Surviving Extreme Heat

Heat Wave - What You Need to Know


Heat can be deadly. Being in extreme heat for too long can cause a variety of responses, all grouped under the name hyperthermia. All are serious and should be addressed quickly. Seniors are more likely to experience heat related problems than the general population. This is particularly true if the person is taking medications.

The American Red Cross, FEMA, and the National Weather Service want you to have information to stay safe. They offer the following:


What are the Terms?
  • Heat wave
    Prolonged period of excessive heat and humidity. The National Weather Service steps up its procedures to alert the public during these periods of excessive heat and humidity.

  • Heat index
    A number in degrees Fahrenheit (F) that tells how hot it really feels when relative humidity is added to the actual air temperature. Exposure to full sunshine can increase the heat index by 15 degrees F. More...

  • Heat cramps
    Heat cramps are muscular pains and spasms due to heavy exertion. Although heat cramps are the least severe, they are an early signal that the body is having trouble with the heat.

  • Heat exhaustion
    Heat exhaustion typically occurs when people exercise heavily or work in a hot, humid place where body fluids are lost through heavy sweating. Blood flow to the skin increases, causing blood flow to decrease to the vital organs. This results in a form of mild shock. If not treated, the victim may suffer heat stroke.

  • Heat stroke
    Heat stroke is life-threatening. The victim's temperature control system, which produces sweating to cool the body, stops working. The body temperature can rise so high that brain damage and death may result if the body is not cooled quickly.

  • Sunstroke
    Another term for heat stroke.


What are the Symptoms?
  • Heat cramps
    Muscular pains and spasms, often in leg or abdominal muscles; heavy sweating.

  • Heat exhaustion
    Cool, moist, pale, or flushed skin; heavy sweating; headache; nausea or vomiting; dizziness or fainting; and exhaustion. Body temperature will be near normal. Weak pulse.

  • Heat stroke
    Hot, red skin; changes in consciousness; rapid, weak pulse; and rapid, shallow breathing. Body temperature can be very high-- as high as 105 degrees F. If the person was sweating from heavy work or exercise, skin may be wet; otherwise, it will feel dry even though the person is very hot. Person may have a change in behavior - confusion, being grouchy, acting strangely, or staggering; acting delirious. Person faints or becomes unconscious.


Treatment of Heat Emergencies
  • Heat cramps
    Get the person to a cooler place and have him or her rest in a comfortable position. Lightly stretch the affected muscle and replenish fluids. Give a half glass of cool water every 15 minutes. Do not give liquids with alcohol or caffeine in them, as they can make conditions worse.

  • Heat exhaustion
    Get the person out of the heat and into a cooler place. Remove or loosen tight clothing and apply cool, wet cloths, such as towels or sheets. If the person is conscious, give cool water to drink. Make sure the person drinks slowly. Give a half glass of cool water every 15 minutes. Do not give liquids that contain alcohol or caffeine. Let the victim rest in a comfortable position, and watch carefully for changes in his or her condition. Seek immediate medical attention if vomiting occurs.

  • Heat stroke
    Heat stroke is a life-threatening situation. Help is needed fast. Call 9-1-1 or your local emergency number (or take the person to a hospital, calling ahead). Delay can be fatal. Move the person to a cooler place. Quickly cool the body. Immerse victim in a cool bath, or wrap wet sheets around the body and fan it. Watch for signals of breathing problems. Keep the person lying down and continue to cool the body any way you can. If the victim refuses water or is vomiting or there are changes in the level of consciousness, do not give anything to eat or drink.


What Should I do in a Heat Emergency?
  • Slow down. Avoid strenuous activity. If you must do strenuous activity, do it during the coolest part of the day, which is usually in the morning between 4:00 a.m. and 7:00 a.m.

  • Stay indoors as much as possible. If air conditioning is not available, stay on the lowest floor, out of the sunshine. Each day for several hours, try to go to public buildings with air conditioning such as libraries, schools, movie theaters, shopping malls, or other community facilities. Circulating air can cool the body by increasing rate of evaporation of perspiration. Remember, electric fans do not cool the air, but they do help sweat evaporate, which cools your body.

  • Wear lightweight, loose-fitting, light-colored clothing. Light colors will reflect away some of the sun's energy. Protect face and head by wearing a wide-brimmed hat.

  • Drink plenty of water regularly and often. Your body needs water to keep cool. Water is the safest liquid to drink during heat emergencies. Avoid drinks with alcohol or caffeine in them. They can make you feel good briefly, but make the heat's effects on your body worse. This is especially true about beer, which dehydrates the body. Drink plenty of fluids even if you do not feel thirsty. Please note: People who have epilepsy or heart, kidney, or liver disease; are on fluid-restricted diets; or have a problem with fluid retention should consult a doctor before increasing liquid intake. Find out ahead of time what you should do if your situation falls into one of these categories.

  • Eat small meals and eat more often. Avoid foods that are high in protein, which increase metabolic heat.

  • Avoid using salt tablets unless directed to do so by a physician.

  • Check on family, friends, and neighbors who do not have air conditioning and who spend much of their time alone.

  • Never leave children or pets alone in closed vehicles.


Dog and Cat Under Sprinkler


How Should I Prepare for a Heat Emergency?
  • Install window air conditioners snugly; insulate if necessary.

  • Check air-conditioning ducts for proper insulation.

  • Install temporary window reflectors (for use between windows and drapes), such as aluminum foil-covered cardboard, to reflect heat back outside.

  • Weather-strip doors and sills to keep cool air in.

  • Cover windows that receive morning or afternoon sun with drapes, shades, awnings, or louvers. (Outdoor awnings or louvers can reduce the heat that enters a home by up to 80 percent.)

  • Keep storm windows up all year.

  • Check on family, friends, and neighbors who may need help during an emergency heat event. Help them understand how to stay cool and develop a plan for what they would do during that time.


Operation Fan/Heat Relief

Understanding the consequences of extreme heat on seniors, several local utility companies in the Triangle donate money for the purchase of fans for older adults in need. The fans are offered at no cost. They are distributed by selected local aging services providers in each county, as determined by need and availability. Occasionally, window air conditioners are also made available. Contact your local Council or Department on Aging.

Man Being Cooled by  Fan


Other Help to Keep You Safe

There may be help in your area to help you prepare your home to help you "weather" an extreme heat event and/or to help you pay for electricity to help you keep the air conditioner or fan running.

The first thing to do is to evaluate the current living situation. Is there anything that can be done to make the home more energy efficient? Many power and gas companies offer a free service where a trained professional will come and show you where your home is leaking air. They will also make recommendations on how you might be able to fix the problem(s).

Check the insulation. Is there any? Is it enough? Do the windows or doors need replacing. Some local aging providers offer a Home Improvement program that may or may not help cover some of these type of expenses.

Perhaps cooling only the rooms that are used would help. Close vents and doors to rooms that aren't used. Make sure the basement door is closed. Sometimes hanging a blanket in a doorway without a door works to keep cooler air in and warmer air out in a room being cooled with an air conditioner. Remember that fans do not actually cool a room. However, they will help circulate the air which will help perspiration evaporate which will cool your body temperature. So, there is no need to close off rooms if you are using a fan to keep cool.

If you are living on a limited income, financial help may be available to pay for your electric bills. Assistance may be through the federal government, state programs, local agencies, or gas and electric companies.

Ms. Jane Schwartz
LIHEAP Coordinator
Division of Social Services
325 North Salisbury Street
Raleigh, North Carolina 27603-5905
Need information? Call 1-800-662-7030 (CARE LINE)

You may also contact your local county Department of Social Services.


  • Gas and Electric Companies
    Some utility companies offer varying levels of assistance to those in need. For some it may be reduced rates. For others, a subsidy program may be offered through a state agency. In other cases, the power company may decide to not cut off service to a senior citizen or an older person with severe medical problems if they are unable to pay their bill. If you are having difficulty paying your gas or power company bill, call customer assistance and inquire about what remedies they may have available. If this is too overwhelming for you to do on your own, contact a local Information and Assistance professional for personalized assistance.

Are you worried that your landlord may want to cut off the gas or electricity if you cannot pay a utility bill? Many states and cities now have laws to protect you, at least until other plans are made. Do not wait for a weather event to find out about these programs. Check with your local government or an attorney about the laws that may apply where you live. (N.C. Gen. Stat. §§ 42-1 to 42-14.2; 42-25.6 to 42-76)


More Information on Hyperthermia

For more detailed information including who is at risk, what to do if hyperthermia is suspected, and how to lower the risk of hyperthermia, the following links are offered.


What is the Heat Index and Why is it Important?

Summers are hot in most of the United States. Typically, a section of the country will see one or more heat waves during this time. In North Carolina they tend to combine both high temperature and high humidity, although some of the worst have been catastrophically dry.

The National Weather Service, a part of the National Oceanic and Atmospheric Administration, has developed an indicator of how hot it really feels when humidity and the actual air temperature are combined. This indicator is called the Heat Index.

It is important to note that since Heat Index values were devised for shady, light wind conditions, exposure to full sunshine can increase the values by up to 15 degrees Fahrenheit. Strong winds, particularly with very hot and dry air can also be extremely hazardous and can impact the Heat Index.



  • Heat Index of 130° +
    Heatstroke highly likely with continued exposure and/or physical activity.
  • Heat Index of 105°- 130°
    Heat Stroke possible with prolonged exposure and, heat exhaustion, and/or heat cramps likely with prolonged exposure and/or physical activity.
  • Heat Index of 90°- 105°
    Heat exhaustion and heat cramps possible with prolonged exposure and/or physical activity.
  • Heat Index of 80° - 90°
    Fatigue possible with prolonged exposure and/or physical activity.


Anything above 105°F on the Heat Index chart corresponds to a level of Heat Index that may cause increasingly severe heat disorders with continued exposure and/or physical activity.




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From the National Weather Service - Raleigh Office

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Are You More "At Risk" in the City?

Heat Wave - A Major Summer KillerDuring stagnant atmospheric conditions present during a heat wave, urban areas trap pollutants. When pollutants (car exhaust, etc.) are added to the extreme heat and stagnant air mass, a serious health issue will arise. History has shown that this combination contributes to heat related deaths.

The high inner-city death rates may also be caused by poor access to air-conditioned rooms combined with air pollutants and heat. While air conditioning may be a luxury in normal times, it can be a lifesaver during heat wave conditions.

The cost of cool air moves steadily higher, adding what appears to be a cruel economic side to heat wave fatalities. Indications from the 1978 Texas heat wave suggest that some elderly people on fixed incomes, many of them in buildings that could not be ventilated without air conditioning, found the cost too high, turned off their units, and ultimately succumbed to the stresses of heat." *NOAA


*Earth photo courtesy of NOAA