Brief overview
- What to do in case of heat stroke and heat exhaustion? Remove the affected person from the heat/sun, lay flat (with raised legs), cool (e.g. with damp cloths), give fluids if the affected person does not vomit; place in the recovery position if unconscious; resuscitate if breathing stops
- Heat stroke and heat exhaustion – risks: including drowsiness, nausea, vomiting, circulatory collapse with unconsciousness
- When to see a doctor? As the condition can deteriorate quickly with heatstroke, always call an emergency doctor. In the case of heat exhaustion, a doctor is required if the symptoms worsen and/or the person concerned becomes unconscious.
Attention!
- Never leave people with (suspected) heatstroke or heat exhaustion alone. Particularly in the case of heatstroke, the condition of the person affected can deteriorate suddenly!
- Never apply cooling/ice packs to lower the body temperature directly to the affected person’s skin, but always with a cloth in between (risk of frostbite!).
- Do not give affected persons alcohol to drink.
Heat stroke and heat exhaustion: what to do?
You should react quickly in both cases. However, first aid is particularly important in the case of heatstroke, as the condition of the person affected can quickly become life-threatening.
Heatstroke: What to do?
- classic heat stroke: This is caused by extreme heat and mainly affects older people.
- Exertional heat stroke: It can occur during intense physical activity in high heat (e.g. intense sports on a hot summer day or heavy work on blast furnaces), in people of all ages.
In both cases of heat stroke, first aid is as follows:
- Get into the shade: Get the affected person out of the sun and into the cool, if possible, so that the body can cool down.
- Shock position with full consciousness: Place a conscious person in the shock position – i.e. on their back with their legs elevated. This improves blood circulation in the brain (this can be reduced in the event of heatstroke due to low blood pressure).
- Stable lateral position if unconscious: If the heatstroke patient loses consciousness, check breathing and pulse. If both are present, place them in the recovery position.
- Loosen clothing: Open any tight-fitting clothing (e.g. shirt collar, tie, belt, etc.).
- Lukewarm drinks: If the affected person is conscious, does not feel nauseous and is not vomiting, you should give them sips of lukewarm (not cold!) liquid (e.g. water, mild juice spritzer, tea). This should compensate for the loss of fluids due to the sweating typical of heatstroke. However, do not give fluids in case of nausea and vomiting – there is a risk that the affected person may choke (aspiration).
- Resuscitation: If the victim stops breathing, start resuscitation immediately. Continue this until the emergency doctor arrives or the victim is breathing on their own again.
Heat exhaustion: what to do?
Heat exhaustion is caused by heavy sweating at high temperatures. If too little is drunk at the same time, the body loses a lot of fluids and salts (electrolytes). This puts an enormous strain on the circulatory system – possible consequences are circulatory collapse and unconsciousness. Physical activity in hot weather increases the risk of heat exhaustion.
First aid is as follows:
- Get out of the heat: Get the affected person out of the heat.
- Shock position: Lay the affected person on their back and place their legs higher than their heart.
- Electrolyte-containing drinks: Give the affected person plenty of fluids with minerals to drink (provided they do not vomit). This should compensate for the loss of fluids and electrolytes. For example, water, mineral water or tea with a little salt (approx. 1 teaspoon of table salt per liter) or broth (bouillon) is suitable.
Children with heat stroke or heat exhaustion
First aid measures for children with heatstroke or heat exhaustion are basically the same as for adults. It is important to know that children are particularly at risk of heat stroke and heat exhaustion (especially infants). This is because their bodies are not yet able to regulate their temperature as effectively as adults. In addition, many children do not think about sun protection and drinking enough when playing and romping around.
Therefore, make sure that your children take regular breaks to drink and relax in the shade or indoors. If heat stroke or heat exhaustion does occur, call an ambulance (especially if heat stroke is suspected) and carry out the first aid measures mentioned above (move the child to a shady, cool place, reduce body temperature with moist compresses, etc.).
Heat stroke and heat exhaustion: symptoms and risks
Symptoms of heat stroke depend on the severity:
- Body temperature above 40 degrees Celsius
- dizziness
- headache
- Nausea, vomiting
- disorientation
- Low blood pressure
- accelerated heartbeat
- accelerated breathing
- muscle cramps
- impaired consciousness such as drowsiness or even unconsciousness
As a result of heatstroke, the brain can swell due to water retention – a life-threatening cerebral edema develops. Therefore, if heatstroke symptoms are not recognized and treated in time, the person affected can die within a short time!
Similar to heat stroke, heat exhaustion causes symptoms such as headaches, dizziness, nausea, accelerated pulse and low blood pressure. However, the affected person’s skin is not dry, but moist – the affected person sweats profusely.
The heavy loss of fluids due to sweating reduces the blood volume. The blood vessels then constrict so that those organs that need a lot of oxygen (e.g. brain, kidneys) continue to be supplied. As a result, hands and feet are less well supplied with blood: they appear cold, pale and sweaty.
Symptoms in children
Heat stroke and heat exhaustion: when to see a doctor?
In the event of heat exhaustion, you should call an (emergency) doctor if the person’s symptoms worsen or they lose consciousness.
In the event of heatstroke (or suspected heatstroke), you should always call an emergency doctor immediately. It can quickly become life-threatening for the person affected! They must therefore be treated and monitored in hospital.
Heat stroke and heat exhaustion: examinations by a doctor
A doctor can usually recognize both heat exhaustion and heat stroke quite quickly – based on the symptoms and the information from the initial consultation (medical history). During this consultation, the doctor will ask the patient or accompanying persons about the previous situation. For example, did the patient exercise in extreme heat or in the blazing sun shortly before the symptoms appeared? Did he or she wear warm clothing that promoted heat build-up? Questions about any underlying illnesses are also part of the medical history interview.
The interview is followed by a physical examination. Body temperature, blood pressure and heart rate are particularly important. They help the doctor to further assess the patient’s condition and the severity of the heat illness.
The doctor can check the patient’s brain function with simple neurological tests. This is particularly necessary in the case of (suspected) heat stroke. For example, the doctor uses simple questions to check whether the patient can orient themselves in terms of time and place. He also tests the reflexes of the brain stem, for example the pupillary reflex.
Further examinations are generally necessary, especially in the case of heat stroke:
Blood tests show whether there is a deficiency or excess of certain salts (electrolytes) in the blood due to the heatstroke. The treatment depends directly on these results – a severe shift in the electrolyte balance must be treated immediately. Certain blood values may also indicate damage to important organs (liver, kidneys, heart) as a result of the heatstroke shock.
To rule out other causes of circulatory collapse, the doctor can take an electrocardiogram (ECG). This can also reveal any cardiac arrhythmia that may be caused by the severe lack of salt and fluids during heatstroke.
If the doctor suspects cerebral edema as a result of heat stroke, imaging procedures are necessary for clarification. These include magnetic resonance imaging (MRI) and computer tomography (CT).
In the event of heat exhaustion, the resulting fluid and electrolyte deficiency should be remedied as quickly as possible. Drinking plenty of fluids will help. If necessary, the doctor can also give the patient an infusion. The rapid replacement of fluids and salts stabilizes the circulation. After a few days of rest and restfulness, most people feel completely well again.
Heatstroke treatment should always be carried out in hospital, in severe cases even in the intensive care unit. The first step is to stabilize the patient’s circulation by administering infusions. In addition, the greatly increased body temperature is lowered by cooling measures. For example, the patient can be immersed in cold water, provided their vital functions (such as breathing and circulation) are stable.
Depending on the severity, heatstroke may require further treatment, for example the administration of anti-seizure medication.
How long a heat stroke lasts depends on its severity. With early treatment, the symptoms can subside and disappear after a few hours. However, those affected may still feel weak for some time afterwards. It is therefore advisable to take it easy for a few days, also to avoid a relapse.
The majority of those affected survive heat stroke and heat exhaustion without permanent damage.
If you want to prevent heat stroke and heat exhaustion, you should first know who is particularly susceptible to such heat illnesses. First and foremost, these are people whose body’s own temperature regulation is not yet or no longer fully effective. This includes babies, (small) children and older people. People who spend long periods of time in confined and poorly ventilated rooms or who work there are also at increased risk. This applies, for example, to certain occupational groups (workers in mining or the metalworking industry, sauna masters, etc.).
In addition, physical activity in the blazing sun increases the likelihood of heat stroke and heat exhaustion. This affects road construction workers, for example. Athletes who train or compete under strong sunlight or in hot and humid air are also at risk.
The most important tips for preventing heat stroke and heat exhaustion are therefore:
- Avoid prolonged exposure to high temperatures. Find a cool, shady place, especially at lunchtime.
- Try to avoid direct sunlight for long periods of time. Wear a hat in the sun.
- As an athlete, you should not train in the midday heat, but preferably in the morning or evening hours.
- Wear loose, breathable clothing in hot weather.
- Avoid alcohol and heavy meals in high temperatures.
- Do not leave children alone in a car parked in the sun for long periods of time.
- Make sure that your child takes regular breaks to drink and rest in the shade in hot weather.
Observe the regional heat warnings issued by the German Weather Service. This is particularly important if you are susceptible to heatstroke and heat exhaustion or have children.
