Man cooling off in an inflatable poolby James Hubbard, M.D., M.P.H.

Many years ago, before many of you were born, I trained at a large Dallas hospital. In the summers, the ambulances carried tubs of ice, and if they picked up someone with probable heatstroke, they’d start to ice them then and there.

I don’t know if they still do that, but heatstroke continues to be an emergency, killing hundreds each year and leaving many more disabled. And cooling remains the top priority in treatment.

Heatstroke Warning Signs

In order to know what to do, you need to be able to recognize the warning signs of heatstroke (also called sunstroke). With heatstroke your vital organs shut down. Many people even stop sweating. It’s like your body has given up (or burned out).

One of the first organs that shows damage is the brain. Therefore, many of the signs and symptoms of heatstroke are related to brain function, such as:

  • Agitation
  • Confusion
  • Hallucinations
  • Disorientation
  • Euphoria
  • Seizure
  • Coma

What to Do for Heatstroke When You Can Get Help

Call 911 immediately. Never wait and see if someone with heatstroke is going to get better on their own. Their organs are cooking.

Until the ambulance arrives, cool the person off as best you can. If they can walk and it’s not far, get them into air-conditioning. Otherwise, have them lie down in the shade. Take off all but their underclothes. Spray or bathe them with cool/cold water and fan them. If the person is unconscious, place them on their side so their tongue won’t impede their airway.

What to Do for Heatstroke When You Can’t Get Help

But what can you do if there’s no ambulance—no way to get expert medical help?

Your only hope is to cool the person off as quickly as possible and get some fluids in them. In addition to the guidelines above, here are more tips:

  • If you have ice, place a pack on the person’s groin and armpits, and under their neck.
  • Even if available, there’s a debate about whether someone with heatstroke should soak in a tub of ice water. The problem is, if their heart stops, it’s going to be difficult to do CPR. I think, whatever gets them the coolest the quickest is what you should do.
  • Soak a sheet in the coolest water possible, and wrap it around their bare skin.
  • Fan them for the cooling effect of evaporation.
  • If they’re alert enough, have them slowly drink as much cool water as possible.
  • If you have access to intravenous fluids, now’s the time to give them.

Even if you fully hydrate and cool someone with heatstroke, they’ll have multiple-organ damage. Get them to a medical facility as soon as possible.

You can see why ideally, you catch heat exhaustion before it becomes heatstroke. Have you or has anyone you know had a heatstroke? What happened? How is the person now?

Previous posts in the heat-survival series:

Photo by SSG Jessica Torralva, Army Photography Contest, 2007, FMWRC, Arts and Crafts, “Cooling Off on Down Time.”