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Hot, dry skin and confused? Call 144 first, then cool them down

It is a hot afternoon. The person next to you has stopped sweating. Their skin is hot and dry, they are breathing fast, and their answers no longer make sense.

That is what heatstroke can look like, and the World Health Organization calls it a potentially fatal medical emergency: delay can lead to severe complications or death. In Switzerland, the number is 144.

Heatstroke: three steps, in this order

WHO's short guide:

  1. Call for emergency medical help straight away, before anything else. In Switzerland, call 144.
  2. Cool the person aggressively with whatever you have. Loosen or remove unnecessary clothing, move them at once into shade or an air-conditioned space, and put cold, wet cloths or towels on them. Use ice packs and fans if you have them, or a cold-water bath if that is possible and safe.
  3. Stay with them and watch until help arrives, for signs that they are getting better or worse.

The UK's NHS adds: do not drive the person to hospital yourself; follow the call handler's advice. While you wait, wrap them in a cool, wet sheet, or fan them and sponge them with cold water. If they lose consciousness, put them in the recovery position, tell the ambulance service, check breathing and pulse, and start CPR if there are no signs of life.

How to tell it is heatstroke

Signs of heatstroke, according to the NHS:

  • a very high temperature;
  • hot skin that is not sweating (it may look red);
  • fast breathing and a fast heartbeat;
  • confusion or restlessness;
  • a seizure, or loss of consciousness.

WHO's guide says to get medical help immediately if someone feels faint, dizzy or nauseous, stops sweating, or loses consciousness. WHO/Europe says to call a doctor or ambulance at once for hot, dry skin, delirium, convulsions or unconsciousness. We found no body-temperature threshold on the WHO pages we read, so do not wait for a thermometer.

The NHS also suspects heatstroke if someone is still unwell after 30 minutes of rest in a cool place, cooling and fluids.

Before it gets that far: heat exhaustion

Heat exhaustion is the milder condition, and it can turn into heatstroke. The NHS lists tiredness, dizziness, headache, nausea or vomiting, heavy sweating with pale, clammy skin, cramps in the arms, legs or stomach, a raised temperature, strong thirst and irritability. Colour changes are harder to see on brown or black skin. Switzerland's Federal Office of Public Health (BAG) gives a similar list for heat-related illness: weakness, confusion, dizziness, headache, muscle cramps, dry mouth, nausea, high body temperature and a raised pulse.

What to do

  1. Move the person to a cool or shady place and let them lie down.
  2. Remove unnecessary clothing.
  3. Cool the body: damp cloths, spraying or sponging with cool water, fanning. Cold packs wrapped in cloth under the armpits or on the neck also help.
  4. Give fresh water, or an electrolyte drink if you have one. The NHS also names an isotonic sports drink or oral rehydration powder mixed with water, to replace lost salt.
  5. Stay with them. They should start to feel better within 30 minutes. If they do not improve after a short time, the Swiss advice is to call a doctor or 144.

Who to watch most closely

The WHO heat and health fact sheet names outdoor and manual workers, athletes, people over 65, people with heart, lung or kidney conditions, people with a disability, people living alone, infants and children, and people in homes or facilities without cooling. WHO/Europe adds people on certain medications and the chronically ill, including those with asthma, diabetes or heart disease.

Children should never be left in a parked vehicle, WHO says.

How to keep it from happening

WHO/Europe's advice for hot weather:

  • avoid going out and strenuous activity at the hottest time of day, and stay in the shade;
  • if possible, spend 2 to 3 hours of the day somewhere cool;
  • keep your home cool with the night air and blinds or shutters;
  • wear light, loose clothing and take cool showers or baths;
  • drink water regularly, and avoid sugary, alcoholic or caffeinated drinks;
  • check on family, friends and neighbours who spend much of their time alone;
  • do not leave children, dependent adults or pets alone in parked vehicles.

Alertswiss also suggests cool places such as cellars, schools or libraries.

The one rule

Hot, dry and confused: call 144 first, then cool them down. Do not wait for a thermometer.

This is general first-aid information, not a substitute for training or medical advice.

Sources

Source: https://armsma.org/en/insights/heatstroke-first-aid — © ARMSMA. Reproduced with permission of ARMSMA.

ARMSMA is not a professional educational institution. This material is provided for general awareness only and does not replace professional training, medical advice or official emergency instructions. ARMSMA accepts no liability for reliance on this content.

Source: https://armsma.org/en/insights/heatstroke-first-aid — © ARMSMA. Reproduced with permission of ARMSMA. — ARMSMA is not a professional educational institution. This material is provided for general awareness only and does not replace professional training, medical advice or official emergency instructions. ARMSMA accepts no liability for reliance on this content.