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, cover with a light blanket and move into a
warmer area.) If the victim is conscious, give a
solution of 1 teaspoon 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
facility 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 exhaustion, since it carries
a 20 percent mortality rate. The most important feature
of heat stroke is the extremely high body temperature
(105F, 41C or higher) accompanying it. In heat
stroke, the victim suffers a breakdown of the sweating
mechanism and is unable to eliminate excessive body
heat build up while exercising. If the body temperature
rises too high, the brain, kidneys, and liver may be
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. 4-50). Compare these symptoms with those of
When providing first aid for heat stroke, remember
that this is a true life-and-death emergency. 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 place
available and remove as much clothing as possible.
Maintain an open airway. Place the victim on his 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 cooling when the rectal
temperature reaches 102F; watch for recurrence of
temperature rise by checking every 10 minutes.
Repeat cooling if temperature reaches 103F rectally.
Get the victim to a medical facility as soon as
possible. Cooling measures must be continued while
the victim is being transported.
infusion may be necessary for effective fluid and
electrolyte replacement to combat shock.
Prevention of Heat Exposure Injuries
LEARNING OBJECTIVE: Determine the
steps needed to prevent heat exposure
The prevention of heat exposure injuries is a
command responsibility, but the medical department
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 replaced 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 a person in most situations. DO NOT use salt
tablets unless specified by a physician.
consume alcoholic beverages.
At the command level, prevention centers on an
awareness of the environment. The Wet Bulb Globe
Figure 4-50.Heat exhaustion and heat stroke.