Heat-Related Illnesses

Home Treatment

Emergency first aid

Emergency first aid for heatstroke is needed immediately because this condition is life-threatening. After calling 911 or other emergency medical services, follow these first aid steps:

• Move the person into a cool place, out of direct sunlight.
• Remove the person's unnecessary clothing and place the person on his or her side to expose as much skin surface to the air as possible.
• Cool the person's entire body by sponging or spraying cool (not cold) water and fan the person to lower the person's body temperature. Watch for signs of rapidly progressing heatstroke.
• Apply ice packs on the groin, neck, and armpits, where large blood vessels lie close to the skin surface. Do not immerse the person in an ice bath.
• Check the person's rectal temperature often, and try to cool it to 39°C (102°F) or lower as soon as possible. The longer the body is at a high temperature, the more serious the illness and the more likely it is that complications will develop. Temperatures taken by mouth or in the ear are not accurate in this emergency situation.
• If breathing stops, begin rescue breathing.
• Do not give ASA or acetaminophen to reduce a high body temperature that can occur with heatstroke. These medications may cause problems because of the body's response to heatstroke.
• If the person is awake and alert enough to swallow, give the person fluids [1 L (35 fl oz) to 2 L (70 fl oz) over 1 to 2 hours] for hydration. Most people with heatstroke have an altered level of consciousness and cannot safely be given fluids to drink. You may have to help. Make sure the person is sitting up enough so that he or she does not choke.

Home treatment for mild heat-related illness

When recognized in the early stages, most heat-related illnesses, such as mild heat exhaustion, can be treated at home.

• Stop your activity, and rest.
• Get out of direct sunlight and lie down in a cooler environment, such as shade or an air-conditioned area. Elevate your feet. Remove all unnecessary clothing.
• Cool down by applying cool compresses or having a fan blow on you. Place ice bags under your arms and in your groin area, where large blood vessels lie close to the skin surface, to cool down quickly.
• Drink rehydration drinks, juices, or water to replace fluids. Drinks such as sports drinks that contain electrolytes work best. Drink 2 L (70 fl oz) of cool fluids over 2 to 4 hours. You are drinking enough fluids if your urine is normal in colour and amount, and you are urinating every 2 to 4 hours. Total rehydration with oral fluids usually takes about 36 hours, but most people will begin to feel better within a few hours.
• Rest for 24 hours, and continue fluid replacement with a rehydration drink. Rest from any strenuous physical activity for 1 to 3 days.

Heat syncope (fainting) usually does not last long and improves once you lie down to a flat position. It is helpful to lie in a cooler environment.

Heat edema (swelling) is treated with rest and by elevating your legs. If you are standing for a long time in a hot environment, flex your leg muscles often so that blood does not pool in your lower legs, which can lead to heat edema and fainting.

Heat cramps are treated by getting out of the heat and replacing fluids and salt. If you are not on a salt (sodium) restricted diet, eat a little more salt, such as a few nuts or pretzels. Do not use salt tablets because they are absorbed slowly and can cause irritation of the stomach. Try massaging and stretching your cramped muscles.

Heat rash (prickly heat) usually gets better and goes away without treatment. Antihistamines may help if you are having problems with itching. Keep areas clean and dry to help prevent a skin infection. Do not use baby powder while a rash is present. The powder can build up in the skin creases and hold moisture, allowing the growth of bacteria that may cause infection. Dress in as few clothes as possible during hot weather. Keep your home, especially sleeping areas, cool.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• A seizure occurs.
• Decreased mental alertness develops.
• Shortness of breath develops.
• You are unable to lower the body temperature.
• Vomiting occurs.
• Symptoms become more severe or frequent.

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Author:	Jan Nissl, RN, BS	Last Updated: January 31, 2007
Medical Review:	Martin Gabica, MD - Family Medicine Anne C. Poinier, MD - Internal Medicine H. Michael O'Connor, MD - Emergency Medicine
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