Heat illness emergency response
Recognizing the difference between exhaustion and stroke, and the response that has to be decided before the day it happens.
Heat stroke is a medical emergency with a mortality rate that climbs with every minute of delay, and the single most reliable sign that separates it from heat exhaustion is altered mental status. Every heat standard requires an emergency response procedure, and the reason is that the decisions cannot be made in the moment: who calls, how you describe a site with no address, and that nobody sends a sick worker home alone.
Takeaways
- Tell heat exhaustion and heat stroke apart in the field.
- Start cooling before the ambulance arrives, which is what changes outcomes.
- Write directions to a site that has no street address.
- Name the person authorized to call, and say it out loud to the crew.
Exhaustion or stroke
What to do, in order
Directions to a site with no address
Who is authorized to call
What the crew has to be able to do
Frequently asked questions
- Should I cool someone before the ambulance arrives or wait? Cool immediately. For exertional heat stroke, time to cooling is the strongest predictor of survival and of avoiding permanent injury. Cooling on scene is standard practice, not overreach.
- Can I drive someone to the hospital instead of calling? Not for suspected heat stroke or anyone with altered mental status. They can deteriorate en route with nobody able to help, and you lose the cooling that an ambulance crew can provide.
- Is it acceptable to send someone home who feels unwell? Not alone. Multiple standards specifically prohibit leaving a symptomatic employee unattended or sending them home alone, because unsupervised deterioration is how heat illness becomes a fatality.
- Do I have to retrain after a near miss? Maryland requires retraining promptly after a suspected heat-related illness, and it is good practice everywhere. A near miss is the cheapest lesson available.