Heat stroke is a medical emergency. If someone working in the heat becomes confused, starts slurring, collapses or has a seizure, call triple zero (000) and start cooling them straight away. Heat stroke happens when the body’s core temperature rises so high, usually above about 40°C, that its cooling system fails. It can damage the brain and other organs, and it can kill. It is also preventable, and fast cooling saves lives.
Signs of heat stroke
- confusion, odd behaviour or not making sense;
- slurred speech, staggering or poor coordination;
- hot skin, which may be dry or still sweaty;
- a fast pulse and fast, shallow breathing;
- headache, vomiting, fainting or extreme tiredness; and
- a seizure, collapse or loss of consciousness.
Do not wait for the person to stop sweating. Many people still believe heat stroke always means hot, dry skin. The Australian resuscitation guidelines (ANZCOR) say a lack of sweating is a sign of serious illness, but is only seen in some of the more serious cases. Confusion in the heat is the red flag.
Heat exhaustion or heat stroke?
Heat exhaustion usually comes first. The person has heavy sweating and pale skin, and feels dizzy, faint, weak or very tired, often with a headache, nausea or vomiting and a fast, weak pulse. They are still thinking clearly. Heat exhaustion can turn into heat stroke if it is not treated. Once the person’s thinking or behaviour changes, treat it as heat stroke.
For both, the code of practice says to give immediate help if a worker has dizziness, fatigue, headache, nausea, breathlessness, clammy skin or difficulty staying alert.
First aid for heat stroke
This is general information and does not replace first aid training. Follow your first aider and the triple zero operator.
- Call 000 now, and send for your first aider.
- Start cooling straight away. Do not wait for the ambulance. Move the person out of the sun to the coolest place you can, and take off their hard hat, PPE and extra clothing.
- Cold water immersion is best. If you can, put them in cold water up to the neck (a bath, trough or tub).
- Otherwise, soak them with cold water and fan them hard, and put ice or cold packs on the neck, armpits and groin.
- Drinks only if they are fully conscious and able to swallow. Never give fluids to someone who is confused, drowsy or vomiting.
- If they are unresponsive, put them in the recovery position. If they are not breathing normally, start CPR.
- Keep cooling until the ambulance arrives, or until they start to shiver, and stay with them.
Do not give paracetamol, aspirin or other medicines unless a doctor or the ambulance service tells you to. Cooling is the treatment.
Who is most at risk?
- people doing heavy physical work in hot or humid conditions, in direct sun or near hot plant and surfaces;
- people in heavy or sealed PPE, such as coveralls, respirators and chemical suits;
- new starters and people back from leave who have not built up to the heat;
- people who are dehydrated, unwell (especially with a fever), or have had heat illness before; and
- people taking some medicines or with some health conditions. Talk to your doctor if you are not sure.
How to prevent heat stroke at work
Plan the hot work for the cooler parts of the day, cut the physical effort with mechanical aids, provide shade, fans or air-conditioning, cool drinking water and a cool place for breaks, bring new workers up to the heat gradually, and train everyone to spot the early signs in themselves and their workmates. Our guide to managing heat stress at work covers prevention in detail and has a free A3 poster to download.
Your duties in hot working environments
- A PCBU must ensure, so far as is reasonably practicable, that workers carrying out work in extremes of heat can do so without risk to their health and safety (section 40 of the Work Health and Safety Regulation 2011 (Qld)), as part of the primary duty of care in section 19 of the Work Health and Safety Act 2011 (Qld).
- There is no set temperature at which work must stop. Each business needs to assess its own heat risks: the conditions, the work and the people.
- The approved Managing the Work Environment and Facilities Code of Practice 2021 says to remove or reduce exposure first, for example with fans, air-conditioning, insulation, mechanical aids and moving work to cooler times. Water, rest breaks, a slower pace, light clothing and training help, but are least effective on their own.
- Workers must be trained to recognise the early symptoms of heat-related illness in themselves and others and to report problems straight away.
- First aid equipment and trained first aiders, or access to them, must be provided (section 42 of the Regulation), and the emergency plan (section 43) should cover heat stroke.
- A heat illness that needs immediate treatment as an in-patient in a hospital is a notifiable incident. The business must notify Workplace Health and Safety Queensland immediately (sections 35, 36 and 38 of the Act).
Our heat stress policy template and heat stress and working outdoors SWMS set this out ready to adapt, and the first aid policy template covers your first aid arrangements.
This is general information, not legal or medical advice. Check the current law or talk to Workplace Health and Safety Queensland for your situation, and follow first aid training and triple zero (000) instructions in an emergency.
This Post Is Part Of A Series: 101 Toolbox Topic Ideas For The Construction Industry
Do you struggle to come up with toolbox talk ideas each week to discuss with your workers? Fear no more, Work Safety QLD is here to the rescue with 101 Free Toolbox Talk Ideas for the Construction Industry.
Templates for this job
Ready-to-edit Word and Excel templates for Queensland workplaces.
