# Adult heat illness / hyperthermia

Move promptly to cooling and escalate when mental status or perfusion is abnormal.

Population: Adult / adolescent. Scope: ALS.
Status: published. Source-linked OCEMS summary.
Summary updated: 2026-09-16.
Source checked: 2026-09-16.
Source version: See the linked OCEMS source for revision and implementation dates..
Canonical page: https://www.ocmedic.com/guides/heat-illness/
Official source: [SO-E-025 — Thermal](https://www.ochealthinfo.com/sites/hca/files/import/data/files/12029.pdf)

Independent OC Medic summary. Does not replace the complete policy, current system notices, or clinical judgment.

## Key cautions & base contact

- Do not give oral fluids to someone who cannot safely protect the airway.
- Pediatric fluid doses and required base contact differ; use the pediatric thermal guide.

## Source documents

- [SO-E-025 — Thermal](https://www.ochealthinfo.com/sites/hca/files/import/data/files/12029.pdf)

## Recognize severity

- Mild/moderate features include malaise, tachycardia, nausea, or vomiting while conscious. Confusion/altered consciousness, hot dry skin, or hypotension activates the severe pathway.
- Assess the exposure, work/exertion, fluid intake, medications, mental status, and circulation. Reassess frequently for progression.

## Mild or moderate illness

- Move away from the heat to shade/cooler air with good airflow; use a fan when available.
- Encourage water or a balanced electrolyte drink without caffeine/stimulants if oral intake is safe. Use cool wet towels or cold packs as tolerated.

## Severe illness

- Check SpO₂ and provide the source’s oxygen support when room-air saturation is below 95%.
- For hypotension/poor perfusion with clear lungs/no CHF, give saline 250 mL IV and reassess; repeat to a maximum 1 L to support perfusion.
- Use available active or passive cooling, including cold packs at the axillae, posterior neck, and groin, plus airflow with appropriate skin exposure.

## Transport and reassessment

- Provide ALS escort to the nearest appropriate ERC; contact base if further stabilization orders are needed.
- Continue cooling and monitoring during transport. Report mental-status and perfusion trends, exposure, cooling methods, fluids, and treatment response.