Too hot, too cold
Tell heat exhaustion from heat stroke and cool someone fast when it's serious, and rewarm someone with hypothermia gently.
Heat exhaustion or heat stroke?
Heat exhaustion
Heavy sweating, pale clammy skin, headache, dizziness, nausea, cramps, a fast pulse, thirst, tiredness. Still clear-headed. Uncomfortable, and a warning to act.
Heat stroke: an emergency
Very high body temperature (roughly 40°C or more) with confusion, strange behaviour, slurred speech, hot skin (it may be dry or still sweaty), fits or collapse. Call the emergency number.
Heat exhaustion: cool them down
- Into the cool and shade
Move them somewhere cool and shaded, or air-conditioned.
- Lie down, feet slightly raised
And take off extra layers of clothing.
- Drink
Water, or an oral rehydration drink, in sips.
- Cool the skin
A wet cloth on the skin, and a fan.
- Better within about 30 minutes?
They should start to improve within about half an hour (NHS advice). If they don't, or they get confused, treat it as heat stroke.
Check yourself
Sort the signs: heat exhaustion, or heat stroke?
- Sweating heavily, dizzy, but answering clearly
- Confused and saying strange things
- Headache, cramps and feeling sick
- Collapsed, with very hot skin
- Slurred speech after hours in the sun
- Thirsty and tired, and knows where they are
Show the answer
Heat exhaustion: Sweating heavily, dizzy, but answering clearly, Headache, cramps and feeling sick, Thirsty and tired, and knows where they are
Heat stroke: Confused and saying strange things, Collapsed, with very hot skin, Slurred speech after hours in the sun
Heat stroke: call, then cool fast
- Call the emergency number
Heat stroke can kill, and every minute at that temperature matters.
- Cool as fast as you can
Immersing them in cold water up to the neck works best, if it's available and safe. Otherwise soak them with cold water and fan them hard.
- Cold packs at the neck, armpits and groin
Wrapped in a cloth, where big blood vessels run close to the skin.
- No drinks if they're confused or drowsy
They could choke. Keep cooling until help takes over.
- If they become unresponsive
Check breathing: recovery position if they're breathing normally, CPR if they're not.
Who is most at risk from heat
- Older people, and babies and young children.
- People doing hard physical work or sport in the heat.
- People with long-term illnesses.
- Anyone left in a car in the sun: it heats up fast. Never leave a child in a parked car, even for a few minutes.
Check yourself
After a football match on a summer afternoon in Ahvaz, Reza is confused, his skin is burning hot and he's stumbling. What do you do?
- Give him a big bottle of ice-cold water to drink quickly
- Call the emergency number and cool him fast: cold water, a fan, and cold packs at the neck, armpits and groin
- Let him sit in the shade and check on him in half an hour
- Walk him home so he can take a cool shower
Show the answer
Call the emergency number and cool him fast: cold water, a fan, and cold packs at the neck, armpits and groin
Right. Confusion in the heat means heat stroke, which is an emergency. Call, and cool him as fast as you can until help takes over.
Hypothermia
When the body loses heat faster than it can make it and its core temperature drops below 35°C. Signs: shivering (which may stop as it gets worse), pale cold skin, slurred speech, confusion, clumsiness, drowsiness, slow breathing. Wet clothes and wind make it happen much faster.
It doesn't need snow. A walker soaked by rain on a windy mountain in spring can become hypothermic.
Hypothermia: warm them gently
- Get to shelter
Out of the wind and wet, and insulate them from the cold ground.
- Take off wet clothing
Wet clothes keep pulling heat out of the body.
- Wrap them up, and cover the head
Dry blankets, a sleeping bag or a foil blanket, and a hat.
- A warm, sweet drink, only if fully alert
Never for someone drowsy or confused.
- Handle gently, and call if it's severe
Rough handling is risky for a very cold person. Confusion, drowsiness or shivering that has stopped: call the emergency number.
Check yourself
On a hike on Tochal, rain has soaked Kian's friend. She's shivering hard and her speech is slurred, but she can answer you. What's the best plan?
- Keep walking fast so she warms up by moving
- Shelter, wet clothes off, dry layers and a hat, insulate her from the ground, a warm sweet drink since she's alert, and call for help
- Rub her arms and legs hard to get the blood moving
- Give her a sip of alcohol to warm her up
Show the answer
Shelter, wet clothes off, dry layers and a hat, insulate her from the ground, a warm sweet drink since she's alert, and call for help
Right. Stop the heat loss, warm her gently, and since her speech is slurred, call for help too.
What not to do with someone who's too cold
- Don't rub or massage their arms and legs.
- No hot bath and no direct high heat: no hot-water bottles straight on the skin, no heat lamps.
- No alcohol. It makes the body lose heat faster.
- Warm them gradually, from the body outwards, with dry layers and shelter.
FROSTBITE
Frozen fingers, toes, nose and ears
Frostbitten skin looks white or grey, feels hard, and is numb. Warm it gently: tuck the hands into the armpits, or use warm, not hot, water. Don't rub it, and don't rewarm it if it could freeze again before you reach shelter: refreezing does more damage. Then get medical help.
Rubbing frostbitten hands with snow is an old tradition. It damages the frozen tissue further.
Check yourself
Rubbing frostbitten fingers hard warms them faster, so it's a good idea.
Show the answer
False
False. Rubbing damages frozen tissue. Warm the fingers gently in the armpits or in warm, not hot, water, only if they won't refreeze, and get medical help.
Lesson recap
- Confusion is the sign that turns heat or cold into an emergency.
- Heat exhaustion (sweaty, dizzy, clear-headed): shade, lie down, loosen clothes, drink, cool the skin. Not better in about 30 minutes? Treat it as heat stroke.
- Heat stroke (confused, very hot, collapsing): call, and cool fast with cold water, fanning and wrapped cold packs at the neck, armpits and groin.
- Hypothermia (below 35°C: shivering, slurred, confused): shelter, wet clothes off, dry layers and a hat, a warm sweet drink only if alert, handle gently.
- Don't rub, don't use a hot bath or direct heat, no alcohol. Frostbite: warm gently, never rub, and only if it won't refreeze.
- General education, not a certificate: when in doubt call your emergency number, and take a hands-on course.