What should you know about treatment of heat stroke in elderly?

Heat stroke occurs when the body cannot control its temperature and brain or other organ function becomes affected. An older adult may become confused, unusually sleepy, unsteady, weak, or unable to respond normally. Vomiting, a very high body temperature, rapid breathing, or collapse can also occur. Some older people take medicines or have heart, kidney, or neurological conditions that make heat stress harder to recognise or manage. Heat exhaustion can progress to heat stroke, but the two conditions require different urgency. See [Heat Exhaustion](/conditions/heat-exhaustion/) for earlier warning symptoms.

Call emergency services first. Move the person to a cool place, remove excess clothing, and begin active cooling with cool wet cloths, a fan, or water applied to the skin. Continue cooling while waiting for help. Do not give food, drink, or tablets to a confused, drowsy, vomiting, or unconscious person because they may choke. If the person is fully awake and swallowing safely, ask the emergency dispatcher whether small sips are appropriate. Hospital teams may use cooling, blood tests, monitoring, and IV fluid therapy while checking kidney, heart, brain, and other organ function.

Every suspected heat stroke episode needs emergency assessment, even if the person seems better after cooling. Confusion, collapse, seizure, inability to wake, severe weakness, breathing difficulty, or a very hot body are especially urgent signs. Do not leave the person alone or send them to travel without medical support. Record the time heat exposure began, the person's medicines and health conditions, and any temperature reading, then share this with the emergency team.

Ask what organs were affected, which blood tests need repeating, and whether kidney function or fluid balance requires follow-up. Ask when medicines can be restarted or adjusted, how much activity is safe during recovery, and how to prevent another episode. Discuss air-conditioning, hydration reminders, medication review, check-ins from family or carers, and a plan for hot days. [IV Fluid Therapy](/treatments/acute-and-urgent-care/iv-fluid-therapy/) may be used when oral fluids are unsafe or insufficient.