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This is first-aid guidance, not a diagnosis. Heat illness can worsen quickly, so treat uncertain or deteriorating cases as emergencies.
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First, decide whether this is heatstroke or heat exhaustion
Heat-related illness exists on a spectrum, but the response changes sharply when brain function is affected. CDC/NIOSH describes heat stroke as “the most serious heat-related illness.” Do not wait for a particular skin appearance or for home treatment to work if the person has altered mental status.
| What you observe | More consistent with heat exhaustion or dehydration | Possible heatstroke — emergency |
|---|---|---|
| Alertness | Awake, coherent, able to answer normally | Confusion, unusual behavior, irritability, slurred speech, collapse, seizure, or loss of consciousness |
| Skin and sweating | Heavy sweating, pale skin, skin that feels cool or clammy | Very hot skin; it may be dry or the person may be sweating heavily. Sweating status alone cannot rule heatstroke in or out. |
| Other symptoms | Thirst, headache, dizziness, weakness, nausea, cramps, fast breathing or heart rate, reduced urine | Very high body temperature, neurologic changes, seizure, or worsening condition after heat exposure |
| Immediate priority | Cool the person, rest, give safe fluids, and obtain medical advice | Call emergency services now and begin rapid cooling; do not wait to see if symptoms settle |
Heat exhaustion commonly follows loss of water and salt through sweating. Dehydration is the fluid-loss component and can occur with heat exposure, exercise, fever, vomiting, or diarrhea. A person can be dehydrated without having every sign of heat exhaustion, and heatstroke can develop even when the initial symptoms seemed mild.
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What to do for suspected heatstroke
Confusion, altered responsiveness, slurred speech, seizure, collapse, or unconsciousness after heat exposure should be treated as heatstroke. The person does not need to have dry skin, and you should not spend time trying to confirm a temperature before acting.
- Call emergency services immediately. Use your local emergency number; CDC/NIOSH guidance in the United States uses 911, while NHS and British Red Cross guidance in the United Kingdom uses 999. Tell the dispatcher that heatstroke is suspected.
- Stay with the person and move them to a cooler location. Use shade, an air-conditioned room, or another place away from radiant heat. Remove outer or unnecessary clothing so heat can leave the body.
- Start active cooling while waiting. If it is safe and practical, place the person in a cold-water or ice bath. Otherwise wet the skin, apply cold wet cloths or wrapped ice packs to the head, neck, armpits, and groin, and circulate air with fanning. The British Red Cross describes covering the person with a cold wet sheet and continually pouring cold water over it; if no sheet is available, sponge or spray cool water while fanning.
- Keep monitoring breathing and responsiveness. Follow the dispatcher’s instructions. If the person becomes unresponsive and is not breathing normally, begin emergency resuscitation steps if you are trained and able, and use an automated external defibrillator when available.
- Do not give anything by mouth when swallowing is unsafe. No drinks should be given to someone who is confused, unconscious, vomiting, or unable to swallow reliably. Choking and aspiration are more immediate risks than replacing fluid by mouth.
Do not leave to obtain supplies if another person can call, fetch cooling materials, or guide responders. Rapid cooling and professional care take priority over measuring temperature, finding a sports drink, or waiting for improvement.
What to do for heat exhaustion
Heat exhaustion usually presents with heavy sweating, dizziness, headache, weakness, nausea, cramps, pallor, and a fast pulse or breathing rate while the person remains mentally clear. CDC/NIOSH also lists thirst, irritability, elevated body temperature, and reduced urine output. British Red Cross guidance notes that the skin may be sweaty and cooler rather than dry and burning hot.
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- Move to a cool place. Stop the activity, get out of direct sun, and use air conditioning or shade where possible.
- Have the person rest. Loosen or remove unnecessary outer clothing. Help them sit or lie in a comfortable position and stay with them while symptoms are assessed.
- Cool the skin. Use cool water, wet cloths, sponging, or a spray bottle, and fan the damp skin. Continue cooling rather than wrapping the person in heavy clothing or blankets.
- Offer small, frequent sips only if fully alert. Water is suitable. NHS guidance also lists an isotonic drink or oral-rehydration powder mixed with water as options for replacing salt lost through sweating. Stop fluids if the person vomits, becomes drowsy or confused, or cannot swallow safely.
- Arrange medical advice. NHS guidance says heat-exhaustion symptoms should start to improve within 30 minutes of cooling. That is a UK clinical advice threshold, not permission to wait when symptoms are severe, worsening, or accompanied by any heatstroke sign.
Call emergency services if confusion develops, the person faints or has a seizure, vomiting prevents drinking, symptoms get worse, or the person does not improve with cooling and rest. A person who cannot keep fluids down may need assessment and treatment that cannot be provided safely at home.
How to handle dehydration after heat exposure
Dehydration means the body has lost more fluid than it has replaced. Sweating in hot weather or during exertion is a common cause, and salt is lost with sweat as well. Thirst, dry mouth, headache, dizziness, weakness, dark or infrequent urine, and fatigue can point toward fluid loss, but these signs do not reliably distinguish simple dehydration from heat exhaustion or early heatstroke.
For an alert adult who can drink
- Move out of the heat and stop exertion before drinking.
- Take frequent small sips of water rather than forcing a large volume at once.
- If substantial sweating has occurred, an isotonic drink or oral-rehydration powder mixed according to its instructions can replace some salts as well as fluid. These products support hydration; they do not treat heatstroke or replace medical evaluation.
- Continue observing alertness, breathing, urine output, and the ability to keep fluids down.
When oral fluids are not safe
Do not pour water into the mouth of a confused, unconscious, actively vomiting, or poorly responsive person. Place an unconscious but breathing person in the recovery position if you know how, call emergency services, and follow the dispatcher’s instructions. Heatstroke treatment requires emergency cooling and medical care, not a drink.
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When to escalate instead of treating at home
Use a low threshold for professional advice because heat illness can progress rapidly. Escalate immediately for any of the following:
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- Very hot body temperature or rapidly worsening symptoms after heat exposure.
- Repeated vomiting, inability to swallow, or inability to keep fluids down.
- Symptoms that worsen during cooling, or no clear improvement after cooling and rest.
- A person whose condition cannot be monitored reliably, especially if alone.
Do not use the NHS 30-minute heat-exhaustion guidance as a countdown for suspected heatstroke. Neurologic changes require an emergency call at once. If you are unsure which condition is present, choose the safer response: call for medical help, begin cooling, and withhold drinks until swallowing is clearly safe.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Prevention before and during hot weather
Prevention is mainly about reducing heat gain, replacing fluids regularly, and noticing deterioration early. CDC prevention guidance dated July 20, 2026, recommends carrying and refilling a water bottle, taking shade and rest breaks, and checking on people who may not recognize their own symptoms.
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- Plan activity around heat. Choose cooler parts of the day, build in shaded breaks, and reduce intensity when the heat or humidity rises.
- Keep fluids accessible. Carry a reusable water bottle and refill it. Drink regularly instead of waiting until you are intensely thirsty.
- Create a cooling option. Know where air conditioning, a public cooling location, or reliable shade is available before starting outdoor work or exercise.
- Use indoor fans appropriately. CDC says to use fans indoors only when the indoor temperature is below 90°F (32.2°C). When the room is hotter than that, use air conditioning or go to a cooler location rather than relying on a fan alone.
- Check on others. Contact family, friends, and neighbors during hot spells, particularly anyone living alone or with a chronic medical condition.
- Account for clothing and workload. Lightweight, breathable clothing and planned pauses reduce heat load; protective equipment or heavy uniforms may require additional controls and supervision.
A water bottle can make regular drinking easier, but it does not prevent heat illness if someone remains in dangerous heat without breaks. Oral-rehydration powder is a supportive option for an alert person who can swallow, not a substitute for cooling or emergency care.
Who needs extra attention
Heat affects people differently. CDC identifies pregnant people, children and teenagers with asthma, and people with heart disease or other chronic conditions as groups needing particular care. British Red Cross guidance also highlights young and older people and those with chronic heart or lung disease or diabetes. Some medicines and reduced ability to sense thirst can add risk.
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Common mistakes and safer alternatives
| Mistake | Why it is dangerous | Safer approach |
|---|---|---|
| Waiting for dry skin before calling for help | Heatstroke may include profuse sweating, so dry skin is not required. | Act on confusion, collapse, seizure, or other mental-status changes. |
| Giving a drink to a confused or vomiting person | They may choke or aspirate the fluid. | Withhold oral fluids, call emergency services, and follow instructions. |
| Leaving the person alone to fetch water or supplies | Responsiveness can deteriorate suddenly. | Stay with them while another person calls or gathers cooling materials. |
| Using a fan in a room hotter than 90°F | CDC cautions that a fan is not the right indoor strategy at that temperature. | Use air conditioning or move to a cooler location. |
| Waiting 30 minutes in every case | The NHS interval applies to heat exhaustion beginning to improve after cooling, not to heatstroke signs. | Call immediately for neurologic symptoms, deterioration, or failure to improve. |
What to tell emergency responders
While help is on the way, note when the person was exposed to heat, what activity they were doing, how much they may have drunk, whether vomiting occurred, and any medical conditions or medicines you know about. Tell responders about confusion, seizures, fainting, or changes in breathing. Continue the cooling measures that are safe and practical until professionals take over.
Guidance from the NHS, British Red Cross, CDC/NIOSH, CDC, and American Red Cross is intended to support first aid, not replace emergency assessment. Emergency numbers and local protocols differ, so use the number for your country and follow the dispatcher’s directions.
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