What is the immediate treatment for heat exhaustion?

Immediate Treatment for Heat Exhaustion

For heat exhaustion, immediately move the person from the hot environment, remove excess clothing, limit exertion, and provide cool liquids if the person is able to swallow. 1

Recognition and Assessment

Heat exhaustion is characterized by:

• Sudden onset of symptoms including nausea, dizziness, muscle cramps, feeling faint, headache, fatigue, and heavy sweating 1
• Core temperature below 104°F (40°C) without central nervous system dysfunction 2
• Cardiovascular hypoperfusion 2

It's critical to differentiate heat exhaustion from heatstroke, which is a life-threatening emergency characterized by:

• Altered mental status (confusion, seizures, loss of consciousness) 1
• Core temperature ≥104°F (≥40°C) 1
• If heatstroke is suspected, activate emergency services immediately 1

Step-by-Step Treatment Algorithm

1. Remove from heat source

   • Move the victim to a cool, shaded environment 1
   • This is the first critical step to halt the progression of heat illness

2. Remove excess clothing

   • Take off as many clothes as possible to facilitate cooling 1
   • Loosen any tight clothing that remains 3

3. Position the victim properly

   • Have the victim lie down in a cool place 1
   • Elevate legs slightly if signs of shock are present

4. Active cooling measures

   • Apply cool water spray to the skin 1
   • Use fans to promote evaporative cooling 1
   • Apply ice packs to neck, axillae (armpits), and groin 1
   • Cold shower if available 3
   • Apply wet towels and rotate them frequently 1

5. Fluid replacement

   • Encourage drinking cool fluids if the person is conscious and able to swallow 1
   • Preferably provide fluids containing carbohydrates and electrolytes 1
   • For athletes or those with prolonged exertion, 4-9% carbohydrate-electrolyte drinks are recommended over plain water 1

6. Monitor for improvement or deterioration

   • Watch for signs of worsening condition (altered mental status, loss of consciousness)
   • If symptoms worsen or don't improve within 30 minutes, activate emergency services 4

Special Considerations

For Children and Adolescents

• Children are particularly vulnerable to heat illness 1
• Provide fluids at regular intervals: 100-250 mL (3-8 oz) every 20 minutes for 9-12 year-olds 1
• Adolescents may need up to 1.0-1.5 L (34-50 oz) per hour 1

For Athletes and Those Performing Physical Activity

• Anyone experiencing heat exhaustion should not return to activity for the remainder of the day 1
• Rest is essential to prevent progression to heatstroke 5
• For those with muscle cramps, gentle stretching and massage of affected muscles may help 1, 5

Common Pitfalls to Avoid

• Delayed recognition: Early warning signs include flushed face, hyperventilation, headache, dizziness, and confusion 5
• Inadequate cooling: Don't just provide fluids; active cooling is essential 1
• Returning to activity too soon: Complete rest is necessary until symptoms fully resolve 1
• Overlooking medications: Certain medications (diuretics, antihistamines, beta-blockers) can increase risk of heat illness 1
• Ignoring environmental conditions: Heat exhaustion risk increases significantly when temperature exceeds 80°F, especially with high humidity 1

Heat exhaustion is a serious condition that can rapidly progress to life-threatening heatstroke if not properly treated. The most critical interventions are removing the person from heat, initiating cooling measures, and providing appropriate hydration 1.