How to Treat Heatstroke

Heatstroke is a severe condition that must not be taken lightly. It is sometimes called heat exhaustion, and it occurs when the body is exposed to extreme heat for a prolonged period, causing the body temperature to rise to 40°C or higher. If you are alone when experiencing heatstroke or helping someone who is, follow some basic guidelines outlined below. The first step is to gradually lower the body temperature. If you do this early enough, your body will naturally recover. If heatstroke is allowed to persist for too long, the consequences can become severe. If possible, seek medical attention immediately.

Call Emergency Services. Depending on the symptoms and the patient's condition, you will need to decide whether to contact a private doctor or call emergency services at 115. Pay close attention to the symptoms. Prolonged heatstroke can damage the brain, causing anxiety, confusion, stroke, headaches, dizziness, fainting, hallucinations, loss of control, loss of consciousness, and restlessness. Heatstroke can also affect the heart, kidneys, and muscles. It is better to be cautious than regret later. Call emergency services if you notice any of the following symptoms:

• Signs of shock (e.g., pale lips and nails, confusion)
• Loss of consciousness
• Body temperature above 38.9°C
• Rapid breathing and/or quick pulse
• Weak pulse, unconsciousness, nausea, vomiting, dark urine
• Stroke. If the person is experiencing a stroke, clear the area to ensure the patient’s safety. If possible, place a pillow under the patient's head to prevent them from hitting their head on the ground during a seizure.
• If the symptoms persist (for more than an hour), call emergency services.

Avoid using medication. Our instinct is often to take medicine when we feel unwell. If you're suffering from heatstroke, certain medications may actually worsen the condition. Avoid fever reducers like aspirin or acetaminophen. These drugs can be harmful during heatstroke as they can increase bleeding risks and complicate sunburn blisters. Fever-reducing medications are effective for infections, not heatstroke.

• Do not give anything to someone with heatstroke if they are vomiting or unconscious. Anything placed in their mouth could cause choking.

Cool the patient's body. While waiting for emergency assistance, move the patient to a shaded or cooler area (preferably somewhere with air conditioning). If possible, place the patient in a bath, under a shower, or in a stream or pond. Avoid making the temperature too cold. Using ice can worsen slow heartbeats or even cause a stop. However, never do this if the patient is unconscious. You can place a cool, wet cloth on their neck, groin, and/or underarms. If possible, spray and fan the patient to promote cooling through evaporation. Spraying cold water or applying a wet cloth to the patient's body before fanning them helps cool more effectively than submerging them in water.

• Help the patient remove tight clothing (hat, shoes, socks) to facilitate cooling.
• Do not rub alcohol on the patient's body. This folk remedy can cause a rapid cooling of the body, which leads to dangerous sudden temperature changes. Always use cold water, never alcohol.

Rehydrate and replenish electrolytes. Give the patient small sips of cool water or a saline solution (1 teaspoon of salt per liter of water) to combat dehydration and salt loss from sweating. Ensure the patient does not drink too quickly, as it could cause shock. If you don’t have saline or cool water, regular drinking water will suffice.

• You may also give the patient salt tablets, which help balance the body's electrolytes. Be sure to read the instructions on the salt tablet container.

Keep the patient calm. A calm patient is better able to cope with the situation. Help reduce confusion by encouraging deep breaths. Focus on things other than the heatstroke. Worrying only causes the blood vessels to dilate, increasing the body temperature.

• Massage the patient’s muscles gently. The goal is to increase circulation in the muscles. Cramps are an early sign of heatstroke, especially in the calves.

Let the patient lie down. One of the hallmark symptoms of heatstroke is fainting. Keep the patient safe when they lose consciousness by laying them down.

• If the patient faints, stabilize their body by turning them onto their left side and bending their left leg. This position is known as the recovery position. Check the patient’s mouth to ensure they’re not choking on vomit. The left side is the best for blood circulation since the heart is located on this side.

Know who is at risk of heatstroke. Elderly individuals, workers exposed to hot environments, obese people, those with diabetes, kidney or heart issues, as well as infants, are all at higher risk. Those with ineffective or non-functional sweat glands are also more vulnerable. Avoid activities that require the body to retain heat, especially in hot weather, such as exercising, wrapping children in too many clothes, or staying in the sun for prolonged periods without drinking water.

• Some medications can also increase the risk of heatstroke. These include beta-blockers, diuretics, and certain drugs used to treat depression, mental disorders, or Attention Deficit Hyperactivity Disorder (ADHD).

Pay attention to the weather. If the temperature is above or close to 32°C, exercise caution. Avoid taking infants and the elderly outside during such weather.

• Be aware of the urban heat island effect. This phenomenon occurs when urban areas are hotter than rural areas, with temperatures sometimes 1-3°C higher, and in the evening, the difference can reach up to 12°C. It happens in areas affected by pollution, greenhouse gases, water contamination, air conditioning use, and energy consumption.
• Wear light-colored clothing suitable for the weather.

Avoid direct sunlight. Take frequent breaks and seek shade when working outdoors. Use sunscreen to protect against sunburns. Always wear a hat when going outside, especially if you’re prone to heatstroke.

• One unfortunate cause of heatstroke is sitting in a hot car. Never sit in a parked car on a hot day, and never leave children alone in a car, even for just a few minutes.
• If you plan to exercise, avoid doing so during the peak heat hours from 11:00 AM to 3:00 PM.

Drink water to stay hydrated. Monitor the color of your urine, which should be light yellow and clear.

• Avoid drinking coffee. Coffee stimulates the body when you need to cool it down. Even though black coffee is 95% water, the caffeine in it can be harmful when you're showing signs of heatstroke. It can make your heart beat faster and harder.

Avoid drinking alcohol outdoors in hot weather. Alcohol can affect body temperature by constricting blood vessels, making it harder for blood to circulate and keep the body warm.

• A cool, shaded area
• A place with cold water or a shower
• Cold compresses or ice packs
• Wet cloths
• A fan
• Cold drinks or saltwater solution