In preparation for the upcoming summer temperatures, the following guidelines should be put in place. When continued exposure to air temperatures or heat index readings, exceed 95 degrees Fahrenheit, this puts certain individuals at an increased risk for heat related illness. Elderly offenders (over 55 years of age) and mental health patients on psychotropic medication have the greatest risk potential. Other factors contributing to an individual's risk include:
- Chronic illnesses, particularly respiratory and cardiovascular disease and diabetes
- Recent illness involving fluid loss from vomiting and diarrhea
- Humid weather
- Working or residing in a hot environment
- Loss of body fluids from sweating and failure to drink sufficient quantities of replacement fluids
- Heavy, restrictive clothing
The effects of extreme heat can be insidious and may compromise an individual's health status even before it becomes apparent. Simple overexposure can cause heat exhaustion in elderly persons. Recognizing the early onset of symptoms is essential. Signs and symptoms of heat exhaustion include:
- Dizziness, fatigue, faintness, and headache
- Skin that is pale and clammy
- Weak rapid pulse
- Breathing that is fast and shallow
- Muscle cramps, usually of the abdomen or legs
- Intense thirst
People who do not receive adequate treatment for the symptoms of heat exhaustion will likely develop symptoms of heat stroke. This condition is life threatening. Signs and symptoms of a heat stroke include:
- Skin that becomes hot, dry, and appears flushed
- Perspiration ceases
- Body temperature is elevated and may reach 107 degrees Fahrenheit
- Rapid pulse
- Mental confusion
- Eventual loss of consciousness
Offender mental health patients who are taking psychotropic medications are also at increased risk for sun and heat sensitivity. They should avoid direct sun or extreme heat exposure. They should receive a break every 30 minutes in shade, and should be encouraged to drink fluids when the heat index temperature exceeds 85 degrees. Exercise should be encouraged only in the early morning rather than in the highest heat of the day. Facility work crew supervisors should contact Medical Services for recommendations regarding work crew restrictions.
Offenders should have access to hats and sunscreen as appropriate for their work assignment.
Treatment must be initiated when symptoms of heat exhaustion are identified. Immediate first aid measures include:
- Get the person out of the heat and into a cooler environment
- Place them in the shock position (lying on back with feet elevated) if indicated
- Remove or loosen clothing
- Cool them by fanning and/or with cold packs, wet towels or sheets
- Offer water (4-5 ounces) every 15 minutes if they are conscious and can tolerate it
Each facility must develop a contingency plan to ensure adequate protection for offenders who have the greatest risk potential. Elements of this plan should include:
- Identification of offenders who meet the criteria for risk (i.e., over 55 or on psychotropic medications)
- Routine assessment of offenders who are at risk when air temperatures or heat index readings exceed 95 degrees Fahrenheit (unless the offender is housed on an air-conditioned unit).
- An air-conditioned area available between sunrise and sunset if needed. Symptomatic offenders at risk may be successfully managed in the air-conditioned area during daylight hours and returned to their housing units after sunset.
- Fans available to elderly offenders who have other risk factors and do not live on air-conditioned housing units.
Please provide appropriate consultation and advisement to your facility head. It will require a cooperative effort by medical and security to ensure that measures are implemented to protect offenders who are at risk for heat related illnesses.