Clinical signs of heat stroke

Heat stroke can follow intense activity or prolonged heat, and it can also affect someone resting in a hot environment. The key concern is altered brain function: confusion, slurred speech, loss of coordination, collapse, or a seizure. Sweating may be present or absent, so dry skin is not required. Heat exhaustion may cause heavy sweating, weakness, headache, nausea, or dizziness but does not explain marked confusion. Vomiting can occur with either condition and should not delay emergency action.

Call emergency services immediately. Move the person to shade or an air-conditioned place, remove excess clothing, and cool the skin with cool wet cloths, fanning, or a cool shower if this can be done safely. Stay with them and monitor breathing. Do not give drinks to a confused, drowsy, or unconscious person, and do not leave them alone to recover. Hospital treatment may include IV fluid therapy and active temperature control.

Treat suspected heat stroke as an emergency whenever heat exposure is followed by confusion, collapse, seizure, severe agitation, or a very high temperature. Emergency assessment is also needed for repeated vomiting, breathing difficulty, or worsening drowsiness. Do not wait for symptoms to settle or rely on a home thermometer reading when the person’s behaviour has changed.

After recovery, ask what exposure or medicine may have increased risk, how to return safely to activity, and which cooling and hydration plan suits the person. Mention any chronic illness, recent infection, or medicines that affect sweating or fluid balance.