Heat stroke & heat exhaustion

Recognising heat exhaustion (preliminary stage)

1. Pale, clammy, sweaty and rather cool skin
2. Headache, dizziness, nausea, thirst and a feeling of weakness
3. Fast pulse and fast breathing
4. The person is usually still awake and responsive – body temperature is only slightly raised

Recognising heat stroke (life-threatening)

1. Hot, often reddened skin – classically dry, but may be moist after exertion in the heat
2. Core body temperature above 40 °C
3. Central nervous system disturbances: confusion, restlessness, slurred speech, seizures and even unconsciousness
4. Fast pulse, headache, nausea

First aid for heat stroke

1. Call emergency number 144 immediately – heat stroke is life-threatening
2. Move the person to a cool, shaded place and loosen or remove tight or excess clothing
3. Cool immediately: apply cool, damp cloths and fan the person; place cold compresses or ice wrapped in a cloth on the wrists and ankles, groin, neck and armpits
4. A cold bath cools fastest: if there is a tub, immerse the body up to the neck in cold water, sitting or lying – for around 15 minutes or until the person is clear-headed again. Keep the head above water and do not leave the person alone for a single moment (ERC Guidelines 2025)
5. If the person cannot safely be put into a tub: immediately douse or shower them with cold water, apply wet cloths and fan vigorously
6. If circulation is weak, lay flat and elevate the legs
7. Monitor breathing and consciousness continuously until the emergency services take over

First aid for heat exhaustion (person who is awake)

1. Move them to a cool, shaded place and have them lie down
2. Elevate the legs
3. Only as long as the person is fully alert and conscious: give water or an electrolyte drink in small sips
4. If the condition worsens, if the person becomes confused or if there is no improvement, call 144

What NOT to do

1. No fever-reducing medication – it does not work for heat stroke and can also cause harm
2. Do not delay cooling for fear of the cold – with heat stroke, rapid cooling is what counts
3. Never put ice or cold packs directly on the skin, always wrap them in a cloth
4. Do not leave the person alone

Unconscious person

1. If breathing is normal, place in the recovery position and continue cooling
2. If there is no breathing or breathing is not normal (agonal gasping): start resuscitation immediately
3. 144 must have been called – if possible by a second person

Sunstroke – the related danger

1. Caused by direct sunlight on the unprotected head and neck (irritation of the meninges)
2. Signs: bright red, hot head, headache, stiff neck, nausea – the rest of the body is not severely overheated
3. Move the person into the shade, slightly elevate the upper body and head
4. Cool the head and neck with damp, cool cloths
5. If there is impaired consciousness, vomiting or a seizure, call 144

Risk groups & prevention

1. Particularly at risk: infants and young children, older people, people with chronic and cardiovascular diseases, pregnant women
2. Increased risk during physical exertion in the heat and with certain medications (e.g. diuretics)
3. NEVER leave children and animals in a parked car – the interior heats up to life-threatening levels within minutes
4. On hot days: drink plenty, avoid the midday heat, cover your head, seek out cool rooms

Further sources

• Swiss Samaritans First aid for heat emergencies
• Suva Heat and sun – protection and first aid
• ERC Guidelines 2025: First Aid Cooling in heat stroke (p. 10, in English)
• Guide: Protection in heat & drought Prevention during heatwaves
• Ambulance 144 Medical emergency