Heat waves pose a severe risk to patients, especially the elderly, in German hospitals. Many facilities are ill-prepared, leading to potentially life-threatening situations. A Berlin-based doctor shares her experiences and the necessary steps to protect patients.
Heat as a silent threat in hospitals
Andrea Nakoinz, an anesthesiologist at the Unfallkrankenhaus Berlin, vividly recalls a harrowing day when a heatwave nearly caused a tragedy. An elderly patient, awaiting surgery, became delirious due to dehydration and extreme heat, fearing that the doctors intended to poison her. This incident underscores the growing danger of heat in hospitals, particularly as climate change makes such scenarios more frequent.
Nakoinz warns that the elderly are especially vulnerable to heat-induced delirium and other complications, with recovery often difficult or impossible. However, heat also poses risks to pregnant women, individuals with pre-existing conditions, and children. The Robert Koch Institute estimates that around 3,200 deaths in Germany during the summer of 2023 were indirectly related to heat. Additionally, thousands of people suffer from heat-related illnesses requiring emergency care, where the heat can further exacerbate their conditions.
Inadequate hospital infrastructure against heat
Many hospitals in Germany are ill-equipped to handle extreme heat. According to the German Hospital Institute (DKI), only 38% of patient rooms are air-conditioned. Most hospital buildings date back to the 1970s and 1980s, with outdated infrastructure making the installation of modern air conditioning systems nearly impossible. Retrofitting these buildings would be costly, and hospitals are already financially strained.
While air conditioning is crucial for maintaining safe temperatures, Nakoinz points out that many systems use environmentally harmful refrigerants and consume significant amounts of electricity. She advocates for more efficient alternatives, such as cooling ceilings or concrete core activation, though these solutions also face financial barriers. The lack of adequate funding for hospital upgrades remains a significant issue, with Nakoinz highlighting the insufficiency of the current support available, even under recent healthcare reforms.
Preparing hospitals for future heatwaves
Despite the challenges, Nakoinz urges hospitals to develop individual heat protection or heat action plans. These plans should include appointing heat protection officers, training staff, conducting heat-focused rounds, and ensuring patients have access to sufficient water and heat-friendly meals. Simple measures, like relocating physiotherapy sessions to cooler areas, can also make a significant difference.
Nakoinz emphasizes the importance of setting realistic expectations: heat protection plans are not about maintaining a comfortable 20°C indoors when it’s 40°C outside but about keeping hospitals functional and preventing further harm to patients. She warns that severe heatwaves are inevitable in Germany, and if hospitals cannot cope, the government will need to intervene with financial support to prevent a public health crisis.
