Interviewer: Dr. Scott Youngquist is an emergency room physician. First of all, let's just talk about, I'm out in the heat, what are the symptoms that I might have started to get heat stroke?
Dr. Youngquist: Well, mild symptoms may feel like a mild flu-like illness. All the way up to severe symptoms, such as confusion, trouble breathing, chest pain, abdominal pain.
Interviewer: All right. So it's degrees, not just a singular condition?
Dr. Youngquist: Exactly.
Interviewer: All right. And the kind of . . . I'm trying to recall when I thought maybe I might have had heat stroke. I remember feeling a little nauseous, I think, a little light headed, really tired and fatigued. And then after about a half hour, 45 minutes, that kind of went away after I got out of the sun. Is that pretty normal?
Dr. Youngquist: Yeah, that would describe someone with a mild heat related illness, I would say, and not severe hyperthermia or heat stroke.
Interviewer: All right. And did I do the right thing just by getting out of the sun? Should there have been other things that I did at that point?
Dr. Youngquist: No, you did exactly the right thing. You want to stop any exertional activity that generates metabolic heat, such as running, jogging, forceful exertion. Get out of the heat and get to a cool environment. And then replenish any fluid losses through sweating or from the heat alone by drinking water or an electrolyte solution.
Interviewer: And I imagined once you start feeling those light symptoms, you should really take that as a warning so it doesn't get more severe. Explain what could potentially happen if you didn't?
Dr. Youngquist: Absolutely. There are all sorts of problems that can arise from heat related illness if it's not treated early. And those include things like liver failure, shock, hemodynamic collapse, things that cause you to go ultimately into cardiac arrest and death.
Interviewer: So it's something to take very seriously. If it's a mild case and I get better after about a half hour, I'm good, how long should I wait, though, before maybe, even in that mild case if the symptoms aren't going away before, maybe, I consider seeing a doctor?
Dr. Youngquist: Well, I think in your case, you know, if it's 30 to 45 minutes after you've treated the mild symptoms, if they're resolving or they've resolved completely, you don't need to go see a doctor for that.
Interviewer: All right. And if you do go see a doctor, what types of treatments would you give me then at that point?
Dr. Youngquist: Well, you'll get a careful history and physical examination. And then the treatment from there will depend on the severity of the case, but may include intravenous fluids, it may include passive or active cooling measures, and investigation into evidence of end organ damage.
updated: June 15, 2021
originally published: June 26, 2019
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