Medicines for Heatstroke

What it is

Heatstroke is a serious, life-threatening condition that occurs when the body becomes dangerously overheated and can no longer control its temperature, allowing it to rise to a very high level (usually a core temperature of around 40°C or above). It is a medical emergency and needs urgent treatment. It often develops when heat exhaustion is not treated and progresses, but can also come on rapidly, particularly during hot weather (classic heatstroke, affecting the vulnerable such as older people and those with health conditions) or during strenuous exercise in the heat (exertional heatstroke). The key features that distinguish heatstroke from heat exhaustion are the effects on the brain and body: the person may become confused, disorientated, agitated, drowsy or unconscious, may have a seizure, may have a very high temperature, and may have hot skin that is no longer sweating (although in exertional heatstroke the skin can still be sweaty). Other signs include a fast heartbeat, fast breathing or shortness of breath, and feeling or being sick. Because heatstroke can rapidly damage the brain and other organs and can be fatal, it must be treated as an emergency — emergency services should be called immediately, and the person should be cooled down while waiting for help. Those at higher risk include older people, babies and young children, people with long-term illnesses or taking certain medicines, and people exercising or working hard in the heat. Prevention through keeping cool and hydrated, and recognising and acting on the warning signs of heat illness, are vital.

How it is treated

Heatstroke is a medical emergency: the priority is to call emergency services immediately and to cool the person down as quickly as possible while waiting for help, because rapid cooling improves the outcome. While waiting for the ambulance: move the person to a cool place; remove outer clothing; cool them however you can — for example by covering the skin with cool water (sponging or spraying) and fanning, applying cold packs to the neck, armpits and groin, or immersing in cool water where safe and appropriate for exertional heatstroke; and keep them lying down. If the person is conscious and able to drink, give them fluids, but do not give fluids if they are drowsy or not fully alert. Stay with them and monitor them; if they lose consciousness and stop breathing normally, be prepared to give CPR. In hospital, treatment includes rapid cooling, fluids, and support for the body’s organs, along with monitoring and treating any complications. The most important messages are prevention and prompt recognition: heatstroke is prevented by keeping cool and hydrated in hot weather, avoiding strenuous activity in extreme heat, and taking particular care of those at higher risk; and it must be recognised and treated as an emergency, because early cooling and urgent medical care save lives. The key takeaway is that heatstroke is a life-threatening emergency — call emergency services and cool the person immediately.