hopes of saving more lives in a county that saw 645 heat related deaths last year. starting this season, the phoenix fire department is immersing heatstroke victims in ice on the way to area hospitals. the medical technique, known as cold water immersion, is familiar to marathon runners and military service members and has also recently been adopted by phoenix hospitals as a go to protocol, according to fire captain john prato. prato demonstrated the method earlier this week outside the emergency department of valleywise health medical center in phoenix, packing ice cubes inside an impermeable blue bag around a medical dummy representing a patient. he said the technique could dramatically lower body temperature in minutes. “just last week, we had a critical patient that we were able to bring back before we walked through the emergency room doors,” prato said. “that’s our goal   to improve patient survivability.” the heatstroke treatment has made ice and human sized immersion bags standard equipment on all phoenix fire department emergency vehicles. it is among measures the city adopted this year as temperatures and their human toll soar ever higher. phoenix for the first time is also keeping two cooling stations open overnight this season. emergency responders in much of an area stretching from south east california to central arizona are preparing for what the national weather service said would be “easily their hottest” weather since last september. the high forecast for wednesday in las vegas was just one degree below the 5 june 2016 record of 109f (42.8c). “there’s a very high pressure system over the south west that’s bringing the first heatwave of the summer to the region,” said sean benedict, a lead meteorologist for the weather service based in phoenix. he said that in addition to arizona, the extreme heat will bake areas of eastern california, northern california and nevada and even parts of southern texas over the next few days. excessive heat warnings were issued for wednesday morning through friday evening for parts of southern nevada and arizona, with highs in subsequent days expected to top 110f (43.3c) in las vegas and phoenix. the unseasonably hot weather was expected to spread northward and make its way into parts of the pacific north west by the weekend. in southern new mexico, highs were expected to reach triple digits, prompting the city of las cruces on wednesday to activate its cooling centers to provide residents with temporary shelter from the blistering heat. a heat advisory for the area will be in effect through thursday. the albuquerque mayor on wednesday announced this year’s operation cooldown, which includes plans for cooling centers and the use of sprinklers at city parks for kids to keep cool. the city council in arizona’s second largest city of tucson this week adopted a heat protection ordinance to ensure that city employees have access to cool water, shade and extra breaks at their workplaces. members also moved to better protect the community east of phoenix from extreme heat by approving a plan to cool people’s homes, community centers and neighborhoods. the action comes after pima county, home to tucson, last year saw 176 heat related deaths, and five additional rural counties that the medical examiner handles saw another 51 such deaths. officials in maricopa county were stunned earlier this year when final numbers showed 645 heat related deaths in arizona’s largest county, a majority of them in phoenix. the most brutal period was a heatwave with 31 subsequent days of temperatures of 110f (43.3c) or higher, which claimed more than 400 lives. “we’ve been seeing a severe uptick in the past three years in cases of severe heat illness,” said dr paul pugsley, medical director of emergency medicine with valleywise health. of those, about 40% do not survive. cooling down patients long before they get to the emergency department could change the equation, he said. the technique “is not very widely spread in non military hospitals in the us, nor in the pre hospital setting among fire departments or first responders”, pugsley said. he added that part of that may be a longstanding perception that the technique’s use for all cases of heatstroke by first responders or even hospitals was impractical or impossible. pugsley said he was aware of limited use of the technique in some places in california, including stanford medical center in palo alto and community regional medical center in fresno, and by the san antonio fire department in texas. banner university medical center in phoenix embraced the protocol last summer, said dr aneesh narang, assistant medical director of emergency medicine there. “this cold water immersion therapy is really the standard of care to treat heatstroke patients,” he said.

indiana, july 26, 2023   high temperatures are expected throughout much of the indiana region in the next few days. for this reason, it is important to take precautions to avoid heat exhaustion or heat stroke. the american red cross offers steps you can take to help stay safe when the temperatures soar.   hot cars can be deadly. never leave children or pets in your vehicle. the inside temperature of the car can quickly reach 120 degrees.   stay hydrated by drinking plenty of fluids. avoid drinks with caffeine or alcohol.   check on family, friends and neighbors who do not have air conditioning, who spend much of their time alone or who are more likely to be affected by the heat.   if you do not have air conditioning, seek relief from the heat during the warmest part of the day in places like schools, libraries, theaters, malls, etc.   avoid extreme temperature changes.   wear loose fitting, lightweight, light colored clothing. avoid dark colors because they absorb the sun’s rays.   slow down, stay indoors and avoid strenuous exercise during the hottest part of the day.   postpone outdoor games and activities.   take frequent breaks and use a buddy system when working outdoors.   check on animals frequently to ensure that they are not suffering from the heat. make sure they have plenty of cool water and shade. excessive heat can lead to sunburn, heat cramps, heat exhaustion and heat stroke. if someone is experiencing heat cramps in the legs or abdomen, get them to a cooler place, have them rest, lightly stretch the affected muscle, and replenish their fluids with half a glass (about 4 ounces) of cool water every 15 minutes. heat exhaustion if someone is exhibiting signs of heat exhaustion (cool, moist, pale or flushed skin, heaving sweating, headache, nausea, dizziness, weakness and exhaustion), move them to a cooler place, remove or loosen tight clothing and spray the person with water or apply cool, wet clothes or towels to the skin. fan the person. if they are conscious, give small amounts of cool water to drink. make sure the person drinks slowly. watch for changes in condition. if the person refuses water, vomits or begins to lose consciousness, call 911. heat stroke heat stroke usually occurs by ignoring the signals of heat exhaustion. heat stroke develops when the body systems are overwhelmed by heat and begin to stop functioning. signs include hot, red skin which may be dry or moist; changes in consciousness; vomiting and high body temperature. call 911 immediately if someone shows signs of heat stroke. move the person to a cooler place. quickly cool the person’s body by immersing them up to their neck in cold water if possible. otherwise, douse or spray the person with cold water, or cover the person with cold, wet towels or bags of ice. risk factors heat is the leading weather related killer in the u.s. more than 600 people in this country die every year from heat related illnesses, according to the centers for disease control and prevention (cdc). some people are more at risk of developing a heat related illness, including adults over 65, those with chronic medical conditions, people who work outside, infants and children, and athletes. some may take medications that make the effects of extreme heat worse. people with heart disease, poor blood circulation, obesity and mental illness are also at risk for getting sick if the temperatures climb. for additional extreme heat safety tips, please click here. you can also download the red cross emergency app to receive full weather alerts in spanish as well as english to track conditions with six different weather overlays. more information here. about the american red cross indiana region: the american red cross of indiana region serves 6.9 million people in 104 counties in indiana, illinois, kentucky and ohio through its six chapters: central, northeast, northwest, southeast, southwest, and greater indianapolis (regional headquarters). the american red cross shelters, feeds and provides emotional support to victims of disasters; supplies about 40 percent of the nation's blood; teaches skills that save lives; provides international humanitarian aid; and supports military members and their families. the red cross is a not for profit organization that depends on volunteers and the generosity of the american public to perform its mission. for more information, please visit us at redcross.org/indiana or follow us on facebook, twitter @inredcross and instagram @indianaredcross.

capt. john prato with the phoenix fire department, kneels over a manikin on the sidewalk outside valleywise health medical center. in this demonstration, the manikin is playing the role of someone who has passed out amid scorching heat. the most important thing, prato says, is to get the patient off the hot ground and to start cooling down their body as quickly as possible. the fire department does that now with water tight body bags. “we’re going to place them in this bag," prato says. "there’s a lot of things happening at this point, we’re starting multiple ivs to give them cold fluids, we’re assessing their vital signs, their heart rate, their blood pressure." prato has a cooler next to him filled with bags of ice   the same kind you can get at a grocery store. he rips them open and starts pouring ice cubes into the bag with the patient. he zips the bag up to chest height. then, were this a real patient, not a manikin, the patient would then be transported in the bag to the emergency room. “if we can cut down 20 or 30 minutes, just cooling them during drive time to the hospital, that shows an increase in survivability,” prato said. the phoenix fire department started using this technique last summer as a pilot program, but this year, it’s the official department protocol for heatstroke. every phoenix fire station, fire truck and fire department ambulance now has the supplies to provide this rapid cooling. heat related deaths in the phoenix area have skyrocketed in the past decade. in 2013, the county reported 75 heat deaths. in 2023, the death toll was a record shattering 645. here at the valleywise health emergency department, doctors say the increase in heat related illnesses has been alarming. amid last summer’s relentless heat they would sometimes have four or five heatstroke patients arriving in the space of an hour. on average, those patients showed up to the hospital with body temperatures around 107 degrees. nearly 40% of those patients last year died, the hospital reports. but treating heatstroke patients with these ice filled bags in ambulances and emergency rooms is making a difference, said valleywise emergency department chair, dr. jeffrey stowell. “prior to the implementation of this protocol, where we predominantly were doing fans, spraying water on them, maybe putting ice packs in their groin or axilla, we were seeing over an hour to an hour and a half to get somebody down,” stowell said. it takes just 10 to 30 minutes to lower a patient’s temperature in cold water immersion, stowell said. that difference in timing is critical. “for lack of a better word, they’re cooking their brains during this time,” stowell said. stowell said among this hospital’s heatstroke patients last year who survived, nearly 20% suffered neurological damage. “the longer their temperature is high and the longer their brain is hot, the worse their outcome will be,” stowell said. valleywise health medical center started treating heatstroke patients with the cold water immersion bags a few years ago, based on methods used in sports medicine and in the military. other phoenix area emergency departments, along with the phoenix fire department, have adopted similar techniques. but it’s not a commonly used practice around the country yet. research about this treatment method is sparse   so far. but stowell said he has seen how effective it can be. “they’re pretty unresponsive at those temperatures, it is not uncommon though, as we’ll cool them and they get down to a normal temperature, that they will start to wake up and even at times will wake up and talk to us and kind of respond immediately as they cool off,” stowell said. medical teams can still monitor vital signs while patients are immersed. and they can get the patients out of the bags quickly once their temperature starts to drop. the bags are inexpensive and valleywise er staff said cleanup is easy. as this hospital has ramped up use of this method over the past few years, there have been a few logistical challenges, like just not having enough ice on hand to fill the bags. but emergency physician, dr. geoffrey comp said the hospital has streamlined the process ahead of this summer. “we’ve been able to partner with our cafeteria and food service workers to have all of our ice ready for us in huge, huge tubs,” comp said. it’s important to be prepared. if trends continue the way they’ve been going, doctors in this er expect to see more heatstroke patients this summer and in years to come. but while phoenix is one of the hottest places in the country, heat is a growing threat everywhere. more than two thirds of americans experienced heat alerts in 2023, according to the centers for disease control and prevention. comp said the ice filled body bags could be beneficial for other emergency rooms and fire departments. “i keep in contact with a lot of residents that have graduated from our program and they’re telling me, ‘hey, i did it up in idaho, i did it over in california,’” comp said. “it’s really encouraging to see that work that we’re doing here in phoenix is hopefully taking off in other parts of the country.”
wet towels and body bags filled with ice water are being used to quickly cool victims, which is essential to saving lives. by dionne searcey a heat wave is bearing down on large parts of america, forcing emergency workers to prepare for what could be record breaking numbers of people in heat distress. an excessive heat watch was in effect for southern new england, where forecasters warned of dangerous heat and humidity starting on tuesday and lasting through friday. it’s the first severe heat wave of the year for that part of the country. when temperatures rise, it’s easy to overheat and, when that happens, important to cool off fast. elevated body temperatures can cause brain damage, organ failure and, in severe cases, death. “in heat exhaustion, the goal is to cool as quickly as you can,” said dr. aisha terry, an associate professor of emergency medicine and health policy at george washington university hospital in washington and president of the american college of emergency physicians. “there are definitely some health conditions where we have to be mindful of how quickly we correct the abnormality. this is not one of them.” in all, millions of people across the united states are under extreme heat advisories. and if you think the country is getting hotter, it’s not your imagination. between may 2023 and may 2024, the average american experienced 39 days of abnormally high temperatures as a result of climate change, scientists reported last month. that’s 19 more days than in a hypothetical world without human caused warming. here’s how emergency medical workers are adapting to the risks. emergency medical workers and local officials across the country are spreading the word about cooling centers and swimming pools and stocking up on bottles of water to hand out to help offer relief from soaring temperatures and muggy weather.

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