How to Survive Heat Injuries

June 23, 2013 by | Be the first to comment »

We are entering another summer and that means a greater risk of heat injuries, ranging from minor annoyances like sunburn, to medical emergencies like heat stroke. This risk is especially significant for those of us in warmer areas, like desert or tropical environments.

Common sense and preparation can go a long way in preventing heat injuries in the first place, and basic first aid knowledge can help you survive them if they do occur—most heat injuries can usually be treated successfully in the field with basic techniques and supplies.

Preventing Heat Injuries


We had a saying in the Marine Corps: “The more you sweat in training, the less you bleed in battle.” This concept applies to activity in hot weather as well; if you spent all spring watching reruns of The Golden Girls in your La-z-boy with the AC cranked down to 70°, you need to take some time building up your tolerance to the heat of summer before you go off on a 10–mile hike. Whenever we deployed to the desert, we would often spend the first week at base camp getting acclimatized to the heat with physical labor, light physical training, hand-to-hand combat, etc., and add to our workload over time. In relatively short order, our unit could operate at full capacity, conducting fire and maneuver operations in full gear, 20+ mile forced marches with packs in excess of 80 pounds, and maintaining defensive positions from dawn to dusk, with no shade in 130°+ temperatures. You can do the same thing. Spend your first week getting used to the heat in relative safety by working in your yard, taking short walks, and engaging in other limited outdoor activities, then as you become more comfortable, increase your physical demands. Before long, you’ll be able to hike miles into a swamp or desert and back with little effort.


Our bodies regulate temperature through evaporative cooling; when our core temperature reaches a certain point, we begin sweating, which then evaporates—a chemical reaction that causes a cooling effect. The fluid lost through sweating and urinating must be replaced. The average person needs to drink a minimum of between 2.25–3.25 quarts of water per day. In a hot environment, that number increases dramatically. A simple way to tell if you’re drinking enough water is to monitor the color of your urine—it should be nearly clear. Below is a general guideline for maintaining hydration at various temperature ranges, under various working conditions:

Easy Work Moderate Work Hard Work
Tempurature Water Intake (Quarts/Hour) Water Intake (Quarts/Hour) Water Intake (Quarts/Hour)
78°–81.9° ½ ¾
82°–84.9° ½ 1
85°–87.9° ¾ 1
88°–89.9° ¾
90°+ 1

Cover up

It may seem counterintuitive to wear long clothing in a hot environment, but think about all the nomads you’ve seen in magazines wandering the deserts dressed in flowing robes and head wear. It’s not a fashion statement—it’s something learned over thousands of years of living in the desert. The purpose it two-fold; it protects you from the Sun’s burning UV rays, helping to prevent sunburn, and it helps your body retain critical fluids. Your sweat is absorbed into your clothing, allowing it to evaporate more slowly, thus cooling you for longer.

You can also soak a scarf or other cloth in water and wear it over the back of your neck. It will block the sun from your neck, and as the water evaporates, it will cool the blood passing through the veins and arteries in your neck, thus cooling your body.

Any exposed skin should be doused with sunblock—at least SPF 15, but I recommend much higher, especially if you’ll be outdoors for an extended period of time.


Most of us—especially men—like to think of ourselves as invincible superheros who can endure anything. I hate to break the news, but none of us are. Even in the Marine Corps, we would occasionally take breaks and we were in peak physical condition. You need to do the same—especially in a hot environment. Try to take a break at least once an hour.

Shut your pie hole

Seriously, close your mouth. Aside from making you look dumb, walking around with your mouth agape like some club-dragging Neanderthal will speed up dehydration because your mouth and throat are mucus membranes, so as they dry out, your body will send more fluids to keep them moist. To make matters worse, a dry mouth and throat will make you feel even thirstier than you really are.

Wear sunglasses

It’s easier than you think to burn your retinas, and once that happens, you’re stuck where you are unless someone comes to save your ass.

Treating Heat Injuries

No amount of diligence will prevent all heat injuries, so you need to know how to treat them if they arise. There are several types, but fortunately, most are simple to treat, even in the field with minimal supplies.

The first two injuries I’m going to talk about, sun burn and sun blindness, are not specifically “heat injuries” but are warning signs that true heat injuries may be on the way.


I think it’s safe to say we’ve all experienced this at least once in our lives. Treatment is simple: avoid rubbing the affected area, gently apply a salve, such as aloe vera, drink plenty of water, and take a pain reliever such as Acetaminophen, ibuprofen, naproxen or aspirin. Those with anti inflammatory properties, like ibuprofen are ideal. Then refer to my earlier suggestion and cover up to avoid additional damage.

Sun blindness

Sun blindness is basically sun burn on your retinas. First of all, know that this will bring a level of pain that you cannot possibly imagine. Severe cases feel like having coarse sand poured into your eyes and rubbed around. I know this because I once made the mistake of briefly welding without a mask. That 30–second exposure burned the hell out of my retinas, and when the pain kicked in later that evening, my eyes were clamped firmly shut while my tear glands pumped non-stop. This went on until the following morning. A day in extreme sunlight without proper protection can have the same effect.

As with sunburn, take a pain reliever such as Acetaminophen, ibuprofen, naproxen or aspirin. Then, cover your eyes and sit tight until you’ve recovered. If you find yourself in a situation where you don’t have sunglasses, you can improvise a pair by cutting two slits in any opaque material that you can attach to your face, as in the illustration below. Will you look stupid? Absolutely, but not nearly as stupid as you’ll look wandering around blindly bumping into trees, rocks, and stumbling off cliffs.

Improvised Sunglasses

Heat cramps

This is most easily identified by painful cramps in your larger muscle groups, like your legs, arms, or abdomen, and is caused by extended physical activity and excessive loss of electrolytes from heavy sweating.

Treatment is simple: rest, rehydrate, and replenish your electrolytes. The first two steps are self-explanatory and the third is equally simple. You can replenish your electrolytes with a 0.1% oral salt solution (½ teaspoon of salt to 1 quart of water), a sports drink like Gatorade, or even an MRE or other salty food. A massage will improve circulation and help to loosen the muscles up, while speeding reintroduction of fluids and electrolytes to the affected area, and if possible seek out shade.

Heat exhaustion

Symptoms include an elevated temperature, heavy sweating, headache, lightheadedness, nausea/vomiting, and tingling sensations. Heat exhaustion, like heat cramps, is caused by dehydration and excessive loss of electrolytes, but it’s far more serious because it can quickly lead to a heat stroke.

The treatment for heat exhaustion is similar to heat cramps—rest, rehydrate, and replenish your electrolytes; the main difference is the volume and rate at which you rehydrate. You still need to replenish your electrolytes with a 0.1% oral salt solution (½ teaspoon of salt to 1 quart of water), a sports drink like Gatorade, or an MRE or other salty food, but you also need to take in 1–2 liters of fluid over 2–4 hours. Ideally, you should seek professional medical care as soon as possible, even if you feel fine after recovering.

Heat stroke

A heat stoke is the most serious heat injury as it can cause permanent damage and even death. Symptoms can include an elevated temperature, absence of sweating, central nervous system disturbances, brain damage, kidney failure, liver failure, and blood clotting abnormalities.

Treating a heat stroke quickly is critical to survival. Often, victims of heat stoke will be unconscious, so they should be turned on their side in case they vomit to prevent choking. Intravenous solution should be administered to rehydrate. Remove clothing and lower the body temperature as quickly as possible by dousing with cool water and fanning, or even placing ice packs in the groin, armpits, and/or behind the neck. Seek immediate professional medical care as soon as possible.

Melanie Swick (a.k.a. Survival Chick) grew up wanting to be a rocket scientist, but when she realized she that required way too much math, she took to her second dream—spending time in the wilderness. Today, when she's not hiking, camping, or hunting, she's blogging about it. You can connect with Melanie on Facebook.

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