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Spike in heat-related health problems seen in Fla. emergency rooms

Officials say the true number of heat-related illnesses is underreported

By Liz Freeman
Naples Daily News

NAPLES, Fla. — Kelly Roofing is tough about summer’s heat to help workers in Southwest Florida stay hydrated and safe.

During the summer months, the family-owned company based in Naples goes through three pallets of powdered Gatorade, co-owner Ken Kelly said.

During the cooler winter months, two pallets of the powdered Gatorade are used, at $12,000 for each pallet.

Each job site has one five-gallon cooler for every two workers. The powdered Gatorade mixed with water is free to employees.

“Each individual is going to consume 2½ gallons of Gatorade a day,” Kelly said.

Gatorade is much better than water because it restores electrolytes lost through sweating, he said.

This summer has brought temperatures higher than normal, and emergency room doctors and nurses are seeing the consequences of spikes in heat-related problems such as muscle camps and rapid heart beat. Such problems can become dire, causing damage to vital organs and even death.

In North Naples on Monday, a construction worker, Luke K. Sannicandro, 37, died shortly after becoming ill about 4 p.m. while working on a roof, according to Collier County Sheriff’s Office reports. He was told to rest, and paramedics were called when he was found shaking slightly on the ground. He could not be revived.

The Lee Memorial Health System in Lee County has had a 48 percent increase in heat-related ER visits this year, with 161 patients from May through July combined at the system’s four ERs, compared with 109 patients in the same period last year.

Physicians Regional Healthcare System in Collier County has had more patients in its emergency rooms this year with heat-related issues, said Dr. James Roach, chairman of the emergency medicine department at Physicians Regional-Pine Ridge.

“Recently, I had two patients in one day suffering from heat issues, one of whom was admitted with muscle breakdown and kidney failure,” Roach said in a statement.

“With extreme temperatures and high humidity, dehydration is common,” he said. “It leads to muscle cramps, irritability and elevated core body temperatures.

“In moderate to severe heat conditions, patients have dry mouth, and for children, they do not produce tears.

“Listlessness and irritability are also symptoms.

“In the most severe cases, heat illness is evidenced by altered mental status, and coma.”

Heat-related emergencies are frequent in emergency rooms in Collier, and incidents probably are under-reported because medical coding is for treating the injuries, said Dr. Jeffrey Panozzo, chairman of emergency medicine for TeamHealth, the medical group in the emergency rooms for the NCH Healthcare System.

The heat-related problems range from heat cramps, heat exhaustion to heat stroke and can overlap and progress, he said.

“They are not a single entity and can blend,” Panozzo said. “Our objective is to stop the illness. They can progress.”

Heat cramps are the most benign, he said, and often happen from intense exercise.

Next on the spectrum is heat exhaustion, when a person not acclimated to the heat passes out from activity, he said. Those patients coming to the emergency rooms often are visitors from Northern states and weekend exercisers who are in air conditioning during the week.

With heat exhaustion, a person’s heart cannot keep pace with the exertion and the pulse is racing and the person collapses and there can be injuries to the heart, kidneys and liver, he said.

The third on the spectrum is heat stroke which is not a stroke in the traditional sense but there are acute neurological symptoms where the person becomes confused and agitated because the body isn’t able to regulate body temperature.

What’s important for the public to understand is that heat-related injuries are preventable by staying hydrated, wearing the proper clothing, and getting out of the hot environment by taking breaks, said Betsy Novakovich, director emergency services for NCH.

How quickly someone can progress from suffering heat cramps to heat stroke depends on the individual, she said.

“One person could go very quickly on the spectrum,” she said.

At the first sign of muscle cramps, take action, Panozzo said.

“The body is telling you to stop if you get a cramp,” he said.

Kelly, co-owner of Kelly Roofing, said the best preventive measure for his workers is staying hydrated with Gatorade because it restores electrolytes lost in sweating, which water doesn’t do, and second is protecting your body from the sun with long sleeved shirts and pants, and a wide-brimmed hat. The only part of the body of his workers that are exposed are around their eyes.

When someone sweats, the moisture gets absorbed in the clothing and pulled away from the body, and that helps to keep the body cooler, he said.

People should also wear light-colored clothes but not white.

“The problem with a white cotton shirt is the sun gets through it,” he said. “You want some color in the shirt but very light. We prefer light grey.”

Also critical is pressing cold compresses to the back of your neck and wrists because those areas can cool you faster. Lastly, taking frequent breaks for 15 minutes every half hour of work will help avoid getting overheated, Kelly said.


  • Dark-colored urine (sign of dehydration)
  • Dizziness, fainting, headache
  • Muscle cramps, stomach cramps
  • Nausea, vomiting, diarrhea
  • Profuse sweating
  • Rapid heart beat


  • Drink fluid but no caffeine/alcohol
  • Remove tight/unnecessary clothes
  • Take a cool shower, bath, or sponge bath
  • Sit near a fan, apply cold towels to skin

Copyright 2016 the Naples Daily News