Heatstroke
The most serious of the heat-related syndromes, heatstroke can be brought on by exercise or work in a hot environment, coupled with inadequate fluid intake.
Young children, older adults, obese people, and people born with an impaired ability to sweat are at high risk of heatstroke. Additional risk factors include alcohol use, cardiovascular disease, and certain medications.
In heatstroke, the body’s standard mechanisms for cooling itself, such as sweating, are lost.
Signs and Symptoms of Heatstroke
The signs and symptoms of heatstroke include:
- A temperature of more than 104 F (40 C)
- Cessation of sweating
- Irritability, confusion or unconsciousness
- Feeling dizzy or lightheaded
- A headache
- Nausea
- Fainting (may be the first sign in older adults)
- Hot, dry or moist skin
- Rapid heartbeat
- Rapid and shallow breathing
- Elevated or lowered blood pressure
First Aid Treatment for Heatstroke
Heatstroke is a medical emergency that occurs when the body overheats and can no longer regulate its temperature, leading to potentially life-threatening damage to the brain and other vital organs. If you suspect someone has heatstroke, it’s critical to act quickly. Here’s a comprehensive guide on first aid treatment for heatstroke:
1. Recognize the Signs
Be alert for symptoms such as:
- A very high body temperature (typically above 104°F or 40°C)
- Altered mental status (confusion, agitation, slurred speech, or seizures)
- Hot, dry skin—or occasionally profuse sweating—depending on the cause (exertional vs. classic heatstroke)
- Rapid, shallow breathing and a rapid heartbeat
- Nausea, vomiting, headache, and dizziness
Early recognition is key. If you observe these signs, especially in a hot environment, treat it as a medical emergency2.
2. Call for Emergency Help
- Immediate Action: If you suspect heatstroke, call 911 (or your local emergency services) immediately. Do not wait—prompt medical attention is crucial for reducing the risk of organ damage and other complications.
3. Move the Person to a Cooler Environment
- Remove from Heat: Quickly move the person to an air-conditioned space or at least a shaded, cooler area. The goal is to stop further heat accumulation.
- Remove Excess Clothing: Take off unnecessary clothing to allow the body to cool more effectively.
4.Initiate Cooling Measures
Begin cooling the person as soon as possible while waiting for emergency help:
- Apply Cool Water: Use a sponge, garden hose, or spray bottle to gently wet the person’s skin with cool water. You can also place the person in a cool shower or tub if available.
- Fan the Person: Enhance evaporation and heat loss by fanning the person while dousing them with cool water.
- Use Ice Packs: Place ice packs or cold, wet towels on key areas such as the armpits, neck, groin, and back. These areas have major blood vessels and can help rapidly lower body temperature.
- Damp Sheets: Cover the person with cool, damp sheets to help with cooling, especially when combined with fanning.
These strategies work together to help reduce the body’s core temperature toward a safer level (around 101–102°F) without causing a shock from overly rapid cooling3.
5.Monitor the Person Closely
- Watch Vital Signs: Keep an eye on the person’s responsiveness, breathing, and pulse. If the person becomes unresponsive or stops breathing, begin CPR immediately until help arrives.
- Timing: Note the duration of the symptoms and the cooling measures undertaken. This information can be valuable to the medical team upon their arrival.
- Fluid Intake: If the person is conscious and able to drink, offer small sips of cool water or a sports drink with electrolytes. Avoid beverages containing alcohol or caffeine.
6.Prepare for Professional Medical Care
While providing first aid:
- Do Not Delay Medical Treatment: Even if the person starts to seem better, they still need immediate evaluation and treatment in a hospital setting.
- Stay with the Person: Offer reassurance, maintain a calm presence, and provide continuous monitoring until emergency responders or medical professionals take over.
Hypothermia
When the body loses more heat than it can generate, hypothermia occurs.
It is usually the result of being exposed to cold temperatures or a cool, damp environment for a prolonged period, wearing wet or inadequate clothing, or falling into cold water. Even having an uncovered head during cold weather can cause hypothermia.
Signs and Symptoms of Hypothermia
Symptoms of hypothermia usually develop slowly, so a victim may be unaware that they need emergency medical treatment. O
Older adults, infants, young children and people who are very lean are at most risk, and others whose judgment may be impaired by mental illness, Alzheimer’s disease or intoxication, the homeless, and stranded motorists are also at risk. Other risk factors include malnutrition, cardiovascular disease and an under-active thyroid (hypothyroidism).
Hypothermia is an internal body temperature of less than 95 F (35 C), and its symptoms include:
- Shivering
- Slurred speech
- Abnormally slow breathing
- Cold, pale skin
- Loss of coordination
- Fatigue, lethargy or apathy
- Confusion or memory loss
First Aid Treatment for Hypothermia
1. Recognize the Signs
Be alert for symptoms such as:
- Mild Hypothermia: Shivering, pallor, and a feeling of cold. The person might be fatigued or have slurred speech.
- Moderate to Severe Hypothermia: Confusion, clumsiness, drowsiness, or unresponsiveness; slowed or weak pulse; shallow breathing; and in extreme cases, loss of consciousness. If you suspect moderate or severe hypothermia, treat it as a medical emergency.
2. Call for Emergency Help
- Immediate Assistance: Always call 911 (or your local emergency number) if the person shows signs of moderate to severe hypothermia. Even in milder cases, professional evaluation is recommended as complications can arise.
3. Move the Person to a Warmer Environment
- Slow and Safe Transport: Gently move the person indoors or to a sheltered, windproof, and warmer area. Handle them carefully—the affected individual may be frail and prone to injury.
- Protect Against the Cold: If indoors isn’t immediately available, shield the person from the wind by covering them with a heavy blanket or any available insulation.
4. Remove Wet Clothing
- Dry and Replace: Carefully remove any wet clothing from the person. Wet fabrics draw heat away from the body, worsening hypothermia. Replace them with warm, dry coverings—blankets, towels, or dry clothes.
5. Initiate Slow Rewarming
- Focus on the Core: Begin warming the central areas of the body—the chest, neck, and groin—to help restore the core temperature gradually. Do not immerse the person in hot water or use heating lamps, as rapid rewarming can trigger dangerous heart rhythms.
- Warm Compresses: Apply warm, dry compresses or heating pads (wrapped in cloth to avoid direct skin contact) to the chest, neck, and groin areas. Avoid directly warming the extremities (arms and legs) first, since this can lead to peripheral vasodilation and a drop in blood pressure (a phenomenon known as “afterdrop”).
- Warm Beverages: If the person is conscious and able to swallow, offer small sips of warm (non-alcoholic, non-caffeinated) fluids like broth or warm water. This can help raise the internal temperature gently.
6. Monitor Vital Signs and Reassure
- Continuous Observation: Stay with the person and monitor their breathing, pulse, and level of responsiveness. Be prepared to start CPR if the person becomes unresponsive and shows no signs of breathing.
- Offer Comfort: Provide reassurance and try to keep the person as calm as possible. Minimizing stress can help conserve their body heat.
7. Prepare for Professional Medical Intervention
- Transition to Care: Even if rewarming techniques seem effective and the person appears to improve, it is important that they receive further evaluation and treatment from medical professionals. Complications from hypothermia can occur even after initial recovery.
- Avoid Overheating: Ensure that rewarming is gradual. Overly rapid warming can lead to complications such as cardiac arrhythmias.
Prevention of heatstroke
Following these tips may help lower your risk of heatstroke and other heat-related illnesses:
- Stay hydrated by drinking plenty of water or sports drinks that contain electrolytes.
- Lower the amount of time you spend outdoors during very hot weather.
- When you’re outside in hot weather, wear lightweight, light-colored clothing that’s loose fitting.
- Install air conditioners or use fans when indoors in hot weather.
- Avoid exercising and other types of strenuous or extreme physical activity outdoors when it’s hot and humid.
You should never leave a child, animal, or adult in an enclosed hot space like a car or windowless room that isn’t air-conditioned.
Key Points to Remember
- Do Not:
- Rub or massage the person’s limbs, as this can worsen tissue damage by forcing cold blood from the extremities back into the core.
- Rewarm too quickly with extremely hot water, heating pads, or a heating lamp.
- Give alcohol or caffeinated beverages, which can impair the body’s ability to regulate heat.
- Do:
- Call for emergency help as soon as possible.
- Handle the person gently, considering the potential fragility associated with hypothermia.
- Keep rewarming efforts focused on the core of the body.
REFERENCES
- Heat stress. National Institute for Safety and Occupational Health. https://www.cdc.gov/niosh/topics/heatstress/.
- O’Connor FG, et al. Exertional heat illness in adolescents and adults: Epidemiology, thermoregulation, risk factors, and diagnosis. https://www.uptodate.com/contents/search.
- Heat-related illnesses. American College of Emergency Physicians. https://www.emergencyphysicians.org/article/know-when-to-go/heat-related-illnesses
- Managing diabetes in the heat. (2024).
https://www.cdc.gov/diabetes/articles/managing-diabetes-in-the-heat.html - Hot weather safety for older adults. (2022).
https://www.nia.nih.gov/health/safety/hot-weather-safety-older-adults
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