September 1, 2005 Secretary Chertoff:
"And let me tell you, we totally understand what it's like to be sitting on top of a roof or to be sitting in a shelter where it's hot, where you're worried about when you're going to be picked up, where you're thirsty, where you're hungry, where you're afraid for yourself or you're afraid for members of your family. There is no way a catastrophe can be minimized. I mean, this is a personal tragedy for everybody that's involved, those on the scene and the family members who are elsewhere as well."
6. Heat stroke - least common of the heat illnesses but almost always fatal unless promptly recognized and treated. The urban, elderly poor are the most common victims of heat stroke. Characterized by a body temperature above 40.6º C. Predisposing factors: salt and water depletion, infection, fever following immunization, lack of acclimatization, obesity, drugs, fatigue. [The Government of the United States of America?] Predisposing diseases: cardiovascular disease, diabetes mellitus, malnutrition, acute or chronic alcoholism, hyperthyroidism, impaired sweat production, and potassium deficiency. May be divided into two forms: classic and exertional.
a. Classic - occurs after several days of temperatures above 37.0º C or somewhat lower temperatures but with high relative humidity. Active perspiration is continuous but eventually fails and body temperature rises sharply. The first symptom may be sudden collapse. In 80% of cases onset is sudden and the patient becomes delirious, comatose or may have a seizure. In the other 20% of cases the patient may have weakness, dizziness, nausea, syncope, or frontal headache prior to collapse. Muscle cramps are unusual. Patients progress to coma. Hot and dry skin is usual but sweating may persist.
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