PORT ORCHARD – The Kitsap County Coroner’s Office is investigating four deaths believed to be related to the recent heat wave that scorched the region last week.

The victims, ranging in age from 66 to 88, were all residents of Kitsap County, according to officials.

“All the victims were found in indoor and outdoor locations with high ambient [air] temperatures of 100 degrees Fahrenheit or higher,” said Dr. Lindsey Harle, a forensic pathologist with the coroner’s office.

The deaths involved a 71-year-old male, a 66-year-old female, an 80-year-old male and an 88-year-old-female, the coroner’s office stated.

“They included elderly individuals. Some had additional risk factors like cardio-vascular disease. Some individuals were wearing multi-layers of clothing despite the temperature,” Harle said. “In some cases, this was due to psychiatric illness and in some cases, this was related to homelessness.”

A blistering heat wave that hit the region June 25 delivered furnace-like heat for four days. Record-setting temperatures were recorded across the Northwest – Bremerton hit 106, Seattle 108, Spokane 109 and Portland recorded a high temperature of 116.

Washington authorities linked 57 deaths in the state to the recent heat wave.

Across the state, more than 1,900 emergency department visits took place for suspected heat-related illness, according to Katie Pope, a state Department of Health public information officer. 383 of these visits led to hospital admissions. People came to the ER because of heat exhaustion, dehydration, dizziness, temporary loss of consciousness and collapse, Pope said.

Meteorologists attributed the extreme temperatures to a dome of high pressure over the Pacific Northwest, combined with human-caused climate changes.

Here’s how a heat-related death happens, according to the coroner’s office:

When temperatures soar to excessive levels, the body’s ability to function normally is impaired. Essentially, the body’s ability to dissipate heat is overwhelmed, Harle explained. Sweating is the way one’s body releases heat. To sweat, one’s heart and cardiovascular system has to be pumping blood throughout the body.

“At some point, your heart may not be able to keep up with the temperature surrounding your body. When this happens, you stop sweating because you run out of fluids to sweat,” she said.

“You then have inflammation and direct damage to cells and proteins in your body from the heat. Initially what happens is people will have muscle cramps, headache, nausea and vomiting. As things progress, you develop altered mental status, which a lot of times is drowsiness and inability to communicate.”

A rapid heart rate and rapid breathing follows, and finally you can lose consciousness, she said.

With the body so focused on directing blood to the skin in order to cool down, a lesser amount of blood goes to internal organs, which in turn leads to complications like liver and kidney failure.

How quickly an individual can succumb to heat varies by individual, but she said a person unable to compensate for high temperatures, such as someone who is elderly and has dementia or multiple medical problems, can be impacted in a matter of hours, she said.

Risk factors

There are a number of risk factors that increase the chances of a person suffering a heat-related death.

In addition to exposure to excessive temperatures, risk factors include having a chronic disease like diabetes or cardio-vascular disease, or being unable to care for oneself, such as is the case with young children and some of the elderly, Harle said.

“Those with mental illness who may not be adequately able to care for themselves and make the decision to dress appropriately and find a cooler environment are also at higher risk,” she added.

Those who are socially isolated are another vulnerable group. “They don’t have anyone checking in on them and they may not have the ability, or means, to get out of their home.

“Poverty is also a risk factor because those individuals may not have the means to get out of their house or even turn on their air conditioning if they have it. They many not even have access to the internet to find out about cooling stations or that a heat wave is coming,” she added.

Keeping cool

During the historic heat spell, cooling centers were opened around Kitsap County. Some of those centers were set up at Poulsbo City Hall, a community center in Kingston, a senior center in Bainbridge Island, Bremerton’s Salvation Army and a mobile command center at the Port Orchard Marina.

Cooling centers are a godsend in heat spells, Harle said.

“They are very important because a lot of people do not have air conditioning in their home. In our region, air conditioning is the one greatest factor that makes the difference in heat-related deaths. So, the ability for individuals to go to cooling centers or public places that have air conditioning is very useful.”

Protecting against heat-related illness

The pathologist offered advice on ways people can help prevent heat-related illness in the future.

“It’s a lot of common-sense things — things we don’t necessarily think about since we are not commonly dealing with (heat) issues in our climate,” she said.

Know the weather forecast, particularly in summer. “Be aware that a heat wave is coming.”

Dress appropriately in light clothing that allows you to sweat and cool off.

Avoid doing chores in the heat. Instead, do them in the evening or put them off for a few days.

“The other thing to do is to check on people who may be living alone and have conditions that prevent them from caring for themselves. Check on elderly neighbors or family who live alone. They may be developing symptoms and not recognize it,” Harle said.

While this heat wave has ended, there is no telling when furnace-like temperatures will return. Experts believe the frequency of sweltering weather events is likely to increase in the future — global warming has raised temperatures by 2-degrees Fahrenheit since 1900.

Dr. Lindsey Harle (file photo)