What is the management for heat exhaustion?

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From the Guidelines

Heat exhaustion should be managed by having the victim lie down in a cool place, taking off as many clothes as possible, cooling the victim with a cool water spray, and encouraging the victim to drink cool fluids, preferably containing carbohydrates and electrolytes. This approach is based on the recommendations from the 2010 American Heart Association and American Red Cross guidelines for first aid 1. The key steps in managing heat exhaustion include:

  • Moving the victim to a cool place to reduce further heat exposure
  • Removing excess clothing to help the body cool down
  • Cooling the victim with a cool water spray to lower the body temperature
  • Encouraging the victim to drink cool fluids, such as juice, milk, or a commercial electrolyte-carbohydrate drink, to replenish lost fluids and electrolytes It is essential to note that heat exhaustion can rapidly advance to heat stroke, which can be fatal, so prompt and vigorous treatment is crucial 1. If symptoms worsen or do not improve within a reasonable time frame, or if the victim experiences severe symptoms such as confusion, loss of consciousness, or a high temperature, emergency medical attention should be sought immediately.

From the Research

Management of Heat Exhaustion

The management of heat exhaustion involves several key steps to help the individual recover and prevent progression to heatstroke.

  • Immediate reduction of heat gain by discontinuing exercise and reducing radiative heat source exposure 2
  • Encouraging the individual to drink cool fluids and remove or loosen clothing to facilitate heat loss 2
  • In more extreme situations, employing more aggressive cooling strategies such as cold showers or application of wet towels to lower core temperature 2, 3, 4
  • Replacing fluids and electrolytes if needed, with intravenous hydration potentially necessary in more serious cases 3, 4
  • Monitoring serum sodium levels to prevent cerebral edema 3

Prevention of Heat-Related Illnesses

Prevention of heat-related illnesses, including heat exhaustion, is also crucial.

  • Increasing public awareness of the risks associated with exposure to high temperatures and prolonged exercise 2
  • Gradual acclimation to the heat, increased fluid intake, vapor-permeable clothing, and frequent rest periods for laborers, athletes, and military personnel 4
  • Maintaining hydration and considering alternate living arrangements for frail and elderly persons in hot weather 4
  • Avoiding heat illness by relying on a drinking schedule, favoring sports drinks, monitoring weight and urine, and staying cool when possible 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Heat exhaustion.

Handbook of clinical neurology, 2018

Research

Evaluation and treatment of heat-related illnesses.

American family physician, 2002

Research

Heat emergencies.

American family physician, 1994

Research

Treatment of suspected heat illness.

International journal of sports medicine, 1998

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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