On a blistering Saturday afternoon, a homeless man in his sixties was found unconscious near the Ram Manohar Lohia hospital in Delhi. He was brought in with a body temperature of 107 degrees Fahrenheit, and immersed in a tub filled with water and ice cubes. About an hour and another immersion later, his temperature dipped to around 100 degrees Fahrenheit. 

It was just one of the 11 cases which have been treated at the hospital’s emergency department since May 8 – the day it set up a heat stroke unit to address the rising number of heat-related cases. 

Delhi, like much of northern India, has been experiencing extreme temperatures since last month, with at least two reported deaths so far due to heat stroke, including one who died at RML on Wednesday. India has seen nearly 25,000 cases of suspected heat stroke and 56 deaths from May to May, including those of polling officials, according to media reports.

Central government hospitals in the national capital such as RML have reserved beds while the Delhi government has also allocated two beds at each of its 26 hospitals for such cases, along with five beds at its Lok Nayak Jai Prakash Hospital.

‘Heat stroke more sudden’

“The primary treatment for heat stroke patients is to bring their body temperature back to normal. Cooling is a critical and primary aspect of the treatment process,” explained Dr Venkat, the doctor in charge of RML’s Heat Stroke Unit. 

Staffed by a doctor, a nurse, and a helper, the heat stroke unit is equipped with two mechanical ventilator beds, two immersion tubs, inflatable tubes, and an ice-making machine. “We only immerse semi-conscious patients in the tubs. If a patient is unconscious, we place them on a bed and apply ice cubes to cool their body,” Dr Venkat said.

Among the patients who have received treatment at RML’s Heat Stroke Unit are a Nigerian citizen, rag pickers, and daily wage workers.

On Friday, another patient was transferred to RML’s Heat Stroke Unit from Acharya Bhikshu Hospital. Accompanied by a doctor, the patient had a body temperature of 105 degrees Fahrenheit. “We performed rapid cooling and other procedures to lower his temperature, but decided to transfer him here for specialised care,” the doctor told Newslaundry. By the time he reached the Heat Stroke Unit, his temperature had normalised. 

Doctors at RML speculated it could be a “probable” heat stroke but noted the patient had a mild fever the day before, which is uncommon in heat stroke cases. “Heat stroke is more sudden, but further investigations are ongoing,” a treating doctor said.

Murtaza, the patient’s son and a daily wage worker, insisted the condition was caused by heat exposure. “He roams around in the sun,” he said, adding that their Inderlok residence only has a fan.

Mortality risks

Seema Balkrishna Wasnik, head of the emergency medicine department, noted that of the 11 patients so far, one was critical while two had heat exhaustion and did not require admission. “The first point of contact for any heat stroke patient is the emergency medicine department. If necessary, they are then transferred to other departments based on treatment needs,” Wasnik told Newslaundry.

About a patient who died on Wednesday, Dr Wasnik said, “He had differential diagnoses including pulmonary embolism and septic shock, but his ECG was normal. He survived 24 hours here before being transferred to another department. Only experts can determine the exact cause of death.”

The doctor said that untreated heat stroke can exacerbate other health conditions and significantly increase mortality risk. “If a patient has comorbidities like heart disease, heat stroke can critically worsen their condition. If the temperature isn’t controlled, mortality can rise to 80 percent.”

The temperature in the national capital has been hovering between 40 degrees Celsius and 52 degrees Celsius over the past week. Delhi recorded its highest ever temperature of the season as the mercury soared to 52.3 degrees Celsius on Wednesday last week.

In contrast, parts of eastern India have been reeling under the impact of cyclone Remal. Heavy rain in Assam has left around 14 dead so far.

Prime Minister Narendra Modi on Sunday reviewed the heatwave conditions and stressed the importance of regular safety audits in hospitals and other public places. Forecasts indicate that the heatwave will persist in parts of Rajasthan, Gujarat, and Madhya Pradesh. The prime minister also reviewed the impact of the cyclone and assured continuous support from the Centre to the affected states.

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