The stages of heat illness

Activities during the warmer part of the year whether they be athletic in nature, or simply exertion above what you are used to in extreme temperatures increase the possibility of heat injury.  The most important thing to know  is that heat illness is not an all or nothing event but a  progression that leads to increasingly more severe consequences to your health.  The following breakdown explains in detail the four levels of heat illness, each level compounding on the next

Stages of heat illness


Stage 1: Heat syncope

Signs and Symptoms

Headache and / or Nausea

Immediate Care Strategies

Normal intake of fluids with electrolytes 


Stage 2: Heat Cramps

Signs and Symptoms

Skin: flushed, moist 

Temperature: Normal or slightly elevated (less than 102.5)

Other symptoms: painful cramps, especially in the legs 

Immediate Care Strategies

If cramps are isolated: 

  • Gentle stretching of affected muscle 

  • Rest in a cool place and drink a sports drink, which has electrolytes and salt, or drink cool water.

If cramps are severe: follow heat exhaustion protocol


Stage 3: Heat Exhaustion

Signs and Symptoms

Sweating: Profuse

Skin: Cold, clammy and pale

Temperature: Normal or slightly elevated (less than 102.5)

Heartbeat: Weak but rapidly beating 

Breathing: Shallow

Other symptoms: Dizziness and or Nausea, possible Loss of consciousness

Immediate Care Strategies

  • Place in supine position with feet elevated 12-18 inches

  • Gentle massage of extremities

  • Force fluids 

  • Monitor body temperature and other vitals

  • Refer to physician 


Stage 4: Heat Stroke

Signs and Symptoms

Sweating:  None

Skin: Very hot , dry, either red or a ashen in  darker pigmented skin

Temperature: as high as 106 

Breathing: Labored, even in a semi reclined position

Immediate Care Strategies

This is an extreme medical emergency - seek medical attention ASAP

  • Strip individual down to undergarments

  • Cool quickly starting with the cheat and continuing down the body, (use ice,  water, and or fans)

  • Wrap in cold wet sheets for transport

  • Treat for shock, if breathing is labored place in semi-reclining position.

While this information is essential in being able to recognize the signs and symptoms of heat illness, the best strategy is always prevention.  Stay tuned, next week we will discuss those strategies in detail! 

Information collected from E.T. Howley and B.D. Franks, Health/Fitness Instructor’s Handbook. 3rd ed. Copyright 1997 Human Kinetics Publishers, Inc

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Stay cool -considerations and strategies for avoiding heat illness.

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Exercise in the heat: The good and the bad