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Microsoft word - drs acf dal #09-04 hot weather advisory.doc
DEPARTMENT OF HEALTH 161 Delaware Avenue Delmar New York 12054
Richard F. Daines, MD Wendy E. Saunders Commissioner Executive Deputy Commissioner
DAL: DRS/ACF DAL #09-04
Hot Weather Advisory
Dear Administrator/Operator: The New York State Department of Health would like to remind you of our expectations regarding the protection of Adult Care Facility (ACF) residents from the complications of heat exposure. Many residents in ACFs have cardiopulmonary conditions which make them particularly susceptible to heat-related complications, and a large number of residents are on psychotropic medications which greatly diminish their ability to withstand warm temperatures. Each administrator/operator must provide a program that promotes the social, physical, and mental well being of the residents. To assist you in meeting this goal we are providing you with information and recommended procedures to prevent serious heat-related medical problems among your residents during the hot and humid weather.
• Alert staff to the signs, symptoms and consequences of heat exhaustion, heat stroke and heat
• Alert staff to monitor residents for the signs and symptoms of heat illness (listed below). Notify the
physician of such observations and obtain medical services, if necessary.
• Make information available to both residents and staff on medications (sample list enclosed) that
may cause residents to become more susceptible to heat.
• Assure that facility policies and procedures for heat emergency situations are current, complete,
• Use air circulating and air cooling equipment (window fans, floor fans, mechanical ventilation
systems and air conditioners) to achieve and maintain air movement and air cooling within the facility, especially in resident rooms and resident use areas.
• Protect against temperature elevations within the facility by closing window blinds and shades on
sun-exposed walls, opening windows on shaded walls and turning off heat generating devices, such as lights.
• Assure, through active encouragement and assistance when necessary, that residents maintain
adequate fluid intake (e.g., water and fruit juices should be available). Alcohol should be avoided.
• Adjust menus as needed, incorporating items such as cold plates, salads, etc. Consult with your
• Encourage residents not to lie or sit in direct sunlight, e.g., if outside, encourage residents to sit in
• Encourage residents to wear appropriate clothing while indoors and outdoors.
• Monitor residents engaging in physical activities. Discourage strenuous physical activity as
Additionally, statute and regulations for ACFs require each facility to maintain safe and comfortable temperature levels within the facility. If the outside temperature exceeds 85 degrees Fahrenheit, the guidelines below must be followed:
• One common room is required to be air-conditioned in facilities without central air-conditioning. It
is recommended this room be able to accommodate as many residents as possible. The Department expects that these facilities will turn on the air conditioning in the common room(s) and take air temperatures every hour in all common areas as well as in non air-conditioned rooms at several locations on each floor of the facility.
• The administrator/operator should observe and monitor the residents to make sure the residents are
• If room air conditioners are typically used, the air conditioners must be turned on regardless of a
• If your facility utilizes central air conditioning, there is no need to monitor hourly as long as the
It is recommended that the administrator/operator follow the information and recommendations in this DAL to keep the building cool (i.e., maintaining air movement and protect against temperature elevations within the facility). The Department will hold the ACF operator fully accountable, including the imposition of fiscal penalties to the maximum extent permitted, if a comfortable environment is not maintained when the outside temperature exceeds 85 degrees Fahrenheit.
Thank you in advance for taking precautions to assure the health and safety of your residents during the summer. If you have any questions about requirements or guidelines, you may contact the Adult Home Hotline at 1-866-893-6772 and staff will assist you.
New York State Department of Health
Symptoms of Exposure to Heat & Treatment
Signs & Symptoms
cool water (not iced) every 15 minutes. Monitor the resident carefully. Heat exhaustion can quickly become heatstroke.
degrees); hard, rapid pulse; rapid, shallow breathing.
knots. Resident may have pale or caffeine in them as they can skin.
cause further dehydration, making the conditions worse.
RESIDENTS TAKING THE FOLLOWING MEDICATIONS MAY HAVE ADDED SENSITIVITY TO HEAT AND
Not all inclusive
Tetracyclines, sulfa drugs, quinolones (Cipro, Noroxin, etc.)
Atropine, Benadryl, Cogentin, Ditropan, Donnatol
MOOD STABILIZER DRUGS
Depakote (dr) Depakote (ER) Depakote Sprinkles
Tegretol Tegretol XR Tegretol chew Carbatrol (er)
CONVENTIONAL ANTIPSYCHOTIC DRUGS
Long Acting Antipsychotics
Fluphenazine (Prolixin) decanoate
Haloperidol (Haldol) decanoate
Risperidone (Risperdal Consta)
ATYPICAL ANTIPSYCHOTIC DRUGS
Risperdal, Risperdal Consta, Risperdal M-Tab
Zyprexa, Zyprexa Zydis, Zyprexa intramuscular
AGENTS FOR MANAGEMENT OF ANTIPSYCHOTIC MOTOR SIDE EFFECTS
Note: There is a potential for some drugs to interact with each other to increase a resident’s sensitivity to heat. For case-specific information, consult with the prescriber or pharmacist.
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Eur Arch Psychiatry Clin Neurosci (1999) 249 : 238–246 I. Leykin · B. Spivak · A. Weizman · I. R. Cohen · M. Shinitzky Elevated Cellular Immune Response to Human Heat-Shock Protein-60 in Schizophrenic PatientsReceived: 26 November 1998 / Accepted: 10 July 1999 Abstract Heat shock protein-60 (HSP60) is implicated patients and in controls. Titers of IgA against HSP60 werein several aut