Heat stroke is a medical emergency. Learn to recognize the symptoms discussed in last week’s column and take the appropriate action. The heat stroke victim needs to see a doctor as soon as possible, but the first step is to get the core temperature under control. If you suspect someone has heat stroke, begin treating them immediately while someone else calls 9-1-1. Everything must be done to cool the heat stroke victim immediately. The best solution is to remove them from the sun, immerse the body in cold water, such as a river, stream, or bathtub. Otherwise, remove most of their clothes, douse them with water, and fan them vigorously. Wrapping in wet sheets can help increase the rate of heat loss. If the person is conscious and alert, offer him or her water or other fluids. Avoid caffeinated or alcoholic drinks because they dehydrate you. If the victim starts shivering, slow down the cooling treatment because shivering raises core temperature. Take the person's temperature every 10 minutes if you have a thermometer handy. You should not let the core temperature fall below 38°C as this can result in an uncontrollable slide towards dangerously low temperatures. All the while you should be making arrangements to get the victim to an emergency room. Watch for signs of respiratory arrest (breathing failure) and be ready to give mouth-to-mouth resuscitation (rescue breathing).
The heat exhaustion victim should also be put in a cool place. Lay them down and give small gulps of liquid every few minutes. "Sports" drinks are best but water is often more readily available. You should watch carefully for signs of deterioration, but there's no need to rush to a hospital for a normal case of heat exhaustion.
The way to prevent these problems is to drink very large amounts of liquid during heat waves, especially if you're planning on working or exercising outdoors. If exercising, approximately 500 mL to 1.8 L of water should be consumed in the 3 hours before the activity with about 200 mL to 250 mL consumed every 20 minutes during the activity. Fluid loss continues after the activity is over, so it is important to continue to consume water for several hours after exercise. You shouldn't take salt tablets unless you're also drinking a lot of water.