How to Treat Heat Exhaustion: First Aid in 6 Steps

Watch for changes in how the person is acting and how their skin looks. Someone who was chatty and engaged goes quiet and withdrawn. They stop eating or drinking. Their face may look pale with a flush in the cheeks, and the rest of their skin - chest, arms, legs - looks pale too. There is often a sheen of sweat or clamminess.

Touch their skin. In heat exhaustion the skin frequently feels cool and clammy, not hot. They may say they feel dizzy, faint, light-headed, or nauseous. Headache, weakness, and muscle cramps are common too. These are early warnings - act on them.

Heat exhaustion: pale, clammy, sweating heavily, dizzy. Heat stroke: hot dry skin, no sweating, confused, possible vomiting. The difference matters because heat stroke needs a 911 call right away.

Get them out of direct sun and heat. Indoors with AC is best. Failing that, any shaded spot works - under a tree, inside a car with the AC running, a covered porch, a tent. The goal is to stop adding heat while their body tries to dump what it already has.

If they can walk on their own, support them with an arm around their shoulders. If they are unsteady, sit them down where they are and then carry or assist them to the cool spot. Don't make a dizzy person try to walk a long way unaided.

Help them sit down somewhere they can lean back. A couch, a chair with arms, the back step, even the ground against a wall works. Loosen anything tight - belt, collar, shoes if their feet are swollen, hat or hair tie. Tight clothing traps heat against the body.

Some people feel better lying flat with their legs slightly elevated. That position helps blood return to the chest and head, which can ease the dizziness. Let them choose what is comfortable. The point is to take the work of standing off their body so it can focus on cooling down.

Pour a glass of cool water and hand it to them. Tell them to take small sips, not gulps. Chugging a full glass when you are nauseous tends to come straight back up, and a vomiting patient can't keep fluids down. Sipping over 20 to 30 minutes works.

Plain water is fine for short, mild cases. If they have been sweating heavily for a long time - a hot job site, a long walk, hours at a hot event - an electrolyte drink mix or oral rehydration salts work better than water alone because they replace the salt that came out in the sweat. Avoid alcohol, caffeine, and very cold drinks. These can make nausea worse.

Sit with them and watch closely. Within 20 to 30 minutes they should start to look and sound more like themselves. Color comes back to their face. The clammy sheen fades. Conversation picks back up. They start asking for more water or saying they feel better.

You can help the cooling along. Wet a hand towel with cool water and lay it across their forehead and the back of their neck. Mist their arms and face with a spray bottle. If they have a damp shirt on, fan it - evaporation cools fast. If you have ice packs, keep them on the neck, armpits, and groin spots from step 3.

Don't rush them back into activity. Once they feel recovered, keep them resting and hydrating for the rest of the day. Heat exhaustion can recur in the same day if they go back out into the heat.

Call 911 right away if any of these show up: confusion or disorientation, vomiting that won't stop, loss of consciousness even briefly, hot dry skin with no sweating, body temperature above 103 degrees, seizures, or a rapid weak pulse. Those are signs of heat stroke. Heat stroke is a medical emergency and can cause organ damage or death within an hour.

While waiting for paramedics: keep cooling them with damp cloths, ice packs on the neck and armpits, and any breeze you can create. If they are unconscious but breathing, lay them on their side in the recovery position. Do not try to force water into someone who is not fully alert.

Even if your person seems to recover fully, call their doctor or an urgent care line afterward. Heat exhaustion can leave the body more vulnerable to a second episode for the rest of the day, and a clinician should make the call about any underlying causes (medication interactions, dehydration, an early infection).