From the Guidelines
Heat stroke is a life-threatening emergency that requires immediate medical attention, whereas heat exhaustion is a milder condition that can progress to heat stroke if not addressed. The key differences between heat stroke and heat exhaustion lie in their severity and treatment. Heat exhaustion is characterized by heavy sweating, weakness, dizziness, headache, nausea, and a body temperature that's elevated but typically below 104°F (40°C) 1.
Key Differences
- Heat exhaustion occurs when the body struggles to cool itself through sweating during hot weather or intense physical activity, and treatment involves moving to a cooler place, drinking cool water, loosening clothing, and applying cool compresses.
- Heat stroke, on the other hand, is a life-threatening emergency with a body temperature of 104°F (40°C) or higher, altered mental status (confusion, agitation, slurred speech), hot and dry skin (often with absence of sweating), rapid heartbeat, and possible unconsciousness 1.
Treatment Recommendations
- For heat stroke, immediate medical attention is crucial - call emergency services, move the person to a cooler area, remove excess clothing, and cool them rapidly with ice packs, cool water, or fans while waiting for help 1.
- The most recent guidelines recommend whole-body (neck-down) water immersion (1°C–26°C, or 33.8°F–78.8°F) until the core body temperature is less than 39°C (102.2°F) for adults with exertional hyperthermia or exertional heatstroke 1.
Important Considerations
- Heat stroke involves the body's cooling system failing completely, causing dangerous core temperature elevation that can damage the brain and other organs, while heat exhaustion represents the body's struggling but still functioning cooling mechanisms.
- If not addressed, heat exhaustion can progress to heat stroke, emphasizing the importance of prompt treatment and recognition of these heat-related illnesses 1.
From the Research
Heat Stroke vs Heat Exhaustion
- Heat stroke and heat exhaustion are two heat-related illnesses that can affect individuals, especially those who are vulnerable due to their age, health status, or environmental conditions 2, 3.
- Heat exhaustion is characterized by symptoms such as flushed face, hyperventilation, headache, dizziness, nausea, and confusion, and can be managed by reducing heat gain, drinking cool fluids, and removing or loosening clothing 2, 3.
- Heat stroke, on the other hand, is a life-threatening condition that occurs when the body's temperature regulation fails, causing a severe elevation in body temperature with central nervous system dysfunction, including combativeness, delirium, seizures, and coma 4, 5.
- The main difference between heat stroke and heat exhaustion is the severity of the symptoms and the level of body temperature elevation, with heat stroke being a more severe condition that requires immediate medical attention 6.
Risk Factors and Prevention
- Risk factors for heat-related illnesses include environmental factors, medical conditions, medication use, and inadequate acclimatization 3, 6, 5.
- Prevention measures include increasing public awareness of the risks associated with exposure to high temperatures and prolonged exercise, staying hydrated, monitoring weight and urine output, and avoiding activities during extreme heat 2, 3, 6.
- Acclimatization, adequate hydration, and avoidance of activities during extreme heat are the most effective measures to reduce the incidence of heat-related illnesses 6.
Treatment and Management
- Treatment for heat exhaustion includes mild cooling, rest, and hydration, while heat stroke requires immediate cooling, intravenous fluids, and hospitalization 2, 3, 6.
- Water immersion, especially with cold water, is an effective method for rapidly reducing core body temperature in individuals with heat stroke or exertional hyperthermia 4, 6.
- Patients with heat stroke generally require hospitalization to monitor for medical complications despite rapid cooling, and should refrain from physical activity for at least seven days after release from medical care 6.