What is the treatment for heat exhaustion?

Treatment for Heat Exhaustion

For heat exhaustion, immediate treatment should include removing the person from the heat source, applying ice packs to the neck, axillae, and groin, having them lie down in a cool place, removing excess clothing, cooling with water spray, and providing electrolyte-containing fluids for rehydration. 1

Immediate Cooling Measures

1. Remove from heat source - Move the person to a cool, shaded environment immediately 2, 1
2. Position the patient - Have them lie down in a cool place 2
3. Remove excess clothing - Take off as many clothes as possible to facilitate cooling 2
4. Apply cooling methods:
   • Cool water spray on the skin 2
   • Apply ice packs to the neck, axillae (armpits), and groin 1
   • For severe cases (temperature ≥40°C/104°F), use cold water immersion 1
5. Continue cooling until temperature reaches just under 39°C (102°F) 1

Rehydration Protocol

Provide electrolyte-containing fluids at the following rates 1:

• Adults: 1.0-1.5L per hour
• Adolescents: 1.0-1.5L (34-50oz) per hour
• Children 9-12 years: 100-250mL every 20 minutes

Appropriate fluids include:

• Commercial electrolyte-carbohydrate drinks
• Juice
• Milk 2

Monitoring and Additional Measures

• Monitor vital signs including heart rate, blood pressure, respiratory rate, and temperature 1
• Watch for symptoms of improvement or deterioration
• Consider stretching, icing, and massaging painful muscles if heat cramps are present 2
• Be vigilant for signs of progression to heat stroke (altered mental status, core temperature ≥40°C) 1, 3

Return to Activity Guidelines

• No same-day return to activity for anyone experiencing heat exhaustion 1
• Wait for complete symptom resolution before gradual return to normal activities 1
• Medical clearance may be necessary before resuming strenuous activity, especially in severe cases 1

When to Seek Emergency Care

Activate emergency medical services if:

• Symptoms worsen despite treatment
• Signs of heat stroke develop (confusion, delirium, seizures, coma)
• Core temperature remains elevated despite cooling efforts
• The person has underlying medical conditions that increase risk 3

Prevention Strategies

• Acclimatize gradually to heat over 10-14 days 1
• Maintain proactive hydration with electrolyte-containing fluids before, during, and after heat exposure 1
• Modify activity based on environmental conditions and heat index 1
• Wear lightweight, breathable fabrics in hot environments 1
• Limit time in hot environments, especially during peak heat hours 1

Heat exhaustion is a serious condition that can rapidly progress to potentially fatal heat stroke if not treated promptly and effectively 2. The prognosis is generally good with proper treatment, but careful monitoring is essential to prevent complications 1.