Heat stroke is a less common but far more serious condition than heat exhaustion, since it carries a 20 percent fatality rate. The main feature of heatstroke is the extremely high body temperature, 105º F (41º C) or higher, that accompanies it. In heat stroke, the victim has a breakdown of the sweating mechanism and is unable to eliminate excessive body heat built up while exercising. If the body temperature rises too high, the brain, kidneys, and liver may be permanently damaged.
Sometimes the victim may have preliminary symptoms, such as headache, nausea, dizziness, or weakness. Breathing will be deep and rapid at first, later shallow and almost absent. Usually the victim will be flushed, very dry, and very hot. The pupils will be constricted (pinpoint) and the pulse fast and strong.
When you provide first aid for heat stroke, remember that this is a true life-and-death emergency. The longer the victim remains overheated, the higher the chances of irreversible body damage or even death occurring. First aid treatment for heat stroke is designed to reduce body heat. Reduce body heat immediately by dousing the body with cold water, or applying wet, cold towels to the whole body. Move the victim to the coolest possible place and remove as much clothing as possible. Maintain an open airway. Place the victim on his/her back, with the head and shoulders slightly raised. If cold packs are available, place them under the arms, around the neck, at the ankles, and in the groin. Expose the victim to a fan or air-conditioner since drafts will promote cooling. Immersing the victim in a cold water bath is also effective. Give the victim (if conscious) cool water to drink. Do not give any hot drinks or stimulants. Get the victim to a medical facility as soon as possible. Cooling measures must be continued while the victim is being transported.