Heat Stroke Symptoms and First Aid: Staying Safe in Bangladesh's Heat

Status: Pending Qualified Medical Review. This article has not yet been reviewed by a qualified medical professional.

Summer in Bangladesh can be brutal. Rickshaw pullers, construction workers, street vendors, farmers in the field, students waiting for buses, older people in tin-roofed homes — everyone feels it. When the body cannot cool itself, heat illness can develop quickly, and heat stroke can kill.

The WHO describes heatstroke as a medical emergency with a high case-fatality rate. The good news is that heat illness is largely preventable, and fast first aid can save lives. This guide explains how to recognise heat exhaustion and heat stroke, and exactly what to do.

Heat Exhaustion vs Heat Stroke

These are two stages of heat illness. Heat exhaustion is a warning. Heat stroke is an emergency.

The NHS says heat exhaustion does not usually need emergency help if the person can cool down within 30 minutes. If it turns into heatstroke, it must be treated as an emergency.

Symptoms of heat exhaustion (NHS)

• Tiredness
• Dizziness
• Headache
• Nausea or vomiting
• Heavy sweating, with pale, clammy skin (colour change may be harder to see on brown skin)
• Cramps in the arms, legs and stomach
• A high temperature
• Being very thirsty
• Feeling irritable

Symptoms of heat stroke (NHS)

• A very high temperature
• Hot skin that is not sweating, and may look red
• Fast breathing and a fast heartbeat
• Confusion, restlessness, lack of coordination
• Seizure (fit)
• Loss of consciousness

Quick comparison

First Aid for Heat Exhaustion

The NHS recommends four steps:

1. Move them to a cool place — shade, a fan, an air-conditioned room, or a cooler indoor space.
2. Remove unnecessary clothing — such as a jacket, socks, or extra layers.
3. Give plenty of water. An oral rehydration solution (ORS) or an isotonic sports drink can also help replace salt lost in sweat.
4. Cool the skin — spray or sponge with cool water and fan them. Cold packs wrapped in cloth placed under the armpits or on the neck also help.

Stay with them. They should start to feel better within 30 minutes.

Example

Rafiq, a 40-year-old rickshaw puller in Dhaka, feels dizzy, sweaty and has leg cramps at 2 pm. A shopkeeper helps him sit in the shade, gives him ORS, wets his face and neck, and fans him. After 20 minutes he feels better. He rests for the rest of the afternoon. This was heat exhaustion caught early.

First Aid for Heat Stroke — Act Immediately

Call 999 or take the person to the nearest hospital right away if they have signs of heat stroke, including:

• Still unwell after 30 minutes of rest, cooling and fluids
• A very high temperature
• Hot skin that is not sweating
• Fast heartbeat, fast breathing or shortness of breath
• Confusion or lack of coordination
• A seizure
• Loss of consciousness

While waiting for help (NHS)

• Wrap the person in a cool, wet sheet, or fan them, or sponge them down with cold water
• If they lose consciousness, put them in the recovery position (on their side) and tell the emergency service
• Check breathing and pulse; if they show no signs of life, start CPR if you know how

Important safety points

• Do not give fluids by mouth to someone who is confused, very drowsy or unconscious — they may choke
• Do not leave them alone
• Do not drive yourself to hospital if you have symptoms — ask someone else

Who Is Most at Risk?

The WHO says vulnerability to heat depends on both body factors (age, health) and exposure (job, living conditions). The NHS advises checking on children, older people and people with long-term conditions such as diabetes or heart problems.

In Bangladesh, people at higher risk include:

• Older adults, especially those living alone
• Babies and young children
• Pregnant women
• People with heart disease, diabetes, kidney disease, high blood pressure or mental health conditions — the WHO notes heat can worsen cardiovascular disease, diabetes, asthma and mental health
• Outdoor workers — rickshaw pullers, day labourers, construction and brick-kiln workers, farmers, traffic police, delivery riders
• Garment and factory workers in hot, poorly ventilated spaces
• People living in tin-roofed homes or crowded urban areas. The WHO notes that loss of green space and materials like metal roofs increase heat exposure
• People taking certain medicines (such as some for blood pressure or mental health) — ask your doctor

How to Prevent Heat Stroke

The NHS recommends:

• Drink more fluids, especially if you are active or working
• Wear light-coloured, loose clothing
• Avoid the sun between 11 am and 3 pm
• Avoid alcohol
• Avoid extreme exercise in the heat
• On very hot days indoors, close curtains, and close windows if it is hotter outside than inside; switch off hot electrical equipment and lights

Practical tips for Bangladesh

• Carry a water bottle; do not wait until you feel thirsty
• Keep ORS packets at home, at work and in your bag in summer
• Use an umbrella or gamchha for shade and to wet and cool the neck
• If you work outdoors, take short breaks in the shade often
• Schedule hard physical work for early morning or evening
• Never leave children or older people in a parked car or closed vehicle
• Check on elderly neighbours and relatives during heatwaves
• Watch for heat alerts from the Bangladesh Meteorological Department and health advisories from DGHS

Fasting in the heat

If Ramadan falls in hot months, people with diabetes, kidney disease or heart disease should speak to a doctor about whether fasting is safe, and everyone should drink enough fluid between iftar and sehri.

Related reading: If you have heart or blood pressure problems, read about high blood pressure symptoms and home monitoring. Staying hydrated also matters for kidney stones and when fasting in Ramadan.

Frequently Asked Questions

What are the first signs of heat stroke?

Confusion, hot dry skin, very high temperature, fast heartbeat and breathing. Heat exhaustion — heavy sweating, dizziness, cramps — often comes first.

How do you cool down someone with heat stroke?

Call 999 first. Then wrap them in a cool wet sheet, fan them, or sponge them with cold water while waiting.

Can ORS help with heat exhaustion?

Yes. The NHS says oral rehydration solution can help replace salt lost through sweating.

How long does heat exhaustion take to recover?

With cooling and fluids, people usually feel better within 30 minutes. If not, treat it as heat stroke.

Is heat stroke the same as sunstroke?

"Sunstroke" is an older term for heat stroke caused by sun exposure. Treat it the same way — as an emergency.

Can children get heat stroke?

Yes. The NHS says heat exhaustion symptoms are often the same in adults and children. Children are at higher risk and need close watching.

After Heat Illness: Talk to a Doctor on ShifaMate

If you or a family member had mild heat exhaustion and has recovered, but you have questions — for example about medicines, fluids, or working safely with diabetes or high blood pressure — you can consult a verified doctor through ShifaMate. You can also browse ShifaMate doctors.

ShifaMate is not an emergency service. For any sign of heat stroke, call 999 or go to hospital immediately.

References

• NHS. Heat exhaustion and heatstroke
• World Health Organization. Heat and health (fact sheet)
• Directorate General of Health Services, Bangladesh

This article is for general information and does not replace advice from a qualified doctor.