consciousness as the head is lowered, which im-
proves the blood supply to the brain. Signs and
symptoms of heat exhaustion are similar to those
of shock; the victim will appear ashen gray, the
skin cool, moist, and clammy and the pupils may
be dilated (fig. 4-75). The vital signs usually are
normal; however, the victim may have a weak
pulse, together with rapid and shallow breathing.
Body temperature may be below normal.
Treat heat exhaustion as if the victim were in
shock. Move the victim to a cool or air-
conditioned area. Loosen the clothing, apply cool
wet cloths to the head, axilla, groin, and ankles,
and fan the victim. Do not allow the victim to
become chilled (if this does occur, then cover with
a light blanket and move into a warmer area). If
the victim is conscious, give a solution of 1 tea-
spoon of salt dissolved in a liter of cool water.
If the victim vomits, do not give any more fluids.
Transport the victim to a medical treatment facil-
it y as soon as possible. Intravenous fluid infusion
may be necessary for effective fluid and electrolyte
replacement to combat shock.
Sunstroke is more accurately called heat stroke
since it is not necessary to be exposed to the sun
for this condition to develop. It is a less common
but far more serious condition than heat exhaus-
tion, since it carries a 20 percent mortality rate.
The most important feature of heat stroke is the
extremely high body temperature (105°F, 41°C,
or higher) accompanying it. In heat stroke the vic-
tim suffers a
breakdown of the sweating
is unable to eliminate excessive
Figure 4-75 .Heat exhaustion and heat stroke.
body heat build up while exercising. If the body
temperature rises too high, the brain, kidneys, and
liver may be permanently damaged.
Sometimes the victim may have preliminary
symptoms such as headache, nausea, dizziness,
or weakness. Breathing will be deep and rapid at
first, later shallow and almost absent. Usually the
victim will be flushed, very dry, and very hot. The
pupils will be constricted (pinpoint) and the pulse
fast and strong (fig. 4-75). Compare these symp-
toms with those of heat exhaustion.
When providing first aid for heat stroke,
remember that this is a true life-and-death
The longer the victim remains
overheated, the more likely irreversible brain
damage or death will occur. First aid is designed
to reduce body heat fast.
Reduce heat immediately by dousing the body
with cold water or by applying wet, cold towels
to the whole body. Move the victim to the coolest
possible place and remove as much clothing as
possible. Maintain an open airway. Place the vic-
tim on his or her back, with the head and
shoulders slightly raised. If cold packs are
available, place them under the arms, around the
neck, at the ankles, and in the groin. Expose the
victim to a fan or air conditioner, since drafts will
promote cooling. Immersing the victim in a cold
water bath is also very effective. If the victim is
conscious, give cool water to drink. Do not give
any hot drinks or stimulants. Discontinue cool-
ing when the rectal temperature reaches 102°F;
watch for recurrence of temperature rise by check-
ing every 10 minutes. Repeat cooling if
temperature reaches 103 rectally.
Get the victim to a medical facility as soon as
possible. Cooling measures must be continued
while the victim is being transported. Intravenous
fluid infusion may be necessary for effective fluid
and electrolyte replacement to combat shock.
Prevention of Heat Exposure Injuries
The prevention of heat exposure injuries is a
command responsibility, but the medical depart-
ment plays a role in it by educating all hands about
the medical dangers, monitoring environmental
health, and advising the commanding officer.
On the individual level, prevention centers on
water and salt replacement. Sweat must be re-
placed ounce for ounce; in a hot environment,
water consumption must be drastically increased.
Salt should be replaced by eating well-balanced
meals, three times a day, salted to taste. In the
field, C rations contain enough salt to sustain