Heat stroke: how to recognise it and what to do
Heat exhaustion is treated at home; heat stroke is a medical emergency. How to tell them apart and what to do in the first minutes.
Heat kills more people than most weather phenomena, and it does so quietly: no visible destruction, indoors, disproportionately among older adults living alone. Telling the two stages apart is what changes the outcome.
How to tell them apart
| Sign | Heat exhaustion | Heat stroke |
|---|---|---|
| Sweating | Heavy | May have stopped |
| Skin | Cool, pale, clammy | Hot, red, sometimes dry |
| Mental state | Conscious, maybe dizzy | Confusion, slurred speech, unconsciousness |
| Pulse | Fast and weak | Fast and strong |
| Temperature | Normal or slightly raised | Very high |
| What to do | Cool and rehydrate | Call emergency services and cool |
What to do for heat exhaustion
- Move the person somewhere cool and shaded.
- Loosen or remove excess clothing.
- Apply cool damp cloths, or a lukewarm shower.
- Give water in sips, if they are fully conscious.
- Watch them: if they worsen or become confused, call emergency services.
What to do for heat stroke
- Call emergency services immediately.
- Move the person somewhere cool.
- Cool actively and aggressively: cold water on the skin, wet cloths, ice or cold packs at the neck, armpits and groin, and moving air.
- Give nothing by mouth if there is confusion, vomiting or loss of consciousness.
- Keep cooling until help arrives.
Who is at greatest risk
- Older adults, especially those living alone.
- Infants and young children.
- People with heart, kidney, respiratory disease or diabetes.
- People taking diuretics, blood pressure medication, antidepressants or antipsychotics.
- Outdoor workers and anyone exercising during peak hours.
- Anyone without air conditioning or a cool place to go.
- How to cool your house without air conditioning Close by day, ventilate by night, and cool people before rooms. What actually works and why a fan can make things worse.
- Who is most at risk during extreme heat Heat does not affect everyone equally. Which ages, conditions and medications raise the risk, and how to organise check-ins.
Gear that covers this
Products that match what the guide above recommends.
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Cooling towels
Activated with water, they lower skin temperature by evaporation. Useful at the neck and forehead while help arrives.
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Clinical thermometer
Body temperature is what separates heat stroke from heat exhaustion. Without measuring it you are guessing.
Frequently asked questions
What is the difference between heat exhaustion and heat stroke?
In heat exhaustion the person sweats heavily, has cool clammy skin and stays conscious. In heat stroke the skin may be hot and dry, body temperature climbs sharply and confusion or loss of consciousness appears: that is a medical emergency.
What do I do while help is on the way for heat stroke?
Move the person somewhere cool and cool them actively: cold water on the skin, wet cloths, ice at the neck, armpits and groin, and moving air. Do not give anything by mouth if they are confused or unconscious.
Can I give salt or sports drinks?
Only if the person is fully conscious and has no medical restriction. With confusion, vomiting or loss of consciousness, nothing by mouth: there is a choking risk.
Who is most at risk from heat?
Older adults, infants and young children, people with chronic conditions or on certain medications, outdoor workers, and anyone without air conditioning.