How Las Vegas medical experts and outreach teams are working to prevent heat-related injuries and pavement burns

Editor's note: Este artículo está traducido al español.

When Louis Lacey and his homeless outreach teams at HELP of Southern Nevada make their rounds each week, it is common for them to see people laid out on scorching concrete or slumped over on bus stop benches, drenched in sweat and struggling to breathe in the dry heat.

Every summer brings 911 calls reporting residents suffering dangerous heat-related medical emergencies — and a lesser-known danger: pavement burns, injuries caused by contact with a surface hot enough to sear skin.

Lacey recalled a person who, years ago, suffered a medical episode in the summer heat, collapsed onto the street and sustained third-degree burns on a leg because the person couldn’t get up fast enough. The leg ultimately had to be amputated below the knee, Lacey said.

Pavement alone, baked under the Southern Nevada sun, can exceed 150 degrees — enough to leave unsuspecting victims with traumatic burns requiring extensive medical care.

“Something as simple as grabbing a hot escalator railing or stair railing; sitting down on the pavement for just a few minutes to tie your shoelaces or something, those short amounts of contact that we normally wouldn’t even think about can lead to first-degree burns to start with, and sometimes even those very brief contact times can evolve into something much deeper,” said Dr. Rabia Nizamani, medical director of the Lions Burn Care Center at University Medical Center.

UMC is home to Nevada’s only verified burn center, which treats patients injured by hot pavement and other outdoor surfaces, among other causes. The burn center has already admitted 22 patients for severe pavement burns this summer — double the 10 seen in June 2025.

In 2024, the hottest summer on record in Southern Nevada, UMC reported a record year for pavement burn admissions, with 94 people treated.

Nizamani said all 16 beds in her unit are currently full, forcing staff to deploy resources beyond the burn unit to treat patients requiring specialized wound care. Not all of these patients have pavement burns specifically, but many still require extensive treatment and longer hospital stays.

Pavement burns develop from exposure to hot asphalt, concrete and other paved surfaces. Skin burns also can result from contact with an object that has been sitting in the sun long enough to turn dangerous — a metal mailbox, for instance.

A hot enough surface can cause a minor burn within seconds, but it typically takes a few minutes of exposure for these wounds to progress into third- or fourth-degree burns, the most severe level.

Nizamani said pavement burns stand apart from other burns because they “tend to be extremely deep” — meaning what starts as a third-degree burn can worsen over time as the skin reacts to the injury. A fourth-degree burn can reach down to muscle, tendon or bone and demand more intensive care, including surgery, Nizamani added.

Pavement burns tend to progress more slowly than other burn injuries, because pavement stays so hot and people typically remain in contact with it longer than they would, say, an open flame. The injury can start out looking like a sunburn, then evolve over several days into a third- or fourth-degree burn — one that can leave a patient hospitalized for days.

That doesn’t mean every pavement burn requires surgery, but Nizamani worries about patients who come in after prolonged contact with pavement. Those patients are more likely to develop a much deeper burn that calls for “more serious surgery” as treatment.

As experts continue to ring the alarm about increasing temperatures in the American Southwest, burn center staff fear it could be another busy summer.

The overall increase in patients admitted for pavement burns could be due to the growing Southern Nevada population and more people knowing to seek treatment for these injuries, Nizamani said. But a rise in temperatures continues to be a main factor.

Las Vegas and Reno are among the fastest-warming cities in the nation, according to experts. As local jurisdictions race to mitigate heat’s impact on residents, temperatures continue to intensify — turning everyday outdoor items into potential hazards.

In June 2024, the Sun used an Etekcity Lasergrip 1080 Infrared Thermometer to measure the temperature of various surfaces throughout the valley at different times of the day. At almost 4 p.m. on one day measurements were taken, a plastic brown slide in the middle of a playground at Sunset Park had reached 167.3 degrees. It was 110 degrees at that time.

On the Strip, similar readings were taken from the black hand rail on an escalator in front of Park MGM — 158.2 degrees at 2 p.m. on a 108-degree day — and a brown bench at the Linq Promenade that had been sitting in the sun — 152.4 degrees at 3 p.m. the same day.

Nizamani explained that many pavement burn patients in Las Vegas include tourists who may underestimate the heat or lack awareness of the way the sun’s ultraviolet waves can significantly raise the surface temperatures of common structures around the Strip.

But it’s not just the Strip where these problems can surface.

The concrete floor at an unshaded bus stop for Route 203 at Spring Mountain Road and Wynn Road — in front of the Spring Mountain Plaza — had a 141.8-degree temperature by 12:30 p.m. June 24, 2024, when the day’s high was projected to reach 108 degrees.

Groups most vulnerable to sustaining pavement burns include people with underlying medical conditions that may cause them to faint or not feel pain, as well as people taking medications that increase their risk of fainting.

The elderly, young children and outdoor workers are also at higher risk. So is Southern Nevada’s homeless population, who are typically exposed to the elements at a higher rate and may not have the ability to seek shelter in a cooler environment during the daytime.

The Southern Nevada Health District launched its street medicine team in November, creating a team of medical professionals and representatives from local outreach groups to meet the local homeless community where they are with medical care and resources.

While they haven’t seen any cases of pavement burns firsthand, team members are aware of people experiencing heat-related illnesses. Last year, the SNHD recorded 284 heat-associated deaths and 2,217 heat-related emergency room visits.

The heat is bad enough, Lacey said, and noted that adding that substance use and constant exposure to the sun is “a recipe for disaster” and “increases the possibility of fatalities immensely.”

To help the homeless community, the health district, using a grant from Clark County, has prepared and distributed “heat mitigation care packages” filled with water, sunscreen, burn gel, cooling towels, a hat, sunglasses and educational resources about cooling centers or other places to seek shelter on hot days.

“Hot summers are dangerous for everybody, but especially so for people experiencing homelessness,” said Dr. Rosanne Sugay, a medical epidemiologist with the SNHD. “But really, just for the general public as well … pavement burns can happen to anyone, and it’s not very uncommon for kids to be running around barefoot and then stepping on a hot pavement, and it doesn’t take that long to get pavement burns from even something as simple as that.”

Lacey sits on a county group dedicated to getting more people into the dozens of community centers and libraries across the valley that are set up as cooling centers when temperatures get too hot.

His outreach teams at HELP of Southern Nevada also frequently roam the streets looking for people experiencing heat distress or at risk of pavement burns.

They will offer assistance to anyone in need during these times, providing cold water, cooling towels, a ride to a cooling center or bus fare so the person can get to somewhere with air conditioning on their own if possible.

Nizamani recommends that people stay out of the heat at the hottest times of day; cover up with light layers to avoid burns; and stay hydrated with water and electrolytes. Anyone who is feeling unwell should stay indoors, and shoes should always be worn outside — even in your own yard — to prevent injuries.

Lacey also encouraged those who can to donate items like water, sunscreen, hats, flip-flops, small fans and cooling towels to local homeless outreach organizations so they can distribute them to the community. He added that anyone can help by carrying around a small cooler of cold water bottles in their car and handing them out to people they see on the street in the sun — regardless of whether they’re homeless or simply a passing pedestrian.

“We need to be kind to each other, and we need to look out for each other,” Lacey said. “A bottle of water can save somebody’s life; giving somebody a hat to get their head out of the sun can save their life; getting somebody some burn cream or a cooling fan can save their lives; and it’s a sad state if we stop trying to take care of each other and stop being concerned for each other’s welfare. I mean, that’s what makes people people — we help each other.”