“I’m Just Hot… Right?”
Recognising and Treating Heat Exhaustion & Heat Stroke in the Outdoors
Written from the perspective of an EMT
You’re an hour into a coastal hike. It’s roasting. One of your group sits down suddenly, looking pale, sweaty, and just not quite right. “I’m fine,” they say. But are they?
As an EMT, I’ve treated more than a few heat-related emergencies — on city streets, at music festivals, and the uplands of the UK where help is hours away. The key to managing heat illness is catching it early, acting fast, and knowing when ‘just hot’ becomes dangerous.
1. Heat Exhaustion (🚨 WARNING SIGN)
Caused by loss of fluids and electrolytes through sweat. It’s your body saying, “I’m struggling here!”
Signs & Symptoms:
Pale, clammy skin
Heavy sweating
Headache or dizziness
Nausea or vomiting
Muscle cramps
Weakness or collapse
Fast pulse, breathing shallow
Core temp often <40°C
What to Do:
Move to a shaded or cooler spot
Get them to lie down, elevate legs if light-headed
Loosen or remove clothing
Cool with wet cloths, fans, or breeze
Offer sips of water or electrolyte drinks
Monitor – symptoms should improve within 30 minutes
⚠️ If symptoms worsen or don’t improve → treat as heat stroke
2. Heat Stroke (🔥 LIFE-THREATENING)
This is a medical emergency. The body’s temperature regulation system has failed.
Signs & Symptoms:
Hot, dry skin (may stop sweating)
Confusion, slurred speech, irrational behaviour
Rapid pulse, high temperature (≥40°C)
Collapse, seizures, or unconsciousness
What to Do:
Call for emergency help immediately (PLB, radio, 999 if possible)
Move to shade and strip outer clothing
Cool aggressively – sponge or pour water on skin, fan air over them
Use evaporation: wet the skin, then fan
Place ice packs at neck, armpits, groin if available
Do not give fluids if the casualty is drowsy, confused, or unconscious
Be ready for CPR if they stop breathing
🛑 Left untreated, heat stroke can lead to organ failure or death. Fast cooling saves lives.
🧭 Why This Matters in the Outdoors
Unlike city settings, help can be hours away. You are the first responder. You might be the only responder for some time.
Early recognition = better outcomes. And in hot weather, heat-related illness can sneak up fast, especially when:
You’re pushing on despite the heat
There’s no shade or breeze
People aren’t drinking enough (or too much plain water with no salts)
Group members feel pressure not to “slow everyone down”
✅ Prevention: Stay Cool, Stay Safe
Most heat illness is avoidable. Here’s what works in the field:
Before the Day Starts:
Hydrate before heading out (urine should be pale yellow)
Pre-plan water & shade stops
Brief your group on heat illness signs
During the Day:
Encourage regular water + salty snacks
Avoid over-hydration (plain water + no salt = risk of hyponatraemia)
Schedule rest breaks in shade
Watch out for the quiet ones – heat illness can present subtly
Wear light-coloured, loose clothing, hats, sunglasses
After the Day:
Cool down slowly
Rehydrate with fluids containing electrolytes
Check on group members – some symptoms can appear later
🏕️ Final Thoughts
Heat-related illness isn’t just a desert or jungle problem. I’ve seen heat stroke on a Welsh hill and dehydration in a rainy Lake District summer. It’s not just about temperature — it’s about overheating in any environment where heat and exertion combine.
Outdoors, you don’t always get a second chance. Listen to the early signs. Treat fast. And if in doubt, stop and cool — the summit will wait.
Need more practical training? Our outdoor first aid courses cover real-world scenarios, kit choices, and field-based casualty care — including heat illness management in remote settings.
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