10 Treatments for Heat Stroke

The first step is to get the person out of the heat. An air-conditioned space is best. If none is available, move them to a shaded, cool area. A fan works best when used with water on the skin; in very hot air, a fan alone does little and can even add heat, so pair it with misting or damp cloths. Have the person lie down on a soft surface to prevent injury from a fall or seizure. The priority is getting them out of the heat as quickly as possible.

Call 911 right away, ideally at the same time you start cooling the person. Heat stroke can be fatal, and even survivors can face severe consequences, including kidney failure, heart failure, muscle damage, and permanent brain damage. Many of these become irreversible if treatment is delayed, so never wait to see if the person improves on their own. Emergency responders have better tools for cooling the body and medications to manage complications like seizures or shivering.

Removing clothing helps the body shed heat. Take off any excess layers right away, such as jackets, hats, sweatbands, and shoes. Tight or restrictive clothing is especially worth removing, since it traps heat and can make things worse. If needed, shirts and pants can come off too. The goal is to expose as much skin as possible to help it cool.

Immersing the person in cool water is one of the most effective ways to bring body temperature down. A bathtub filled with cool water works well. A cool shower can help too, but only if the person is fully alert, since there's a risk of falling. If you're outdoors with no tub or shower, a pool, stream, or pond can do the job. Any of these cools the body's core quickly.

Cold or ice water immersion is the single most effective way to lower core body temperature, and the faster it happens, the lower the risk of death and lasting organ damage. For that reason, it's the preferred emergency cooling method. The cold can be a shock to the system, and in older adults, children, or people with heart conditions, medical professionals weigh that risk carefully. But in a life-threatening emergency, rapid cooling is the priority. Don't withhold it while waiting for help. If you're unsure, cool water immersion or ice packs are a safe alternative until responders arrive.

When immersion isn't possible, evaporation is the next best method. Soak a sheet in cold water and drape it over the person, then aim a fan at them. Or skip the sheet and spray the person with cool water while fanning. Either way, the moving air evaporates the water off the skin and pulls heat away with it.

Wait until medical help arrives before giving the person anything to drink. Current guidance is not to give fluids to a heat stroke patient while waiting for help, since they may be too impaired to swallow safely, and responders will manage rehydration. Hydration matters most for prevention: if you feel overheated or notice early warning signs, cool down and drink water or an electrolyte sports drink before things escalate.

Ice packs or cold compresses are a useful cooling tool, both for bystanders and medical personnel. Focus them on areas where blood vessels run close to the surface: the neck, armpits, groin, and back. Cooling the blood at these points circulates it to the rest of the body. These spots are also near vital organs like the brain, heart, and kidneys, which are most at risk during heat stroke.

Emergency personnel may give medication to stop shivering. Cooling treatments can trigger shivering even when the body is still dangerously hot inside, and shivering raises body temperature, working against the cooling. A muscle relaxant such as a benzodiazepine can stop it. Not every patient needs this, but it's a common part of treatment in serious cases.

In the most severe cases, heat stroke can stop a person's breathing or heartbeat. If someone becomes unresponsive and isn't breathing normally, and you're trained in CPR, begin it while waiting for emergency personnel. Only perform CPR if you know how. Organizations like the Red Cross offer certification classes, and being trained means you're ready to help in an emergency. Once you start, continue until responders arrive and take over.