Nevada’s sweltering summer heat can make staying cool a challenge, and prolonged exposure to high temperatures can pose serious health risks, including heatstroke. David Benaron, M.D., vice chair of Emergency Medicine, explains how heatstroke develops, the warning signs to watch for and what to do if someone experiences heatstroke.

What does heatstroke look like?  

“People expect heatstroke to look like someone drenched in sweat begging for water. What actually walks through my emergency room doors is different. The most surprising sign of heatstroke is a personality change. I've had families bring elderly patients who started cursing at them and behaving strangely, something they'd never done before. They thought it was a stroke. It was heat.” 

What are the effects of a heatstroke? 

“The brain fails early when core temperature passes 104°F. Overheated brain cells misfire, and you get confusion, slurred speech, staggering, strange behavior, and sometimes hallucinations or seizures. Here in Nevada, I've seen lost patients found wandering off trail and arguing with rescuers who were trying to help them. The victim's own judgment is gone, so they rarely recognize the danger themselves. Somebody else has to notice.” 

What is the most unexpected sign of heatstroke? 

“An unexpected sign of heatstroke is dry skin. In severe cases, the sweating mechanism shuts down completely. No sweat on a 105-degree day is alarming, not reassuring. But plenty of patients, especially athletes and outdoor workers, are still sweating when heatstroke hits, so never rule it out just because someone's damp.” 

How is heatstroke different from heat exhaustion or dehydration? 

“Heat exhaustion makes you feel terrible, weak, nauseated, dizzy and sweaty. But your thinking stays clear. Rest, shade and fluids turn it around. Dehydration is just water loss and often rides along with both heat exhaustion and heatstroke. The dividing line is the mind. Once thinking changes, it is heatstroke, and people can die from it.” 

In the event of heatstroke, what is the best protocol? 

“If someone in the heat seems confused, aggressive, or just not themselves, call 911. Don't wait to see if they perk up. Get them to shade, strip extra clothing, soak them with water, put ice packs at the neck, armpits and groin, and fan them. Cooling in those first minutes saves lives.”