"We have been getting patients with up to 42oC (104oF) body temperature, which is dangerously high," Dr Seema Wasnik, HOD, Emergency Medicine, Anaesthesiologist and Intensivist, Critical Care Medicine, at Dr Ram Manohar Lohia Hospital, New Delhi, told FIT.
Although some respite is predicted soon, the India Meteorological Department (IMD) had issued a red alert in Delhi for the past few days — which means a "very high likelihood" of people developing heat related illness and heat stroke — and the ramifications of it can be seen on the ground.
As the city continues to reel under one of the longest and harshest heat waves that northern India has witnessed in the recent past, cases of heat-related illnesses, hospitalisations, and fatalities have shot up like never before.
According to government data, between March and 18 June, at least 110 confirmed deaths have been linked to heat stress, including 25 officials on election duty in the month of May.
Moreover, on 20 June, Delhi Health Minister Saurabh Bharadwaj said that at least 14 people in the national capital have died of heat stroke in the last 48 hours alone.
Delhi's Heat Data: Deaths, Hospitalisations, and Health Risks
Heat stroke is a multisystemic illness that impacts the heart, liver, kidney, and nervous system due to prolonged exposure to high temperatures. This means it affects your whole body.
"Dehydration can also lead to electrolyte imbalance which can lead the patient to become delirious and drowsy. From there on, in the absence of intervention, their condition can rapidly deteriorate," explains Dr Wasnik.
Stroke and heart attack are common outcomes of severe untreated heatstroke.
While elderly people and children tend to be more vulnerable to heat-related illnesses, doctors tell FIT that they have been seeing patients in all age groups, especially those who spend a long time outdoors like guards, labourers, and long-distance commuters.
"We had one young woman come in who was just repairing her phone in the market when she lost consciousness and was brought here. Another patient was a young man riding his motorcycle when he felt dizzy. He collapsed on the side of the road and was brought here," explains Dr Wasnik.
The situation is so bad that on Wednesday, 19 June, Delhi Health Minister Saurabh Bharadwaj took cognisance of the crisis and held an emergency meeting with the heads of state government-run hospitals, directing them to scale up beds for patients with heat-related illnesses.
"All ambulances must also remain on high alert in the day and night, and some ambulances are to be parked near shelter homes and other worst-affected areas."Circular issued by the State Health Department
Inside a Heat Stroke Unit
Speaking to FIT, Dr Ajay Chauhan, head of the heat stroke unit at Dr Ram Manohar Lohia Hospital, explained that the unit itself was started very recently, just last month, in light of the intense heat wave conditions in the country at the time.
He explains that in case of heat stroke, the first thing to do is to bring the patient's body temperature down as quickly as possible to 101oF.
In severe exhaustion heat stroke, it isn't enough to place the patient in a cool environment, rather, they need to be immersed in ice water to bring their body temperature down rapidly. "Unfortunately, we've been getting many such cases recently," he adds.
"The unit has been designed as per the national guidelines. What sets the heat stroke unit apart is that it contains dedicated beds, an ice maker, and immersion tubs specifically to treat heat stroke patients."Dr Ajay Chauhan
A nursing staff who operates heat stroke ambulances at RML Hospital tells FIT, "We have ice packs that we apply on the patient and ice water that we spray on them. The goal is to bring the body temperature below 102o F." In severe cases, the patient is rushed to the hospital's heat stroke unit, where they are given the SOS treatment.
"We've been getting around 10 to 12 patients in the heat stroke unit every day," adds Dr Chauhan.
Other major government-run hospitals in Delhi including Lok Nayak Hospital, Safdarjung Hospital, and Deen Dayal Upadhyay Hospital have also, reportedly, been seeing an influx in cases of severe heatstroke.
So much so that while these cases were previously treated in the medicine department and ICUs, other hospitals are also planning on opening dedicated heat wave wards.
Hospitals Also Reeling Under the Heat Wave
At Safdarjung Hospital, a heat wave ward has been set up, however, right now, sources in Safdarjung hospital tell FIT that the extreme heat is impairing the hospital's functioning in other ways.
A recent tweet on 19 June brought to light how several surgeries scheduled in the hospital had to be postponed because of unavailability of water and dysfunctional ACs.
Sources tell FIT, multiple departments, including Ophthalmology Operation Theatres, Cancer Surgery OPD, Obstetrics and Gynecology OPD, have been experiencing outages for over a couple of weeks.
They add that ACs in the building where the new heatwave unit is situated is also not functioning currently, making it temporarily non-operational.
According to FIT's sources, the hospital authorities have said that the outages have happened because of strain on the chillers due to excessive heat and continuous use. No timeline has been given for their repair.
Protecting Against Heat-Related Illnesses
According to the IMD, the high-temperature situation will likely continue till the end of June with some relief, thanks to sporadic rainfall.
Speaking to FIT for a previous article, Dr Sushila Kataria, internal medicine specialist at Medanta the Medicity, Gurugram, explained that heat stroke is an extreme stage of heat exhaustion which presents a number of warning symptoms first, including,
Dehydration
Diarrhoea
Nausea
Headaches
Chills in the heat
Rapid heart rate
In case a person's body temperature spikes to dangerous levels (over 104 degree), the only treatment is to quickly bring the patient's body temperature down.
Dr Wasnik goes on to say, "There is no specialised equipment or drugs administered in the heat stroke unit. Whatever is managed in the heat stroke unit can be managed at home too if you have a refrigerator and access to ice or cool water."
"If someone near you is presenting signs of heat stress, sponge them with cold water, place ice cubes on strategic points on their body, and try to bring down their temperature as much as possible while you call for help," she adds.
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