The Differences Between Heat Exhaustion and Heat Stroke (and How to Cope With Them)

With a record-breaking heat dome sweeping the eastern half of the United States this week, it’s important to not only stay cool for comfort , but also actively avoid heat exhaustion and its more serious cousin, heat stroke. Knowing the signs of both can help keep you, your friends and family safe.

Heatstroke is a serious illness that can lead to seizures, organ failure and more. And before you get heatstroke, you’ll experience a milder condition called heat exhaustion . Both conditions occur when the body overheats. Normally, our bodies try to cool us down by bringing hot blood from the core to the surface of the skin, where we radiate that heat to the environment. Evaporation resulting from sweating also helps cool our skin. We get into trouble when the environment is too hot or too humid for these mechanisms to cool us down.

Who is at risk for heat exhaustion and heatstroke?

Heatstroke in healthy people is often associated with exercise because exercise raises body temperature. This is especially true if you are not in good shape or are used to working out in cool weather. As you get used to exercising in the heat , your body will learn to cool itself more efficiently.

Factors that increase the risk of heat exhaustion and heat stroke include:

  • Training in high temperatures and humidity.

  • Poor physical shape

  • Large size (regardless of body type – both a lot of fat and a lot of muscle affect your ability to cool down)

  • Dehydration

  • Wearing or carrying equipment such as football pads or a backpack.

  • Alcohol consumption

  • Use of certain medications or supplements, including beta blockers and diuretics.

  • Any disability or illness that makes it harder for you to get out of the heat or cool down.

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Signs and symptoms of heat exhaustion

Heat exhaustion occurs when the body’s temperature rises, but not enough to engage the brain. For example, if you or your overheated friend show any signs of confusion, assume it is heatstroke and seek medical attention immediately.

According to the CDC, signs and symptoms of heat exhaustion may include:

  • Dizziness

  • Nausea and vomiting

  • Headache

  • Fatigue or weakness

  • Heavy sweating

  • Cold, pale and clammy skin

  • Fast, weak pulse

If you begin to feel these symptoms, immediately begin cooling down: move into the shade or turn on the air conditioning, loosen your clothing, drink a cold drink, and watch for any signs that you are feeling worse or not getting better. If you do not recover within an hour, seek medical attention .

Signs and symptoms of heat stroke

Heat stroke occurs when the body temperature is extremely high (over 104, measured rectally) and can affect both the brain and body. A person with heatstroke may be too confused to realize they are in danger , so watch for signs of this in other people.

Heatstroke is a serious condition, so if you suspect it, seek medical attention immediately. If you are at an event with medical personnel (such as running a marathon or playing soccer), alert them. Otherwise, call 911 or your local emergency number. Signs of heat stroke may include some of the above symptoms, such as headache, dizziness and nausea, as well as:

  • Confusion, irritability, or hallucinations

  • Lose consciousness or collapse

  • Problems with walking

  • Convulsions

  • Flushed skin with or without sweating.

You can help the person cool down while you wait for help. Medical personnel may decide that it is best to cool the person before transporting to the hospital, but this depends on whether the person requires other medical treatment. The ideal way to cool down a person with heatstroke is to place them in a bath of cold ice water and stir the water constantly.

If this is not possible, you can use a cold shower or cold hose, or apply icy wet towels to the person’s body and change them every three minutes or whenever they are no longer icy.

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