Hardlook: Don’t ignore early signs of dehydration, say doctors
Doctors said patients reporting to emergencies and OPDs with heat exhaustion were those who spent a considerable amount of time outdoors.
Maya working in her field under high temperature in New Delhi. (Express photo by Praveen Khanna)
It is only around noon on May 20, but Safdarjung Hospital’s emergency has already seen four persons come in with symptoms of heat exhaustion.
One of them, 43-year-old Vikram Pal, had taken a bus from his home in Pitampura for INA. “I got out of the bus and felt dizzy. I had a bottle of water, but finished it during the journey. I sat down on the footpath, vomited. I think I blacked out because when people asked me where I was going, I got confused. Thankfully, someone helped me into an auto and dropped me here,” he said, lying on a hospital bed. Pal came in with low blood pressure. He was administered fluids and kept under observation for an hour before being allowed to go.
Doctors said patients reporting to emergencies and OPDs with heat exhaustion were those who spent a considerable amount of time outdoors. “Patients often discount early symptoms of dehydration like dryness of mouth and tongue, and as a result symptoms aggravate,” said Dr A K Rai, the hospital’s medical superintendent.
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At RML Hospital the same day, about six patients with similar symptoms had come in to the emergency by 3 pm. Two of them had severe gastroenteritis and diarrhoea for a few days. This aggravated their dehydration leading to severe heat exhaustion, said doctors.
On May 18, the Delhi government issued guidelines to all hospitals and nursing homes to create resources for immediate treatment of patients with heat-induced conditions. Hospitals were directed to prepare their emergencies with a cooled area, manpower, medicines, and IV fluids. Indicating that symptoms may range from “fatigue, weakness, nausea, profuse sweating” to “muscle cramps, rapid shallow breathing, rapid pulse, and tachycardia or irregular heart beat, and paleness of skin”, the health department directed hospitals to ensure all symptoms were addressed.
At hospitals across the city, doctors said the rise in temperatures had seen a near simultaneous influx of patients with these episodes. At Sir Ganga Ram Hospital, doctors said patients with heat-related symptoms had been coming in for the last five to six days. “The good thing is that so far we are only getting cases of mild exhaustion, where patients primarily need some cooling down and rehydration. Most of these cases have been in people above 50 years old. These are all people who had some mild confusion, felt nauseous and weakness due to persistent outdoor exposure in high temperatures,” said Dr B K Rao, head of emergency at the hospital. “We have so far not received any patients with symptoms of acute heat-related episodes like loss of consciousness or convulsions.”
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At AIIMS, a senior doctor in the emergency medicine department said, “Patients are complaining of headaches, nausea, dizziness and disorientation. Most of them are from the young working population who spend a lot of time outdoors. So far we have not had to admit anyone, they were administered fluids and electrolytes and observed for a few hours, before being released.”
At Max Hospital in Saket, doctors said OPDs had started seeing many patients with heat related symptoms.
“Heat can aggravate existing diseases like kidney disorders and cardiovascular conditions. Senior citizens should be especially cautious, as should young children,” said Dr Supriya Bali, senior consultant in internal medicine.
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Doctors said if early signs of dehydration are ignored, it can aggravate to neurological disorders. Dr Pranav Kumar, neurosurgeon at Apollo Hospital, said, “Every year we see patients who get heat-induced thrombosis or blood clots in the sinus or other veins in the brain. This year, so far, we have not got any such case. Due to high temperatures and loss of water, blood flow in the brain is affected which leads to clotting,” explained Dr Kumar.
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