When a worker shows signs of heat illness, minutes count. This lesson gives the basic steps from CDC/NIOSH guidance, and the habits that make them work. It is awareness of first response. It does not replace a first aid course, and nobody should treat a worker beyond their training.
The first steps
- Stop the work. Do not let the person go on, or walk off alone.
- Get help. Tell a supervisor or a trained first aider. Call 911 for heat stroke signs, or when you are unsure.
- Stay with the person. Never leave a person with heat illness alone.
- Move to a cool place: shade, an air-conditioned room or a vehicle with the air on.
- Start cooling. Take off extra clothing, such as outer layers, and cool the skin.
- Give water in small sips, if the person is awake and able to swallow. Do not force drinks on someone who is confused or unconscious.
Cooling for heat stroke
While waiting for the ambulance, cool the person as fast as possible. CDC/NIOSH lists these ways:
- a cold or ice-water bath, if you can,
- wet the skin and fan the person,
- cold, wet cloths or cool water on the clothes,
- cold packs on the head, neck, armpits and groin.
Keep cooling until emergency responders arrive and take over.
What not to do
- Do not send a worker home alone, or to a car, to "sleep it off".
- Do not give salt tablets.
- Do not give alcohol or drinks with a lot of caffeine.
- Do not wait to see if it gets better when the signs are those of heat stroke.
- Do not put anything in the mouth of a person who is confused or having a seizure.
Calling 911
Say what you see: a worker with confusion, collapse or seizure in the heat. Give the exact address and site, and where the responders should go. Send someone to the gate or road to meet them. Employers should have this worked out before the shift, with a named person to call and clear directions, which some states, such as California, require in their heat rules.
The buddy system
Heat illness can cloud judgment, so a worker may not know they are in trouble. The buddy system is a pair or small group who watch each other.
- Check your buddy often in hot conditions, and ask how they feel.
- Watch for confusion, slurred speech, clumsiness, unusual quiet or irritability, and heavy sweating or no sweating.
- Remind each other to drink and to take breaks.
- Speak up. Do not wait for your buddy to ask for help.
- Pay extra attention to new workers and people working alone.
Working alone
Workers alone in the heat, such as drivers and delivery staff, are at more risk, since nobody sees the early signs. Employers should set up check-ins by phone or radio, and workers should know what to do if they feel unwell: stop, move to a cool place, drink, and call.
After the event
- The employer should find out what went wrong and fix it.
- A serious case may need to be reported to OSHA. A work-related in-patient hospitalization must be reported to OSHA within 24 hours, and a fatality within 8 hours.
- Never punish a worker for reporting symptoms.
What to remember
- Stop, get help, stay, cool.
- Call 911 for heat stroke signs. Cool fast while you wait.
- Never leave a person alone and never use salt tablets.
- Buddy up and check each other often.