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Hiker lying in the shade of a tree by a stream while a companion fans them with a hat

Someone becomes weak, dizzy or confused on a hike in the heat

Dizziness, weakness, headache in the blazing sun: that is heat exhaustion. If confusion appears, it is heatstroke – call for help and cool at once.

First

  1. Take a break at once: move into the shade, sit or lie down, take off the pack, loosen tight clothing.
  2. If the person is confused, talks strangely, staggers, has a seizure or becomes unconscious: this may be heatstroke – call 112 at once (in Austria 144) and start cooling immediately.
  3. Cool: wet the skin with water and fan air over it, put wet cloths on the neck, armpits and groin. If a cool stream is close, lay the legs and body in it – always supervised.
  4. Only if the person is awake and can swallow well: give small sips of water, ideally with a little salt or sugar (e.g. electrolyte powder).

Call emergency services if

  • Confusion, odd behaviour, staggering or slurred speech
  • A seizure or unconsciousness
  • Hot skin and the person does not become clearer even though you are cooling
  • Vomiting so they cannot drink
  • No clear improvement after about 30 minutes of rest and cooling
  • A child, older or ill person is affected

Emergency numbers for Austria · Change region

What is happening

A steep climb in the midday sun, little shade, not enough to drink: suddenly someone turns pale or bright red, sweats heavily, complains of headache, nausea or dizziness and can hardly go on. That is usually heat exhaustion. With a break, shade, cooling and drinking, the body generally recovers.

It becomes dangerous when the brain is affected: the person becomes confused, talks strangely, staggers, becomes aggressive or drowsy, has a seizure or loses consciousness. That may be heatstroke – a life-threatening emergency. The skin may be hot and dry, but it can also still be wet with sweat. The changed behaviour is what matters.

With heatstroke every minute counts: the faster the body temperature drops, the better the outlook. So: call for help and cool immediately, at the same time. Most effective is cool water over as much skin as possible – with moving air for evaporation or, if possible, immersion in cool water up to the neck under constant supervision.

Especially at risk are children, older people, people with heart or circulation conditions or on certain medications, people who are overweight and anyone not yet used to the heat. But young, fit people can also get heatstroke during heavy exertion.

Step by step

  1. Phase 1

    Straight away

    • Stop. Move the person into the shade or make shade (jacket, emergency blanket, tarp).
    • Pack off, loosen tight clothing, hat off, loosen shoes.
    • Sit or lie down; with dizziness raise the legs.
    • Speak to them and check: does the person know where they are? Do they answer normally? If not – call 112 / 144.

  2. Phase 2

    Cool and drink

    • Wet the skin with water – from the bottle, with wet cloths or clothing – and fan air over it vigorously.
    • Lay wet, cool cloths on the neck, armpits and groin and renew them often.
    • If a cool stream is near and the bank is safe: lay the legs and body in the water, always keep the head safely above water, never leave them alone.
    • Only if fully conscious: give small sips to drink, ideally with a little salt and sugar or electrolyte powder. Not large amounts at once.
    • If heatstroke is suspected, keep cooling continuously until the rescuers take over.

  3. Phase 3

    Afterwards

    • After heat exhaustion, end the tour. Only walk on when there is clear improvement, and then by the shortest way down – ideally in the cooler part of the day.
    • Share out the luggage, walk slowly, take frequent breaks.
    • Anyone who has had heatstroke must go to hospital – even if things seem better after cooling.
    • In the evening and the next day keep drinking enough and avoid exertion.

★ Pro tips

What experienced people do differently: proven practice from mountain rescue, fire services, lifeguards and civil protection that beginners rarely know.

  1. Put forearms in cold water

    Dip hands and forearms in a cool stream or a pot of water. Lots of blood flows close to the skin there, so it cools the body noticeably. Fire services use this during operations in the heat.

  2. Soak your hat and shirt at streams

    At every stream, dunk your hat, neck scarf or shirt and put it back on wet. Evaporation cools you as you walk. It saves drinking water and stops you slowly overheating.

  3. Emergency blanket as a sunshade, not a wrap

    Don't wrap an overheated person in an emergency blanket – it traps the heat. Rig it above them with space underneath so air can flow. Then shade and fanning work together.

  4. Use urine colour as your gauge

    Pale urine means you're drinking enough. Dark urine, or hardly needing to go while sweating heavily, means drink more, with some salt. That's more reliable than thirst, which often lags behind during exertion.

  5. Plan your route around the shade

    Check the map for south-facing slopes – that's where the sun is fiercest. Climb them early in the morning and plan your midday break in forest or by a stream. In high summer it takes the body one to two weeks to adapt properly to heat.

What to watch out for

  • Confusion is the alarm sign

    It is not skin colour or sweating that decides, but behaviour. Anyone who is confused, talks strangely or staggers needs an immediate emergency call and cooling.

  • Drinking with reduced consciousness

    Do not pour anything into a confused or drowsy person's mouth – they may choke. Cooling is then more important than drinking.

  • Too much plain water

    Anyone who drinks a great deal of plain water during long exertion but eats nothing can develop a salt deficiency. Water should go with something salty or an electrolyte drink.

  • Cooling in water – with care

    Immersion cools fastest, but only in calm, shallow water with people holding the head. Never put an unconscious person into water; pour water over them on the bank instead.

Common mistakes

  • Pushing on “just to the summit” although someone is flagging.
  • Waiting to see whether confusion improves.
  • Pouring water into a drowsy person's mouth.
  • Transporting a heatstroke patient first instead of cooling immediately.
  • Experimenting with alcohol rubs.
  • Continuing the tour as planned after heat exhaustion.

Prepare in advance

  • In hot weather start early in the morning and spend the midday hours in the shade.
  • Take enough water and check refill points (huts, springs) beforehand.
  • Pack salty snacks or electrolyte powder.
  • Light, pale clothing, sun hat and sunscreen.
  • Plan shorter, shadier tours on hot days; get used to the heat gradually.
  • Anyone on medication or with existing conditions: discuss with a doctor beforehand whether hot-weather tours are suitable.

Special consideration

Children
Children overheat faster and notice thirst late. Take regular drink breaks – for example a sip at every waymark. With children, rather turn back earlier and call for help earlier.
Older people
With age the sense of thirst weakens and the body regulates its temperature less well. Medicines such as water tablets can make this worse.

Sources

  • Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2019 Update · Wilderness & Environmental Medicine (Wilderness Medical Society), 2019
  • European Resuscitation Council Guidelines 2021: First Aid · European Resuscitation Council – Resuscitation (journal), 2021
  • International First Aid, Resuscitation, and Education Guidelines 2020 · International Federation of Red Cross and Red Crescent Societies (IFRC) – Global First Aid Reference Centre, 2020
  • Heat and health (fact sheet) · World Health Organization
  • 112 – the European emergency number · European Commission
  • Notrufnummern (oesterreich.gv.at) · Bundesministerium für Finanzen – Amtshelfer oesterreich.gv.at

Your situation

What do you notice?
Shade
Drinking water
Who is affected?

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Basics for this situation

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All rules of this situation (7)

  1. [not active] If What do you notice? = Weak, dizzy, headache, nausea – but clear-headed

    Heat exhaustion: at least one long break in the shade, cool down, drink. If there is no clear improvement after about half an hour, or it gets worse, call for help. Do not continue the tour today; descend by the shortest route in the cooler part of the day.

  2. [not active] If What do you notice? = Confused, odd behaviour, seizure or unconscious

    Heatstroke is life-threatening. Call and cool at the same time – cooling matters more than anything else until rescuers arrive. Give nothing to drink if the person is not clear-headed. Unconscious but breathing normally: recovery position, keep cooling.

  3. [not active] If Shade = Open ground, no shade

    Make your own shade: stretch an emergency blanket, jacket or tarp over poles, keep away from the hot ground (lie on the pack).

  4. [not active] If Drinking water = Almost none left

    The remaining water goes to the ill person – to drink if they are awake and to wet the skin. The others rest in the shade instead of searching for water until it gets cooler.

  5. [not active] If Drinking water = Enough with us

    Use water generously for cooling: evaporation from wet skin cools strongly, especially with a breeze.

  6. [not active] If Who is affected? = Child

    Children often notice thirst and overheating late and do not say so. Take a red face, whining or sudden tiredness seriously. Call for help earlier with children.

  7. [not active] If Who is affected? = Older or ill person

    Older people and people with heart, circulation or kidney conditions and certain medications are especially at risk. Mention conditions and medication in the emergency call.