Overview: Heat-Related Emergencies

Heat exhaustion and heat stroke exist on a spectrum of heat-related illness. Heat exhaustion involves dehydration and electrolyte depletion; responds to cooling and fluids. Heat stroke—true medical emergency—involves altered mental status and body temperature exceeding 104°F (40°C). Immediate aggressive cooling prevents death and permanent organ damage .

Recognizing progression from heat exhaustion to heat stroke guides appropriate urgent intervention.

Key Information
Heat exhaustion involves heavy sweating, weakness, nausea, headache, normal mental status, and temperature under 104°F. Heat stroke involves minimal/no sweating, confusion, seizures, loss of consciousness, and elevated temperature. Heat stroke is a medical emergency requiring immediate intensive cooling.

Heat Exhaustion Management

Move person to cool environment. Remove excess clothing. Apply cool water or ice packs to neck, armpits, and groin (large blood vessels). Have conscious person sip cool fluids if available. Monitor closely for progression to heat stroke.

Heat Stroke Emergency Response

Call emergency services immediately—heat stroke requires hospitalization. Begin emergency cooling while awaiting transport. Immerse in cold water if available, or apply ice to major blood vessels (neck, armpits, groin). Remove excess clothing. Do not give oral fluids to unconscious person; aspiration risk is serious.

Advanced Cooling Techniques

Ice water immersion is most effective if available. Alternative methods include cold intravenous fluids (given in hospital), ice packs to key areas, and evaporative cooling (spraying cool water with fans). Aggressive cooling to 101-102°F (38-39°C) is critical; each degree of temperature elevation worsens outcome.

Warning
Heat stroke causes permanent organ damage (especially brain, kidneys, heart, muscles) within minutes. Delay in aggressive cooling significantly increases mortality and disability. Continue cooling during transport to hospital; emergency department cooling may be continued with ice or cold fluids.

Clinical Note
Prevention through hydration, appropriate rest, protective clothing, and avoiding peak heat hours is most effective . High-risk groups—elderly, very young, athletes, those with chronic conditions—require extra precautions. Monitor for complications including rhabdomyolysis, disseminated intravascular coagulation, and organ failure in hospital setting.

Prevention in Hot Conditions

Drink fluids regularly regardless of thirst. Wear light-colored, lightweight clothing. Take frequent breaks in shade or air conditioning. Avoid strenuous activity during peak heat. Check on vulnerable individuals frequently. Never leave children or pets in vehicles.

Heat Stroke: Recognition and Emergency Treatment

Quick Facts

Heat Exhaustion Management

Heat Stroke Emergency Response

Advanced Cooling Techniques

Prevention in Hot Conditions

Sources