EMSC: Exertional Heat Illness Prevention

While exertional heat illness (EHI) is not always a life-threatening condition, exertional heat stroke (EHS) can be fatal is not recognized and treated properly.  Hot temperatures and high humidity are a dangerous mix that contributes to illness and death each year. “No one should die from a heat wave, but every year on average, extreme heat causes 658 deaths in the United States—more than tornadoes, hurricanes, floods, and lightning combined,” said Robin Ikeda, MD, MPH, acting director of the National Center for Environmental Health and Agency for Toxic Substances and Disease Registry. “Taking common sense steps in extreme temperatures can prevent heat-related illnesses and deaths.”


Free Resources
Cool Down First Video - An educational video about the recognition, prevention, and treatment of heat emergencies. This video should be watched by all teachers, parents, coaches, and EMS providers.
Heat Illness Poster - Female - Free poster
Heat Illness Poster - Male - Free poster.
Athlete Poster - Prevention of heat illness.
Hydration Status Poster - A chart like this should be readily available
Heat Related Illness (HRI) Prevention Course - Free training course provided by the CDC on heat emergencies.
Cooling Guidelines for exertional heat illness 

Learn About Heat Emergencies

Heat: Heat Cramps | Heat Stroke | Heat Exhaustion | Heat Wave Facts | Safety Tips

While the elderly, people with health problems, and very young children are the most vulnerable, heat can affect anyone—even strong, healthy athletes can be stricken. Our bodies are cooled primarily by losing heat through the skin and perspiration with evaporation. When our core body heat gain exceeds the amount we can get rid of the body’s natural defense fails and heat-related illness may develop.

Possible heat disorders for people in higher risk groups

  • Heat Index of 130° OR Higher: Heatstroke/sunstroke highly likely with continued exposure.
  • Heat Index of 105°- 130°: Sunstroke, heat cramps or heat exhaustion likely, and heatstroke possible with prolonged exposure and/or physical activity.
  • Heat Index of 90°- 105°: Sunstroke, heat cramps and heat exhaustion possible with prolonged exposure and/or physical activity.
  • Heat Index of 80° - 90°: Fatigue possible with prolonged exposure and/or physical activity.

Heat Cramps

Heat Cramps is a condition that is marked by sudden development of cramps in skeletal muscles and that result from prolonged work or exercise in high temperatures accompanied by profuse perspiration (sweat) with loss of sodium chloride (salt) from the body. Cramps are often the very first sign that the body is having trouble with the heat.

  • When heat cramps occur:
  • Get to a cooler place
  • Rest in a comfortable position
  • Lightly stretch muscles
  • Drink water every 15 minutes

Heat Exhaustion

Heat Exhaustion is a condition marked by weakness, nausea, dizziness, and profuse sweating that results from physical exertion in a hot environment. Blood flow to skin increases, while blood flow to vital organs decreases. Heat exhaustion can cause a form of mild shock. If not treated, the condition will get worse, the body temperature will keep rising, and heat stroke may occur.

Signs of Heat Exhaustion

  • Cool, moist, pale or flushed skin
  • Heavy sweating
  • Headache, nausea, or vomiting
  • Dizziness
  • Exhaustion
  • Body temperature may be normal but most likely will be rising

When heat exhaustion occurs

  • Get the person to a cooler place
  • Remove or loosen tight clothing and apply cool wet cloths
  • If conscious give cool water to drink every 15 minutes
  • Rest in a comfortable position and watch carefully for changes in condition

Heat Stroke

Heatstroke (also called Sunstroke) is a life threatening condition marked especially by cessation of sweating, extremely high body temperature, and collapse that result from prolonged exposure to high temperature. A heat stroke victim’s temperature control system stops working and cannot produce sweat to cool the body. Brain damage and death will result if the body temperature continues to rise and the body is not cooled quickly. If you suspect Heatstroke call 911 or your local emergency number immediately and move the person to a cooler place– help is needed fast!

Signs of Heatstroke

  • Hot, red skin
  • Changes in consciousness
  • Rapid, weak pulse
  • Rapid, shallow breathing
  • Body temperature as high as 105
  • If the person was sweating from heavy work or exercise, skin may be wet; otherwise it will feel dry.

Heat Wave Facts

A Heat Wave is a period of unusually hot weather often combined with high humidity.

Heat Index is the temperature or degrees Fahrenheit (F) indicating how hot it feels when relative humidity is added to the actual air temperature. Exposure to full sun can increase the heat index by 15 degrees.

The National Weather Service (NWS) Heat Index

Heat index chart

To find the Heat Index, look at the Heat Index Chart. As an example, if the air temperature is 95°F (found on the top of the table) and the Relative Humidity is 55% (found at the left side of the table), the Heat Index-or how hot it really feels-is 110°F. This is at the intersection of the 95° row and the 55% column.

Summary of National Weather Service’s (NWS) Alert Procedures

The NWS will initiate alert procedures when the Heat Index is expected to exceed 105°- 1 10°F (depending on local climate) for at least two consecutive days. The procedures are:

  1. Include Heat Index values in zone and city forecasts.
  2. Issue Special Weather Statements and/or Public Information Statements presenting a detailed discussion of:
    • Extent of the hazard including HI values
    • Who is most at risk
    • Safety rules for reducing the risk.
  3. Assist state/local health officials in preparing Civil Emergency Messages in severe heat waves. Meteorological information from Special Weather Statements will be included as well as more detailed medical information, advice, and names and telephone numbers of health officials.
  4. Release to the media and over NOAA‘s own Weather Radio all of the above information.

How to protect your health during extreme heat:

  • NEVER leave children, pets, or others alone in closed vehicles - Within minutes, the temperature inside a car can reach over 140 degrees F, which can kill.
  • Slow down, and avoid strenuous activity. Even the healthiest people may be overpowered if they perform strenuous work outside during the heat of the day.
  • Avoid too much sunshine, and postpone outdoor activities and games
  • Drink plenty of fluids even if you do not feel thirsty
  • Avoid alcohol and caffeine, which promote water loss
  • Avoid extreme temperature changes, such as a taking a cool shower immediately after coming inside from hot temperatures
  • If your home does not have air conditioning, go to a public building every day for several hours
  • If you have to work outside, take frequent breaks, rest in the shade, and drink plenty of water.
  • Dress for the weather: Wear loose-fitting, lightweight, lightly-colored clothing - Lightweight, lightly-colored clothing reflects heat and helps maintain normal body temperature
  • If you must be outside, cover as much skin as possible to avoid sunburn
  • Protect your neck, face and head with a wide-brimmed hat

Plan for extreme heat by developing a survival plan

  • Contact your local emergency management office, National Weather Service office, or the American Red Cross for assistance in developing your plan.
  • Share and discuss your extreme heat survival plan with your family.
  • If your home is not air-conditioned, make alternate plans ahead of time in case of a heat wave. Choose other places you may go to get relief from the heat during the hottest part of the day such as schools, libraries, theaters or other community facilities
  • Plan to change your daily activities to avoid strenuous work during the hottest part of the day.
  • Some medications and medical conditions reduce ones ability to tolerate heat. Discuss these concerns with your doctor.
  • Plan to check on family, friends, and neighbors who do not have air conditioning or who spend much of their time home alone.
  • Plan to wear lightweight, lightly colored clothing. Dark clothing absorbs heat.
  • Get Training - take a first aid course to learn what to do during heat emergencies and other emergencies
  • Log-on to the National Weather Service’s web site for more information.