First aid for heatstroke

Heatstroke occurs in hot and humid conditions when the body fails to control its own temperature. It is a medical emergency. A significant number of cases are seen each year during the summer months in South Africa when temperatures of 28 degrees Celsius and higher and a humidity of above 70%, are reached.

The hallmark of this disease is an extremely high body core temperature of at least 41 degrees Celsius (taken rectally) and a reduced level of consciousness. The person initially becomes irritable and confused and may have seizures. Other early symptoms include weakness, headache, nausea and vomiting and muscular pain. The person has a rapid pulse and a hot, red, and dry skin, even under the armpits. If the condition is not promptly treated, the person becomes unconscious and might die.

There are two types of heatstroke: classical and exercise-induced. Classical heatstroke affects the more fragile – the very young and the elderly, often those with heart disease. It occurs without any exercise activity during a heat wave. Young children left in a hot car are particularly at risk. There is usually no sweating.

Exercise-induced heatstroke is more common in young, healthy, fit athletes who exercise in hot, and especially humid conditions. Athletes who exercise vigorously for short periods are most at risk, such as in short-distance races (6-15 km), rather than marathons. It seems that only certain athletes are susceptible to this condition which suggests an inherited metabolic predisposition.

Heatstroke is deadly and it is crucial that it is recognised early and immediate first aid and medical treatment given. Hospitalisation is always necessary as temperature could increase again after cooling.

Home treatment

• Move the person to a cool, shaded area and check the ABC’s.
• As soon as possible, place the person in a bath of ice water for 5 to 10 minutes to reduce body temperature to 38 degrees Celsius. If the person starts to shiver before 10 minutes are over, take him or her out of the bath. If a bath is not available, apply ice packs or cover the person with cool, wet sheets. The sooner the person is cooled in this way, the lower the risk of mortality.
• Give the person water or a sports drink to drink.
• Get the person to hospital.

Prevention

• Avoid strenuous physical activity outdoors during the hottest hours of the day (10 am to 3 pm). Avoid overexposure to the sun.
• Stay cool. Wear light clothes, a wide-brimmed hat and take a cool bath or shower once or twice a day.
• Stay well hydrated, but be careful not to over hydrate.