EMS Tips

Heat Emergency Assessment Tips

Assessment of Heat Emergencies (heat stroke and heat exhaustion) starts with the scene size-up. Make the scene safe or safer for the patient by ending the heat challenge. Do this by:

1. Removing the patient from the hot environment

2. Shading the patient from direct sun

3. Insulating the patient from hot surfaces like asphalt

You next steps are driven by the patient assessment findings. Heat exhaustion is from fluid loss and is hypovolemia. Look for the classic signs of shock – altered mental status, tachycardia, tachypnea, and pale, cool, and clammy skin. Follow your local protocols for fluid administration or for requesting an ALS intercept.

Heat stroke is a core temperature problem. The patient may or may not be hypovolemic so don’t wait for hot dry skin to begin treatment. Heat stroke needs to be treated with rapid and aggressive cooling.

What methods are you authorized to use or have you used to rapidly cool hyperthermia patients?

When you are active in a hot environment prevent a heat emergency by staying well hydrated, resting as necessary, and assisting heat loss with radiation, convection, conduction, and evaporation. During prolonged exertion continue to eat, especially small and easily digestible snacks that help replace electrolytes.

By Greg Friese

Greg Friese, Stevens Point, Wisconsin, is an author, educator, paramedic, and marathon runner.

Greg was the co-host of the award winning EMSEduCast podcast, the only podcast by and for EMS educators. Greg has written for,, Wilderness Medical Associates, JEMS Magazine, and EMS World Magazine, and the NAEMSE Educator Newsletter.