A holistic approach to climate change in the emergency department: Direct impact of environmental factors on patients

Sarper Yilmaz; Ali Cankut Tatliparmak; Bülent Erbil; Funda Karbek Akarca; Onur Karakayali; Seyran Bozkurt; Recep Dursun; Nurcan Bicakci; Mustafa Ferudun Celikmen; Serkan Yilmaz; Murat Orak; Mehmet Ali Karaca; Mehtap Bulut; Sila Sadillioglu; Yenal Karakoç

doi:10.4103/tjem.tjem_280_25

Sarper Yilmaz¹, Ali Cankut Tatliparmak², Bülent Erbil³, Funda Karbek Akarca⁴, Onur Karakayali⁵, Seyran Bozkurt⁶, Recep Dursun⁷, Nurcan Bicakci⁸, Mustafa Ferudun Celikmen⁹, Serkan Yilmaz¹⁰, Murat Orak¹¹, Mehmet Ali Karaca³, Mehtap Bulut¹², Sila Sadillioglu¹³, Yenal Karakoç¹⁴

¹Department of Emergency Medicine, Zincirlikuyu Medicana Hospital, İstanbul, Türkiye
²Department of Emergency Medicine, Uskudar University Faculty of Medicine, İstanbul, Türkiye
³Department of Emergency Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye
⁴Department of Emergency Medicine, Ege University, School of Medicine, İzmir, Türkiye
⁵Department of Emergency Medicine, Sakarya University Faculty of Medicine, Sakarya, Türkiye
⁶Department of Emergency Medicine, Mersin University Medical Faculty, Mersin, Türkiye
⁷Department of Emergency Medicine, Dicle University Medical Faculty, Diyarbakir, Türkiye
⁸Department of Emergency Health Services, Tekirdağ Provincial Health Directorate, Tekirdağ, Türkiye
⁹Department of Emergency Medicine, Yeditepe University Medical Faculty, İstanbul, Türkiye
¹⁰Department of Emergency Medicine, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
¹¹Department of Emergency Medicine, Dicle University Faculty of Medicine, Diyarbakir, Türkiye
¹²Department of Emergency Medicine, University of Health Sciences, Bursa Faculty of Medicine, Bursa, Türkiye
¹³Department of Emergency Medicine, University of Health Sciences, Istanbul Training and Research Hospital, İstanbul, Türkiye
¹⁴Department of Emergency Medicine, University of Health Sciences, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakir, Türkiye

Keywords: Adaptation, climate change, emergency department, hyperthermia, hypothermia, impact, normothermia, vulnerability

Abstract

Climate change is no longer a distant threat but a present and escalating burden on emergency departments (EDs) worldwide. Its direct and indirect effects, ranging from heatstroke and hypothermia to vector borne disease resurgence and mass casualty incidents, challenge conventional models of emergency preparedness. This narrative review explores the intersection of climate dynamics with ED operational and clinical vulnerabilities. We summarize five core physiological mechanisms by which temperature extremes disrupt homeostasis and review high risk medication classes that may exacerbate heat related morbidity. In addition, we examine the World Health Organization’s mass casualty triage framework and its relevance in climate driven disasters such as floods, wildfires, and explosions. Special attention is given to low resource settings and migration heavy regions, where infrastructure strain and health inequity amplify the impact. We propose integrative, anticipatory planning models that combine clinical vigilance, environmental monitoring, and dynamic triage protocols. By identifying EDs as both front line responders and sentinel systems, this study underscores the urgency of embedding climate resilience into emergency care strategies. Our synthesis aims to support clinicians, policymakers, and health systems in adapting emergency services to the realities of a warming world.

How to cite this article: Yilmaz S, Tatliparmak AC, Erbil B, Akarca FK, Karakayali O, Bozkurt S, et al. Aholistic approach to climate change in the emergency department: Direct impact of environmental factors on patients. Turk J Emerg Med 2026;26:1-18.