# 115 Bring in the fans
In the Northern Hemisphere, these are the warmest months. With drought, global warming, wildfires, and an increasingly urbanized populace no longer in tune with the wisdom of rural elders in coping with weather stress, we face the likelihood of more heat illnesses and EDs with older physical plants less able to cope with inundations of "heat wave" victims. The new issue of AENJ has a nice article to see. Heat Illnesses in the Emergency Department: A Hot Topic.
In "# 14 A Fresh Breeze", we commented on several aspects of fan usage in the ED (q.v.). So, round up as many fans as you can obtain from the hospital, or buy more (but be sure they're inspected or modified by Hospital Engineering for electrical ground safety, hospital grade connecting plugs, or double-insulated casings, adequate finger guards, and screws securing the cage.)
If you delay obtaining enough, when everyone else wants a fan, there will not be enough to go around. Moving air can do much to abate stifling heat when the air conditioning (if you have any) is overwhelmed. Remember, A/C is like a heater in reverse, it can only transfer so many BTUs of heat elsewhere. If there is an electrical brownout, or heat exceeds your BTU transfer capability, or there is additional heat from severe weather or human overcrowding, you will be glad for the low demand of fans and the comfort they provide.
Remind Housekeeping to wipe down the screens daily to decrease accumulating dust. You will need to avoid dust being blown onto a sterile procedure, e.g., a central line. In "# 60 It’s a gas, under there …" (q.v.), you'll find out how to use suction or compressed air to make the patient under the procedural drapes more comfortable.
The "sensible" solution in overwhelming heat, is to keep the air moving so that it can be "sensed" by the patient (easing distress, and for evaporative cooling) for greater comfort.
If "Heat Stroke" (hyperthermia, with altered sensorium and inability to regulate body temperature) is present, expose the patient as much as possible, use wet towels on exposed body surfaces (especially head and torso) upon which moving air from the fans can play, and place ice packs in the groin and axillae, as your initial measures while monitoring temperature and response and fluid infusion.
Click to download 2015's Collected Tips (#85->)
Click to download 2014's Collected Tips #34 -#84
Click to download 2013's Collected Tips (#1 - #33)