Heat stroke

When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Last reviewed: 20 Aug 2025
Last updated: 14 Jan 2025

Summary

Definition

History and exam

Key diagnostic factors

  • profound central nervous system disturbance
  • hyperthermia
Full details

Other diagnostic factors

  • headache
  • nausea and vomiting
  • anxiety
  • dizziness
  • tachycardia
  • jaundice
  • muscle tenderness
  • hypotension
  • gastrointestinal bleeding
  • bruising and skin bleeding
Full details

Risk factors

  • older age
  • impaired cognition
  • patients unable to care for themselves
  • medications
  • people who are unacclimatized to hot environments
  • young, active people exercising intensely under hot, humid conditions
Full details

Diagnostic tests

1st tests to order

  • core temperature measurement
  • serum electrolytes
  • CBC
  • LFTs
  • metabolic profile
  • renal function tests
  • creatine kinase
  • prothrombin time, activated PPT, and INR
  • lactic acid
  • urinalysis
  • chest x-ray
  • arterial blood gas
  • medication/toxicology screen
  • thyroid function tests
  • plasma glucose
Full details

Tests to consider

  • cranial CT scan
  • lumbar puncture
  • blood culture
Full details

Treatment algorithm

ACUTE

heat exhaustion

heat stroke

Contributors

Expert advisers

James L. Glazer, MD, FACSM, CAQSM

Assistant Professor

Tufts University School of Medicine

Boston

MA

Disclosures

JLG declares that he has no competing interests.

Peer reviewers

Martin Bocks, MD

Clinical Lecturer

University of Michigan Congenital Heart Center

Ann Arbor

MI

Disclosures

MB declares that he has no competing interests.

James Milledge, MBBS

Honorary Professor

Department of Physiology

UCL

London

Divulgaciones

JM declares that he has no competing interests.

Paul Hamilton, MD

Director

Department of Emergency Medicine

Mount Sinai School of Medicine

New York

NY

Divulgaciones

PH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Eifling KP, Gaudio FG, Dumke C, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of heat illness: 2024 update. Wilderness Environ Med. 2024 Mar;35(1 suppl):112S-27.Texto completo  Resumen

Roberts WO, Armstrong LE, Sawka MN, et al. ACSM expert consensus statement on exertional heat illness: recognition, management, and return to activity. Curr Sports Med Rep. 2023 Apr 1;22(4):134-49.Texto completo  Resumen

Gauer R, Meyers BK. Heat-related illnesses. Am Fam Physician. 2019 Apr 15;99(8):482-9.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Diferenciales

    • Delirium
    • Meningitis
    • Diabetic ketoacidosis
    Más Diferenciales
  • Guías de práctica clínica

    • Wilderness Medical Society clinical practice guidelines for the prevention and treatment of heat illness: 2024 update
    • ACSM expert consensus statement on exertional heat illness: recognition, management, and return to activity
    Más Guías de práctica clínica
  • Folletos para el paciente

    Heat stroke

    Más Folletos para el paciente
  • padlock-lockedInicie sesión o suscríbase para acceder a todo el BMJ Best Practice

El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad