In the summer of the Kingdom of Saudi Arabia, where temperatures reach over 50 degrees Celsius in some areas, the risk of heatstroke and heat exhaustion is at its peak. Do you know the difference between them? And do you know how to act if one of your family members suffers from heatstroke? This comprehensive guide provides you with everything you need to know about heatstroke and heat exhaustion — symptoms, first aid, prevention methods, and when to go to the hospital immediately — based on information from Mayo Clinic, CDC, and the World Health Organization (WHO).

What is the difference between heat exhaustion and heatstroke?

Heat exhaustion and heatstroke are two different stages of heat-related illnesses, with heatstroke being the most dangerous. Understanding the difference between them can save a person’s life:

Heat Exhaustion

This is the first stage of the negative impact of heat on the body. It occurs when the body loses large amounts of water and salts due to excessive sweating. If not treated immediately, it may develop into dangerous heatstroke. Its symptoms include heavy sweating, pale skin, general weakness, dizziness, headache, nausea, and rapid heartbeat.

Heatstroke

According to Mayo Clinic, heatstroke is a life-threatening medical emergency that occurs when the body’s core temperature rises to 40 degrees Celsius (104 Fahrenheit) or higher. At this stage, the body loses its ability to regulate its temperature. The most dangerous symptoms include changes in mental state (confusion, delirium, seizures), dry and flushed skin (with sweating stopping), rapid breathing, and a fast heartbeat. Without immediate treatment, the brain, heart, kidneys, and muscles can be damaged quickly, and it may lead to death.

Causes and Risk Factors

Causes of heatstroke and heat exhaustion, according to Mayo Clinic:

  • Exposure to a hot environment: Staying in a hot and humid environment for a long time, especially during the peak of the Saudi summer (noon and afternoon)
  • Strenuous physical activity in the heat: Working under direct sunlight or exercising in very hot weather, especially for those not accustomed to the heat
  • Wearing heavy clothing: Prevents sweat from evaporating and naturally cooling the body
  • Dehydration: Not drinking enough water to compensate for fluids lost through sweating
  • Consuming alcohol: Affects the body’s ability to regulate its temperature

Factors that increase the risk of heat-related illnesses:

  • Age: Young children (whose central nervous system is not fully developed) and people over 65 are the most vulnerable
  • Chronic health conditions: Heart disease, diabetes, and obesity increase the body’s sensitivity to heat
  • Medications: Some blood pressure medications, diuretics, and antidepressants may affect the body’s ability to adapt to heat
  • Sudden exposure to heat: Not giving the body enough time to acclimate to rising temperatures (Acclimatization)

Symptoms — How to Differentiate Between the Two Conditions

Symptoms of Heat Stress (need immediate intervention to prevent progression to heat stroke):

  • Excessive sweating
  • Pale, cool, and moist skin
  • General weakness and severe fatigue
  • Dizziness and lightheadedness
  • Mild to moderate headache
  • Nausea or vomiting
  • Rapid heart rate
  • Dark urine (sign of dehydration)
  • Mild muscle cramps

⚠️ Symptoms of Heat Stroke (medical emergency — call for emergency services immediately):

  • Body temperature rises to 40°C or higher
  • Change in mental status or behavior: confusion, agitation, slurred speech, delirium, seizures, coma
  • Hot, dry, and red skin: with cessation of sweating in non-exertional heat stroke
  • Rapid and shallow breathing
  • Severe tachycardia
  • Severe nausea and vomiting
  • Severe pounding headache

Important note: in exertional heat stroke, sweating may continue profusely, so do not rely on cessation of sweating as the only sign!

First Aid — What to Do Immediately?

In case of heat stress:

  1. Move the person to a cool, shaded area or an air-conditioned space immediately
  2. Have them lie down and elevate their feet slightly
  3. Remove excess and heavy clothing
  4. Cool the body with cold compresses on the neck, armpits, and groin, or spray the body with lukewarm water while fanning
  5. Have the person drink cool water or a sports drink (in small, frequent amounts)
  6. If symptoms do not improve within 30 minutes, or if they worsen, seek medical help immediately

⛑️ In case of heat stroke (emergency — call for emergency services immediately):

  1. Call emergency services (997) or go to the nearest emergency room — every minute of delay increases the risk of organ damage
  2. While waiting for emergency services, move the person to a shaded or air-conditioned area immediately
  3. Remove as much of the person’s clothing as possible
  4. Cool the body by any available means: immerse the person in a cool water bath if possible, or use a hose, or place ice packs and cold, wet cloths on the head, neck, armpits, and groin
  5. If the person is conscious, offer them cool water
  6. Do not give any medications to lower the temperature (such as paracetamol) — they are not effective in heat stroke and may cause complications
  7. Do not give fluids if the person is unconscious or having seizures

5 Practical Tips for Prevention in Saudi Summer

  1. Avoid going out during peak hours: stay away from direct sun exposure between 11 am and 4 pm — these are the hottest periods in the Kingdom. Plan your outdoor activities in the early morning or after sunset
  2. Drink water regularly, even if you don’t feel thirsty: thirst is a late sign of dehydration. Drink at least 8-10 cups of water per day in the summer, and increase the amount if you work or exercise outdoors
  3. Wear clothes made of
  4. Clothing: Choose light-colored, loose cotton clothing that allows air to circulate. Wear a wide-brimmed hat and sunglasses. Don’t forget sunscreen (SPF 50+) on exposed areas.
  5. Reduce physical activity in the heat: If you must work or exercise outdoors, take a 15–20-minute break every 15–20 minutes in the shade or an air-conditioned space, and drink cold water. Gradually acclimate to the heat over one to two weeks.
  6. Never leave anyone in a parked car: Even with windows slightly open, a car’s temperature can rise rapidly to deadly levels. Never leave children, the elderly, or pets inside—even for a few minutes.

    7. Myth vs. Fact

    Myth: Heatstroke only happens in direct sunlight.
    Fact: Heatstroke can occur even in the shade or indoors in un-air-conditioned spaces if temperature and humidity are high. Older adults and those without air conditioning are most at risk.

    Myth: Drinking coffee or soda helps cool the body in the heat.
    Fact: Caffeinated drinks (coffee, tea, energy drinks) and sugary sodas increase dehydration because they are diuretics. The best drink in the heat is plain water or sports drinks to replace lost salts.

    Myth: Fever reducers treat heatstroke.
    Fact: Heatstroke is different from fever caused by infection. Medications like paracetamol or ibuprofen do not treat heatstroke and may cause serious complications such as liver or kidney damage. The only correct treatment is rapid physical cooling of the body.

    Frequently Asked Questions (FAQ)

    Q: How can I tell if someone has heatstroke rather than just heat exhaustion?
    A: The key difference is mental status changes. If the person is confused, unable to speak clearly, delirious, or has a body temperature of 40°C (104°F) or higher—this is heatstroke and requires immediate medical attention. Heat exhaustion does not cause altered consciousness.

    Q: How long does it take the body to acclimate to summer heat (acclimatization)?
    A: The body typically needs 7 to 14 days of gradual heat exposure to adapt. During this period, sweating becomes more efficient and starts earlier, salt concentration in sweat decreases, and skin blood circulation improves. Be especially cautious during the first two weeks of summer or when traveling to a hotter region.

    Q: Is it permissible to fast during Ramadan in the summer when temperatures are high?
    A: Fasting during hot summer days is generally safe for healthy individuals, but it’s important to drink plenty of water between iftar and suhoor and avoid direct sun exposure during daylight hours. Medical fatwas advise older adults and people with chronic conditions (diabetes, heart or kidney disease) to consult a doctor before fasting in extreme heat; breaking the fast may be necessary to protect health. Islam grants dispensation to fast for the ill and travelers.

    Sources: Mayo Clinic — Heatstroke | CDC — Extreme Heat | World Health Organization (WHO) — Heat and Health | NHS UK | Ministry of Health, Saudi Arabia

    Note: This article is for educational purposes only and does not replace professional medical advice.

    Consult the specialist doctor. In emergencies, call the ambulance at 997 or go to the nearest emergency center immediately.