As temperatures rise across Ohio, so do emergency room visits for heat-related illness. Whether you’re a youth athlete, weekend warrior, construction worker, coach, parent, or simply spending time outdoors, understanding the warning signs of heat illness can save a life.
The good news? Most heat-related illnesses are preventable.
Heat Illness Exists on a Spectrum
Heat-related illness isn’t just “getting too hot.”
Think of it as a progression:
Heat Stress → Heat Exhaustion → Heat Stroke
Heat exhaustion is the body’s warning sign that it’s struggling to keep up with the heat.
Heat stroke is a medical emergency where the body’s cooling system begins to fail.
The difference can be life-threatening.
The One Symptom That Changes Everything
If you remember only one thing from this article, remember this:
Altered mental status = Heat Stroke until proven otherwise.
If someone in the heat develops:
Confusion
Disorientation
Slurred speech
Strange behavior
Combativeness
Seizures
Loss of consciousness
This is no longer heat exhaustion.
This is heat stroke, and immediate cooling and emergency medical care are required.
Heat Exhaustion: The Warning Stage
Common symptoms include:
Heavy sweating
Dizziness
Weakness
Headache
Nausea
Fatigue
Muscle cramps
Rapid heart rate
Importantly, the person remains mentally normal and can answer questions appropriately.
What To Do:
Move to shade or air conditioning.
Remove excess clothing.
Drink fluids with electrolytes.
Rest.
Monitor closely.
Most people improve within a few hours.
Heat Stroke: A Medical Emergency
Heat stroke occurs when the body can no longer regulate its temperature.
Without rapid treatment, it can lead to:
Brain injury
Kidney failure
Liver damage
Blood clotting disorders
Death
Mortality can be extremely high when cooling is delayed.
What To Do
Call 911 immediately.
Then remember:
“Cool First, Transport Second”
Modern sports medicine and wilderness medicine guidelines emphasize that aggressive cooling should begin immediately—even before EMS arrives.
The goal is to reduce body temperature below 102°F (39°C) within 30 minutes.
Research has shown near-zero mortality when rapid cooling is achieved promptly.
Who Is Most at Risk?
Older Adults
Adults over 65 account for the majority of heat-related emergency transports in many countries.
Why?
Reduced sweating ability
Reduced thirst sensation
Lower cardiovascular reserve
More medications
More chronic medical conditions
Young Children
Children heat up faster than adults because of:
Smaller blood volume
Less efficient sweating
Greater surface-area-to-body-mass ratio
Never leave a child in a vehicle, even briefly.
Athletes
Athletes generate tremendous amounts of internal heat during exercise.
Risk increases with:
High humidity
Football pads and protective equipment
Intense conditioning sessions
Poor hydration
Lack of heat acclimatization
Outdoor Workers
Construction workers, landscapers, agricultural workers, and roofers are among the highest-risk occupational groups.
One striking statistic:
Nearly three-quarters of worker heat-related deaths occur during the first week on the job.
The Most Important Prevention Strategy: Heat Acclimatization
Many people focus on hydration.
Hydration matters.
But the most effective prevention strategy is actually heat acclimatization.
Heat acclimatization is the process of gradually exposing the body to exercise in hot conditions over 10–14 days.
During this process, your body learns to:
Sweat earlier
Sweat more efficiently
Preserve electrolytes
Lower core temperature
Reduce heart rate during exercise
These adaptations dramatically improve heat tolerance.
Practical Acclimatization Tips
If starting a new sport, workout program, or outdoor job:
Start with shorter sessions
Progress gradually
Increase duration before intensity
Allow 10–14 days for adaptation
Avoid “going all out” on day one
Does Hydration Matter?
Absolutely.
Even a 2% loss of body weight from dehydration can significantly impair heat tolerance.
Practical recommendations:
Drink regularly throughout the day.
Don’t wait until you’re severely thirsty.
For activities longer than one hour, consider electrolyte-containing beverages.
Replace fluids after exercise.
However, remember:
Heat stroke can occur even in well-hydrated individuals.
Hydration helps, but it does not eliminate risk.
Medications That Can Increase Heat Risk
Several common medications may impair heat tolerance, including:
Stimulants (Adderall, Vyvanse, amphetamines)
Anticholinergic medications
Some psychiatric medications
Certain blood pressure medications
Non-selective beta blockers
If you’re taking medications and spending significant time outdoors this summer, discuss heat-related precautions with your physician.
The Best Way to Cool Someone Down
If heat stroke is suspected:
Gold Standard: Cold Water Immersion
The fastest and most effective cooling method is placing the person in cold water.
Research consistently shows that rapid cooling saves lives.
If immersion is unavailable:
Ice towels
Ice packs to the neck, groin, and armpits
Cold-water dousing
Aggressive fanning
can all help while awaiting EMS.
Summer Takeaway
Heat illness is largely preventable.
Remember these three points:
Confusion means heat stroke until proven otherwise.
Heat acclimatization is the most effective prevention strategy.
Cool first, transport second.
Whether you’re training for a race, coaching youth sports, working outdoors, or enjoying summer with family, understanding heat illness can help keep you safe.
If you’re an athlete, coach, parent, or active adult with questions about heat safety, exercise in the heat, or return-to-play after heat illness, the team at Columbus Center for Sports & Regenerative Medicine is here to help.
