Why is it in the News?

The Union Health Ministry has issued standardised guidelines for confirming heatstroke and heat-related deaths in the country.

What is a Heatstroke?

• Heatstroke, also known as sunstroke, is a medical emergency resulting from the body overheating due to exposure to high temperatures and humidity or prolonged physical exertion in hot conditions.
• Individuals experiencing heat exhaustion may exhibit symptoms such as fatigue, dizziness, headache, nausea, vomiting, low blood pressure, and increased heart rate.

Criteria for Heatstroke:

• Heatstroke is characterized by body temperatures of 40°C (104°F) or higher, accompanied by delirium, seizures, or coma, posing a potentially fatal condition.

Heatstroke Deaths in India:

• According to analysis of data from the National Crime Records Bureau, over 11,000 people in India died due to heatstroke between 2012 and 2021.

Government Initiatives:

• The Health Ministry released a National Action Plan on Heat-Related Illness in July 2021, outlining strategies to address health challenges posed by heat waves.
• The India Cooling Action Plan (ICAP) aims to mitigate heat impacts by ensuring sustainable cooling and thermal comfort for all by 2037-38.

First Aid Measures for Heatstroke:

• • Move the affected person to a cool, shaded area.
  • Offer water or a rehydrating drink if the person is conscious.
  • Fan the person to promote cooling.
  • Seek medical attention if symptoms worsen, persist, or if the person loses consciousness.
  • Avoid giving alcohol, caffeine, or carbonated beverages.
  • Apply a cool, wet cloth to the person's face or body.
  • Loosen clothing to improve ventilation.

Key Points from the Guidelines:

• Rationale for the Guidelines: Between 2013 and 2022, there was an 85% increase in estimated annual heat-related mortality compared to 1991–2000, driven by global warming and changing demographics.
• Without significant adaptation progress, annual heat-related deaths could surge by 370% by mid-century if global temperatures continue to rise towards 2°C above pre-industrial levels.
• In light of these projections, enhancing our understanding and surveillance of heat-related health issues is imperative.

Preparation and Authorship:

• The guidelines were developed by the National Programme on Climate Change and Human Health (NPCCHH) in collaboration with the National Centre for Disease Control (NCDC).

Objective:

• The guidelines aim to assist hospitals in identifying criteria for categorizing deaths as heat-related or due to heat stroke, promoting evidence-based medical decision-making.

Autopsy Considerations:

• Decisions regarding autopsy should be based on factors such as the circumstances of death, the age of the deceased, and available resources.
• Where feasible, collecting blood, urine, etc., for toxicological examination is recommended, contingent on the condition of the body.

Challenges in Diagnosing Heat-Related Deaths

• Diagnosing heat-related deaths post-mortem presents several challenges, including:
• Frequently unavailable pre-terminal or terminal body temperatures.
• Non-specific autopsy findings vary based on the duration of survival after heat exposure.
• Reliance on-scene investigation for diagnosing hyperthermia, a condition resulting from the body's inability to regulate heat.
• Consideration of circumstances of death and exclusion of alternative causes.
• It's noted that autopsies are not mandatory for heat-related deaths.