Heat Exhaustion & Heat Stroke

As with all other medical problems, a doctor should be called if you are not sure what is wrong, if you do not know what to do for the problem, or if the person is not responding to what you are doing for them.

• Call a doctor for heat exhaustion if the person is unable to keep fluids down or if their mental status begins to deteriorate. Symptoms of shortness of breath, chest pain, or abdominal pain  may indicate that the heat exhaustion is accompanied by more serious medical problems.
• Suspected heat stroke is a true, life-threatening medical emergency. Call for an ambulance and request information as to what to do until the ambulance arrives.
• A person with suspected heat stroke should always go to the hospital (or call for an ambulance) at once.

For heat exhaustion, a person should go to the hospital if any of the following are present:

• Loss of consciousness, confusion, or delirium
• Chest or abdominal pain
• Inability to drink fluids
• Continuous vomiting
• Temperature more than 104°F
• Temperature that is rising despite attempts to cool the person
• Any person with other serious ongoing medical problems

Self-Care at Home

Home care is appropriate for mild forms of heat exhaustion. Heat stroke is a medical emergency, and an ambulance should be called immediately.

For mild cases of heat exhaustion

• For mild cases of heat exhaustion
• Give cool fluids such as water or sports drink (that will replace the salt that has been lost). Salty snacks are appropriate as tolerated.
• Loosen or remove clothing.
• Apply cool water to skin
• Do not use an alcohol rub.
• Do not give any beverages containing alcohol or caffeine.

Heat stroke (do not attempt to treat a case of heat stroke at home, but you can help while waiting for medical assistance to arrive.) Call 911 immediately

• Move the person to a cooler environment, or place him or her in a cool bath of water (as long as he or she is conscious and can be attended continuously).
• Alternatively, moisten the skin with lukewarm water and use a fan to blow cool air across the skin.
• Give cool beverages by mouth only if the person has a normal mental state and can tolerate it.

Follow-up

Before leaving the doctor's office or hospital, be sure the patient understands the instructions that are given by the physician, in particular the information regarding work and activity restrictions. Make sure the patient has a cool environment and plenty of suitable beverages (without alcohol or caffeine).

Prevention

Avoid heat exhaustion by not engaging in strenuous activity in hot, humid environments. People who are not used to the heat should be particularly careful. Intersperse periods of rest in a cool environment with plenty of available fluids to drink. Avoid strenuous activities during the hottest part of the day.

Heat stroke often occurs in people who are unable to modify their environments: infants, the elderly, and bed-ridden people. People who are taking many types of blood pressure, allergy, or depression  medication may also be particularly at risk and should avoid hot environments.

People in supervisory positions such as coaches, trainers, and lifeguards should be trained to specifically recognize signs of heat illness and what preventive measures to take.

Outlook

The prognosis is related to the severity of the heat exposure and the patient's general medical condition. The very young and the very old have the worst outcomes. In general, the prognosis with heat exhaustion is excellent, with full recovery expected. However, with heat stroke, permanent nerve, heart, liver, or kidney problems, or even death, can occur.