Move promptly to cooling and escalate when mental status or perfusion is abnormal.
OCEMS source summary · Updated 2026-09-16
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.
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.