Heat Exhaustion

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Slideshow: Understand the Risks and Signs of Dehydration

How is heat exhaustion diagnosed?

Diagnosis of heat exhaustion is made by circumstantial evidence:

  1. History (exercising or working in a hot environment, living in a hot apartment with no air-conditioning)
  2. Symptoms (excess sweating, headache, weakness, nausea and vomiting)
  3. Physical examination (signs of dehydration)

Laboratory tests are not routinely performed unless the health care professional is concerned about electrolyte imbalance or significant dehydration and kidney failure.

However, it is important for the health care professional to consider other diagnoses, since there are many infectious illnesses that accompany a fever, weakness, nausea and vomiting. This is especially the case in the elderly and very young. In these groups, heat exhaustion may be a diagnosis of exclusion, meaning that other more serious illnesses should be considered before settling on heat as the cause of the problem. History and physical examination may be all that is needed.

What is the treatment for heat exhaustion?

  • Cooling and rehydration are the cornerstones for treating heat exhaustion. The affected individual should stop their activity and then move from the hot environment to a cooler environment. The person may be placed in the shade or taken to an air conditioned environment (don't forget that cars have air conditioning). Clothes may be removed to help with air circulation across the body. Misting the skin with cool water also helps by stimulating evaporation and cooling the body.
  • Rehydration is the next important step in treating heat exhaustion. This may be a challenge if the person begins to suffer from nausea and vomiting. Small sips of water, a mouthful at a time, might be tolerated even if some vomiting persists. Water, sports drink and other electrolyte replacement drinks are reasonable options.
  • If oral rehydration fails or if symptoms persist, intravenous fluids may be required to replace the water loss because of the excessive sweating. Hydration continues until the patient begins to urinate, a signal that the kidneys have sensed that there is enough fluid in the body, and it no longer retains fluid.
  • Muscles cramps and pain may be treated with over-the-counter medications like ibuprofen (Advil, Motrin, Nuprin, etc.) and acetaminophena (Tylenol and others).
Medically Reviewed by a Doctor on 6/18/2015

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