Northern Minnesota's wildfires have pushed air quality to hazardous levels across much of the state this week, with the Minnesota Pollution Control Agency issuing alerts covering the metro, Duluth, Brainerd, St. Cloud, and dozens of other communities.

Combined with an ongoing heat wave, officials describe this as a rare and dangerous as the smoke and extreme heat compound each other's health effects. For members, this is a moment to activate smoke-readiness protocols and pay close attention to residents most at risk.

Why Our Residents Are Especially Vulnerable

Older adults, and particularly those with existing cardiac or pulmonary disease, are among the populations facing the greatest risk from wildfire smoke exposure. Fine particulate matter can aggravate COPD, asthma, and heart failure, and can trigger cardiac events even in residents without a known respiratory diagnosis. When paired with high heat, the body has to manage two physiological stressors simultaneously, dehydration and heat strain, on top of airway irritation and reduced oxygenation.

Immediate Care Considerations

• Keep residents indoors. Suspend outdoor activities, courtyard time, and smoking breaks until air quality improves. If your building has outdoor common areas that residents frequently use, consider posting signage and briefing all shifts, not just nursing staff.
• Optimize indoor air quality. Check that HVAC systems are set to recirculate rather than pull in outside air, and confirm filters are current. If available, portable HEPA air purifiers in common areas and rooms of high-risk residents can meaningfully reduce indoor particulate levels. Keep windows and doors closed.
• Increase respiratory monitoring. Watch for new or worsening cough, shortness of breath, chest tightness, wheezing, or eye/throat irritation especially in residents with COPD, asthma, CHF, or coronary artery disease. Have a low threshold for pulse oximetry checks and physician notification for any acute change.
• Watch for combined heat-and-smoke symptoms. Confusion, dizziness, or lethargy could reflect heat-related illness, hypoxia, or both. Ensure adequate hydration protocols are being followed and that cooling measures such as fans, air conditioning, and cool cloths are implemented, particularly for residents on diuretics or with limited mobility to self-regulate temperature.
• Coordinate with physicians on medication needs. Residents with standing rescue inhalers, nebulizer treatments, or PRN respiratory medications should have those readily accessible. Confirm orders are current for anyone with a history of exacerbations.
• Review your emergency preparedness plan. If your facility is in or near an evacuation-advisory area, confirm your relocation and transportation plans are current, including arrangements for medical equipment, medication transport, and communication with resident families.
• Communicate proactively with families. A brief update of what you're doing to protect residents, and what symptoms would prompt a call goes a long way toward reassurance during a stressful regional event.

Looking Ahead

The MPCA has indicated conditions may improve behind a cold front expected Friday, but with over 800 fires burning in Canada and roughly 20 active in northern Minnesota's Superior National Forest, additional smoke events this summer are likely. Our settings may want to use this week as a prompt to formalize a wildfire smoke response protocol including HVAC readiness checks, HEPA filter inventory, and staff education so subsequent events continue to trigger a practiced responses.

For current alerts, staff and families can check the MPCA's air quality index and the Minnesota Department of Health's wildfire smoke guidance page. Any additional questions please contact Kari Everson.