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Hot Weather First Aid
© 2006


I wanted to make sure I passed along this information from a source that was as reliable as I could find. The following first-aid information is from the Mayo Clinic.

Heat cramps, heat exhaustion and heat stroke are usually associated with strenuous exercise, but can occur in any person, at any time during hot weather. Children and the elderly are particularly susceptible to these ailments.

When I was in the military, during the summer months of basic training, the Air Force placed an ambulance at strategic points around all the training areas. Air Force basic training is in San Antonio, Texas. Each ambulance came equipped with folding canvas bath tubs filled with ice water. Severe cases of heat exhaustion and/or potential heat stroke victims were immersed in this frigid bath even before they were transported to the hospital. I don't know if they still do this, but it seemed like a good idea at the time (1964). Now, they find that the ice "dunk" may cause convulsions. Too bad for us in 1964.

Since most back packs don't include either tubs or ice, you have to be able to respond to these problems with whatever you have on hand. Critical to ALL three ailments is fluid intake. Water! This is one of the major reasons I preach having at least one gallon of water, per person, per day. You could probably double – or triple – that for very strenuous work on a hot day. And you have to have it readily available to respond quickly.

The next step (or simultaneous step) is to seek shade immediately. This is another reason I dwell so much on making shelters, even though they may only be temporary shelters.

Heat Cramps, Heat Exhaustion and Heat Stroke may be 3 separate stages in heat-related illnesses, but they do not necessarily have to go from one to another in this order. It is possible that you will skip the cramps and exhaustion, going straight to Heat Stroke.

Of the three, heat stroke is the most serious. Heat cramps are uncomfortable but not fatal. Heat exhaustion can progress to heat stroke if proper first-aid steps are not done...and heat stroke kills.


Every first-aid web site you look at will ALWAYS refer you to calling 9-1-1 or your doctor for further treatment. In the woods during a crisis, that may not be an option. The key to all these first-aid procedures is lowering the body temperature back to normal, and the intake of body fluids. For the Heat Stroke victim, their life depends on it. In a hospital, they will run intravenous fluids into the bloodstream. You don't have that in the bush.

The only method available to YOU may be to PREVENT IT FROM HAPPENING IN THE FIRST PLACE. Prevention is the key first-aid procedure for the survivalist.

Guidelines for working out in hot weather: PREVENTION

To avoid heat-related conditions:

  • Drink enough fluids. Your body's ability to sweat and cool down depends on adequate rehydration. During heavy exercise in the heat, you can lose almost 2 quarts of water every hour. Recommended fluids include water, sports drinks and diluted fruit juices. Avoid caffeinated beverages such as coffee, tea and cola, which speed the excretion of water from your body.

    Sports drinks include electrolytes — sodium, chloride and potassium — which are lost through sweating. If you're going to be exercising very intensely or for longer than one hour, you may benefit from fluids containing carbohydrates and electrolytes. Keep in mind you can't rely on your thirst to signal how much fluid you need to drink. Your thirst mechanism underestimates fluid loss in the heat.

  • Wear light-colored, loose fitting clothing made of breathable fabric. Dark or nonporous material can increase your temperature and reduce evaporation. Clothing made with polypropylene can help wick moisture away from the skin. Avoid heavy, rubberized clothing, which can be dangerous in any weather. Loose fitting clothing lets more air pass over your body, providing for sweat evaporation and cooling. A light-colored hat or cap can limit your exposure to the sun.

  • Exercise in the early morning or late evening. These are cooler times. If possible, exercise in the shade.

  • Wear sunscreen. Sunburn decreases your body's ability to cool itself.

  • Allow yourself time to get used to higher temperatures. Your body will gradually adapt to the heat, allowing you to exercise with a lower heart rate and lower body temperature. If you're reasonably fit, allow four to five days to get used to higher temperatures. If you live with a chronic health condition or are older, you may need up to 10 to 12 days to adjust. Shorten the length of your exercise routine, lower the intensity, and gradually increase your effort.

  • Talk to your doctor if you have a chronic medical condition or take medications. Find out if your condition or medication might affect your ability to work out in hot weather. Certain medications — such as diuretics and antihistamines — may make you more susceptible to heat-related illness.

As you plan your outdoor activities, keep in mind certain people — young children and older adults, for instance — are at greater risk of heat-related illness. If your activities include people in this age range, pay close attention to them for any signs of distress

Rely on a backup plan

It's always a good idea to have a backup plan when the temperature soars. On days when the heat and humidity are high, avoiding the heat altogether and exercising inside may be your safest option. Indoor alternatives include exercising at the gym, swimming, mall walking or perhaps climbing stairs inside an air-conditioned building. The Mayo Clinic writes for the "city dwellers". This "indoor air-conditioning" does not exist in a survival situation. However, staying put inside a temporary shelter will also work.

Keep it cool, play it safe

Your workouts help you live longer and stay healthier. But don't put your health at risk by working out in extreme heat. Follow the guidelines for working out in hot weather to avoid the risk of heat-related conditions.

Heat cramps: First-aid

Heat cramps are painful, involuntary muscle spasms that usually occur during heavy exercise in hot environments. Inadequate fluid intake often contributes to heat cramps. The spasms may be more intense and more prolonged than typical nighttime leg cramps. Muscles most often affected include those in your calves, arms, abdomen and back, although heat cramps may involve any muscle group involved in the exercise.

If you suspect heat cramps:

  • Rest briefly and cool down.
  • Drink clear juice or an electrolyte-containing sports drink.
  • Practice gentle, range-of-motion stretching and gentle massage of the affected muscle group.
  • If your cramps don't go away in 1 hour, call your doctor.

Heat exhaustion: First-aid

Heat exhaustion is one of the heat-related syndromes, which range in severity from mild heat cramps to heat exhaustion to potentially life-threatening heatstroke.
Signs and symptoms of heat exhaustion often begin suddenly, sometimes after excessive exercise, heavy perspiration and inadequate fluid intake.

Signs and symptoms resemble those of shock and may include:

  • Feeling faint
  • Nausea
  • Heavy sweating
  • Ashen appearance
  • Rapid, weak heartbeat
  • Low blood pressure
  • Cool, moist skin
  • Low-grade fever

If you suspect heat exhaustion:

  • Get the person out of the sun and into a shady or air-conditioned location.
  • Lay the person down and elevate the legs and feet slightly.
  • Loosen or remove the person's clothing.
  • Have the person drink cool water, not iced, or a sports drink containing electrolytes.
  • Cool the person by spraying or sponging him or her with cool water and fanning.
  • Monitor the person carefully. Heat exhaustion can quickly become heatstroke. If fever greater than 102 F, fainting, confusion or seizures occur, call for emergency medical assistance.

Heatstroke: First-aid

Heatstroke is similar to heat cramps and heat exhaustion. It's one of the heat-related problems that often result from heavy work in hot environments, usually accompanied by inadequate fluid intake. Older adults, people who are obese and people born with an impaired ability to sweat are at high risk of heatstroke. Other risk factors include dehydration, alcohol use, cardiovascular disease and certain medications.

What makes heatstroke much more severe and potentially life-threatening is the body's normal mechanisms for dealing with heat stress, such as sweating and temperature control, are lost. The main sign of heatstroke is a markedly elevated body temperature — generally greater than 104 F — with changes in mental status ranging from personality changes to confusion and coma. Skin may be hot and dry, although in heatstroke caused by exertion, the skin is usually moist.

Other signs and symptoms may include:

  • Rapid heartbeat
  • Rapid and shallow breathing
  • Elevated or lowered blood pressure
  • Cessation of sweating
  • Irritability, confusion or unconsciousness
  • Fainting, which may be the first sign in older adults

If you suspect heatstroke:

  • Move the person out of the sun and into a shady or air-conditioned space.
  • Call for emergency medical assistance.
  • Cool the person by covering him or her with damp sheets or by spraying with cool water.
  • Direct air onto the person with a fan or newspaper.

How much water do you need?

Every day you lose water through your breath, perspiration, urine and bowel movements. For your body to function properly, you must replenish its water supply by consuming beverages and foods that contain water.

A couple of approaches attempt to approximate water needs for the average, healthy adult living in a temperate climate.

  • Replacement approach. The average urine output for adults is 1.5 liters a day. You lose close to an additional liter of water a day through breathing, sweating and bowel movements. Food usually accounts for 20 percent of your total fluid intake, so if you consume 2 liters of water or other beverages a day (a little more than 8 cups) along with your normal diet, you will typically replace the lost fluids.

  • Dietary recommendations. The Institute of Medicine advises that men consume roughly 3.0 liters (about 13 cups) of total beverages a day and women consume 2.2 liters (about 9 cups) of total beverages a day.

Even apart from the above approaches, it is generally the case that if you drink enough fluid so that you rarely feel thirsty and produce between one and two liters of colorless or slightly yellow urine a day, your fluid intake is probably adequate.

Beyond the tap: Other sources of water

Although it's a great idea to keep water within reach at all times, you don't need to rely only on what you drink to satisfy your fluid needs. What you eat also provides a significant portion of your fluid needs. On average, food provides about 20 percent of total water intake, while the remaining 80 percent comes from water and beverages of all kinds.

For example, many fruits and vegetables — such as watermelon and cucumbers — are nearly 100 percent water by weight. Beverages such as milk and juice are also comprised mostly of water. Even beer, wine and caffeinated beverages such as coffee, tea or soda can contribute, but these should not be a major portion of your daily total fluid intake. Water is one of your best bets because it's calorie-free, inexpensive and readily available.

Dehydration and complications

Failing to take in more water than your body uses can lead to dehydration. Even mild dehydration — as little as a 1 percent to 2 percent loss of your body weight — can sap your energy and make you tired. Common causes of dehydration include strenuous activity, excessive sweating, vomiting and diarrhea.

Signs and symptoms of dehydration include:

  • Mild to excessive thirst
  • Fatigue
  • Headache
  • Dry mouth
  • Little or no urination
  • Muscle weakness
  • Dizziness
  • Lightheadedness

Mild dehydration rarely results in complications — as long as the fluid is replaced quickly — but more-severe cases can be life-threatening, especially in the very young and the elderly. In extreme situations, fluids or electrolytes may need to be delivered intravenously.

What's more, even mild dehydration — as little as a 1 percent to 2 percent loss of body weight — can cause symptoms such as weakness, dizziness and fatigue and may have a negative effect on long-term health. Severe dehydration, usually defined as a loss of 9 percent to 15 percent of body weight, is a life-threatening medical emergency.

In the simplest terms, dehydration occurs when you lose more water than you take in. Even a slight imbalance causes serious problems because water is essential to human life: It forms the basis for all body fluids, including blood and digestive juices; it aids in the transportation and absorption of nutrients; and it helps eliminate waste.

You can usually reverse mild to moderate dehydration by increasing your intake of fluids, but severe cases need immediate medical treatment. The safest approach is not to become dehydrated in the first place. You can do that by monitoring your fluid loss during hot weather, illness or exercise, and drinking enough liquids to replace what you lose.