Active Case
Heat Exposure Without Symptoms
Training note: CDC's heat guidance for someone with no symptoms is preventive — shade, fluids, air conditioning or finding a location that has one, and knowing the symptoms to watch for. A fan is not a substitute for that. CDC's heat page says to use a fan only when the indoor temperature is below 90°F, because at higher indoor temperatures a fan can increase body temperature. The inside temperature here is unknown, so a box fan cannot be counted as cooling, and the preventive step is a genuinely cooled place today. CDC NIOSH ties a 911 call to heat stroke signs such as confusion, altered mental status, slurred speech, loss of consciousness, seizures or very high body temperature, and treats heat exhaustion signs such as headache, nausea, dizziness, weakness and heavy sweating as needing prompt medical care. Extreme heat on its own, with no signs, is not an automatic 911 call — and if signs appear, that changes immediately. This note is orientation, not a treatment protocol, and nothing here advises on medicines.
Step 1 of 7: Review the case
Read what the case states, what it does not state, and what this practice case is asking you to learn.
Fictional resident
Mrs. Alma Delgado
71 years old · Older adult living with high blood pressure
ZIP code
78237
Preferred language
Spanish and English, comfortable in either
Coverage
Medicare
What is happening
Mrs. Delgado calls a community program herself during an extreme-heat advisory. Her window air-conditioning unit stopped working two days ago and she has been using a box fan. She has no thermometer and does not know how hot it actually is inside the house. She says she feels fine: she is sleeping, eating, drinking water, has no headache, no dizziness, no nausea, and is not cramping. She knows the date and answers every question clearly. She also asks, unprompted, whether this heat and the extra water she is drinking are a problem with her daily blood-pressure tablets. Her daughter lives fifteen minutes away, has air conditioning, and has offered to collect her today. Mrs. Delgado is worried the repair will cost more than she has this month.
What you are practicing here
- Decide what has to be established about how she is feeling right now before you choose any response.
- Judge how fast this needs a response, and be able to say what would change that judgment.
- Choose actions that reduce her exposure today and leave her able to recognize a change.
The detailed learning objectives for this case name the intended answers, so they are shown in the debrief after you submit. The safety note on the case page is different: it states the intended emergency response deliberately, because safety information is never withheld to make an exercise harder.
What the resident says matters most
- Not spending money she does not have
- Staying in her own home if she can
- Not worrying her daughter unnecessarily
Strengths already present
- Called for help herself, before anything went wrong
- A daughter nearby with air conditioning and a standing offer
- Drinking water and tracking how she feels
- Medicare coverage already in place
Stated in the case
- Extreme-heat advisory in effect; no working air conditioning for two days
- She reports no headache, dizziness, nausea, cramps or weakness, and is thinking and speaking clearly
- Using a box fan only, with the indoor temperature unknown, so the home cannot be treated as cooled
- Drinking water; sleeping and eating normally
- She asks whether the heat and the extra water affect her blood-pressure tablets, and has asked no one yet
- Daughter fifteen minutes away with air conditioning has offered to collect her today
- Lives with high blood pressure and takes daily medicine
- Worried the repair cost is more than she can afford this month
Not known — would need asking
- How hot the inside of the home actually is, and whether it cools at night
- Whether the daughter's offer is firm for today, and who will drive
- Whether she has a working phone and someone who will check on her tonight
- What her pharmacist or clinician has told her about her medicines in hot weather
Social determinants in this case
Some domains are stated in the case; others are only possible mechanisms to consider and are not established here. The full five-domain framework is mapped on the Methods page.
- Neighborhood and Built Environment stated in this caseNo working cooling in the home during an extreme-heat advisory.
- Economic Stability stated in this caseShe states the repair cost is more than she can afford this month.
- Social and Community Context stated in this caseA daughter nearby with air conditioning who has offered to host her.
- Health Care Access and Quality stated in this caseShe states she lives with high blood pressure, takes a daily tablet, and has asked whether the heat and the extra water affect it, with no one asked yet. That much is stated. Whether she has a clinician she can reach quickly is not stated, which is why the practiced step is an unanswered medicine question routed to a pharmacist or clinician rather than a care-access finding.
Why this is structural: Whether an older adult can leave a hot house depends on who can drive, what a repair costs, and whether a cooling center is reachable. A household with none of those has the same weather and a different level of risk.