It’s that time of year again, as the weather gets warmer and humidity goes up heat emergencies become more common.

Through proper assessment these types of patients can be easily managed.

Heat Index

With our proximity to two of the largest bodies of fresh water in the world, our area stays relatively humid. That humidity is why the “real feel” temperature is always a higher than the actual temperature.

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NWS Heat Index Chart for reference:

So what does this all mean? Simply put, hot temperatures combined with high humidity place extra stress on the body and make it harder to stay cool. As the heat index rises, so does the risk of heat-related illness… especially during outdoor work, exercise, sporting events, or long periods without air conditioning.

Recognizing these conditions early can help guide assessment, treatment decisions, and the need for rapid cooling interventions before a patient’s condition progresses to a life-threatening emergency.

Levels of Heat-Related Illness

Vulnerable Populations

Certain populations are at significantly higher risk for heat related illness and should raise your index of suspicion during periods of elevated heat and humidity.

Higher risk groups include:

• Older adults
• Infants and young children
• Outdoor workers
• Athletes
• Patients with chronic medical conditions
• Individuals without reliable access to air conditioning
• Homeless populations

Certain medications can also increase susceptibility to heat illness, including:

• Diuretics
• Beta blockers
• Anticholinergics
• Psychiatric medications

Social and environmental factors such as prolonged outdoor exposure, poor hydration, and limited cooling resources can contribute to rapid patient deterioration during extreme heat events.

Treatment

Below is the current NYS protocol for treating heat emergencies in both adult and pediatric patients. Rumor is this will be changing in September 2026 with the protocol update, just in time for fall.

This will be updated once the new protocols are released, and will likely be backwards compatible with medical director approval.

TL;DR

High heat and humidity can quickly overwhelm the body’s ability to cool itself, especially in vulnerable populations. EMS providers should maintain a high index of suspicion for heat related illness during periods of elevated heat index, particularly in patients presenting with weakness, dizziness, altered mental status, syncope, or dehydration.

Recognizing true heat emergencies early and prioritizing rapid treatment and stabilization before transport are critical to preventing progression to life threatening illness and improving patient outcomes.