V. Heat Cramps, Exhaustion, Stroke

Heat Cramps 

Heat cramps are painful, involuntary muscle spasms that usually occur during heavy exercise in hot environments. Inadequate fluid intake often contributes to heat cramps. The spasms may be more intense and more prolonged than typical nighttime leg cramps. Muscle most often affected include those in your calves, arms, abdomen and back, although heat cramps may involve any muscle group involved in the exercise. 

If you suspect heat cramps: 
  • Rest briefly and cool down
  • Drink clear juice or an electrolyte-containing sports drink 
  • Practice gentle, range-of-motion stretching and gentle massage of the affected muscle group
  • If your cramps don’t go away in 1 hour, call your doctor

Heat Exhaustion 

Signs and symptoms of heat exhaustion often begin suddenly, sometimes after excessive exercise, heaving perspiration and inadequate fluid intake. Signs and symptoms resemble those of shock and may include: 
  • Feeling faint
  • Nausea
  • Ashen appearance
  • Rapid, weak heartbeat
  • Low blood pressure
  • Cool, moist skin
  • Low-grade fever

If you suspect heat exhaustion: 
  • Get the person out of the sun and into a shady or air-conditioned location. 
  • Lay the person  down and elevate the legs and feet slightly. 
  • Loosen or remove the person’s clothing. 
  • Have the person drink cool water, not iced, or a sports drink containing electrolytes
  • Cool the person by spraying or sponging him or her with cool water and fanning.
  • Monitor the person carefully. Heat exhaustion can quickly become heatstroke. If fever greater than 102 F, fainting, confusion or seizures occur, dial 911 or call for emergency medical assistance. 


Heatstroke is similar to heat cramps and heat exhaustion. It’s one of the heat-related problems that often result in heavy work in hot environments, usually accompanied by inadequate fluid intake. Older adults, people who are obese and people born with impaired ability to sweat are at high risk of heatstroke. Other risk factors include dehydration, alcohol use, cardiovascular disease and certain medications. 

What makes heatstroke much more severe and potentially life-threatening is that the body’s normal mechanisms for dealing with heat stress, such as sweating and temperature control, are lost. The main sign of heatstroke is markedly elevated body temperature—generally greater than 104 F—with changes in mental status ranging from personality changes to confusion and coma. Skin may be hot and dry, although in heatstroke caused by exertion, the skin is usually moist. 

Other signs and symptoms my include: 
  • Rapid heartbeat
  • Rapid and shallow breathing
  • Elevated or lowered blood pressure 
  • Cessation of sweating 
  • Irritability, confusion or unconsciousness 
  • Fainting, which may be the first sign in older adults

If you suspect heatstroke: 
  • Move the person out of the sun into a shady or air-conditioned space. 
  • Dial 911 or call for emergency medical assistance
  • Cool the person by covering him or her with damp or by spraying with cool water. Direct air onto the person with a fan or newspaper.