Management of heat exhaustion

Heat exhaustion is typically treated as an outpatient, or even in the field, and inpatient hospitalisation is usually unnecessary.

Heat exhaustion (or heat cramps or heat syncope) typically responds to rest in a supine position in a cool environment. Use tepid water spray to cool the patient by evaporation. Rehydration is not a means of cooling but is appropriate if the person has thirst or other symptoms or signs of dehydration, with cool or cold water or an electrolyte solution containing 3 to 8% carbohydrate, such as any sports drinkAustralian and New Zealand Committee on Resuscitation (ANZCOR), September 2020. Intravenous fluids are rarely required.

Aim to cool the patient within 30 to 60 minutes and observe until symptoms have resolved. If symptoms are not improving, heat stroke (or another life-threatening condition) may be developing; arrange urgent transfer to hospital and consider more aggressive cooling, if available, in the interim.

Educate the patient about avoiding heat illness, including delaying return to sport for 48 hours.