Heat illness has a range of stages. Some are mild and some are an emergency. You must know the signs, because early action stops the worse stages. The information here comes from CDC/NIOSH. It is for recognition and first response only, not diagnosis.
Heat rash
- Signs: red clusters of small pimples or blisters, usually on the neck, upper chest, groin or in the elbow creases.
- What to do: move to a cooler, less humid place and keep the area dry. Avoid ointments and creams.
Heat cramps
- Signs: painful muscle cramps or spasms in the abdomen, arms or legs, after heavy sweating.
- What to do: rest in a cool place. Every 15 to 20 minutes drink water and have a snack or drink that replaces carbohydrates and electrolytes. Do not use salt tablets. Get medical help if the cramps do not ease within an hour, or if the person has a heart condition or is on a low-sodium diet.
Heat exhaustion
Heat exhaustion comes from losing too much water and salt.
- Signs: headache, nausea, dizziness, weakness, irritability, thirst, heavy sweating, a higher body temperature, and less urine.
- Action: this needs prompt care. Do not leave the person alone. Move them out of the heat, give small, frequent sips of water, loosen or remove extra clothing and cool the head, face and neck with cool water or cold compresses. They need to be evaluated by a medical professional. If medical care is not available, call 911.
Heat exhaustion can turn into heat stroke. If the person gets worse, or shows any heat stroke sign, treat it as an emergency.
Heat stroke: a medical emergency
Heat stroke is the most serious heat illness. It can cause permanent disability or death, and it is fatal if treatment is delayed.
- Signs: confusion, slurred speech, loss of consciousness, seizures, a very high body temperature, and skin that may be hot and dry or wet with sweat.
- Do not wait. Call 911 and stay with the person. Cool them quickly while waiting.
A worker with heat stroke may seem "just tired" or "acting strange". Never assume it is something else when it happens in the heat.
Rhabdomyolysis
Rhabdomyolysis is the breakdown of muscle, linked with heat and hard physical work.
- Signs: muscle pain or cramps, weakness, and dark, tea- or cola-colored urine. Some people have no signs.
- Action: stop the work, drink water, and get medical care right away.
Warning signs to act on
Treat these as a reason to stop work and get help:
- confusion, odd behavior, slurred speech,
- fainting or collapse,
- no longer sweating when it is hot,
- vomiting, a bad headache or dizziness that does not go away,
- cramps that will not ease,
- a coworker who says "I'm fine" but does not look or act it.
When in doubt
If you are not sure whether it is heat exhaustion or heat stroke, treat it as heat stroke and call 911. A false alarm is better than a death. This course is not a medical diagnosis or first-aid qualification. A trained first aider and a doctor take over from here.
What to remember
- Heat exhaustion: heavy sweating, weakness, dizziness, nausea. Cool, give sips, get medical help.
- Heat stroke: confusion, slurred speech, collapse, seizure. Call 911 now.
- Do not give salt tablets. In doubt, call 911.