Heat Exhaustion and Heatstroke: Awareness, Prevention, Diagnosis and Treatment

Prevention begins with the awareness of one’s environment and altering behaviors that increase the risk of heatstroke when at all possible.

  1. Avoid strenuous activities in excessively hot or humid environments.
  2. If work must be done in the heat outdoors, or indoors in hot situations, take frequent breaks in cooler areas, spray the skin with water, drink water and sports drinks to replace lost electrolytes from sweating, and monitor urine output. Slow the pace of work to decrease the heat generated by the body in order to avoid heat exhaustion or heatstroke. Avoid the sun from 11 a.m. to 3 p.m. when at all possible. Other compensatory techniques for engaging in hot-weather exertional activities include wearing lightweight, moisture-wicking fabric.
  3. Monitoring urine output is an effective way to monitor hydration. The kidneys hold onto water if the body is dehydrated, then urine output drops and urine becomes darker with a strong odor. When hydration is adequate, the urine is clear and normal in amount.
  4. Avoid caffeine and alcohol since these promote dehydration. Alcohol lowers the body’s tolerance for heat as well as acts as a diuretic.
  5. Do not move from a cool to a very hot environment quickly. This prevents the body from adjusting so that it can cool more efficiently.
  6. Pay attention to those at risk during heat waves: the elderly, obese, socially isolated, very young, and those who have no air conditioning to cool their homes. Make certain that they are well hydrated and not alone. Move people to cooling centers if there is one in your area or bring them to a public place that has air conditioning.


Call 911 or an ambulance if the person stops sweating or becomes confused since the heatstroke as a life threatening condition may be developing.


Exertional heatstroke (EHS) is much more common in adolescents and young adults and is one of the leading causes of death in young athletes each year. From 2005 to 2009, there were more than 9,000 events of exertional heat illness per year among high school athletes, reported by the Centers for Disease Control and Prevention. The highest incidence was in American football, with exertional heatstroke occurring at a rate of 4.5 cases per 100,000 athlete exposures (i.e. total practices), and mostly occurring in summer. Policies adopted nationally in 2003 reduced the burden from this problem: from 1995 to 2008, 31 deaths occurred, with only one reported between 2003 and 2011. Exertional heatstroke is also a risk for athletes who train or compete in hot, humid conditions, especially when the heat and humidity are unexpectedly high. The weekend warrior who is determined to go the distance in endurance activities in high heat and humidity is also at risk for exertional heatstroke. Event organizers and coaches are more aware of this danger and are prepared to intervene. However, those who run or cycle alone often have no guidance or support.

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  • Lgibbons July 16, 2017 at 8:25 am

    Wonderful advice.