Medical Lane
M4

HEAT INJURY

5 min (identify) 5 min (treat heat stroke)

Conditions: You see a Soldier who appears to be suffering from a heat injury. Casualty is responsive but confused. On a FOB, non-CBRNE.

Understanding This Task

This is a two-part task: written identification of all three heat injuries (signs, symptoms, and treatments), then a hands-on treatment of heat stroke. Heat stroke is a medical emergency — begin cooling immediately, even before removing clothes.

Key thresholds: Heat exhaustion = up to 104°F. Heat stroke = above 106°F within 15 minutes, with hot/dry skin and confusion.

Common NO-GO Mistakes

  • At least 3 correct signs/symptoms for heat exhaustion and heat stroke
  • 100% accuracy for heat cramps identification
  • Failing to request MEDEVAC for heat stroke
  • Not beginning aggressive cooling immediately

Task Basis: 081-000-0016

ATP 4-02.11 Doctrine

From Army Techniques Publication 4-02.11, 23 March 2026 — Chapter 17: Climatic and Environmental Injuries

Heat cramps and heat exhaustion (para 17-13): Heat exhaustion is often preceded by heat cramps — muscle cramps of the arms, legs, or abdomen. These conditions act as early indicators. Identify and treat before they progress to heat stroke: rest, water, shade, evaluation, and possible medical care. Heat exhaustion signs include heavy sweating, pale/cool/clammy skin, weakness, dizziness, headache, muscle cramps, elevated heart rate, and nausea. Temperature may be elevated but typically remains below 104°F (40°C).

Heat exhaustion treatment (para 17-10): Move to a cooler environment. Have the casualty lie down and elevate legs slightly. Provide cool water or electrolyte drink. Loosen or remove tight or unnecessary clothing. Apply a cool wet cloth to the skin, especially on the neck, face, and armpits. Use a fan to aid evaporation. If no improvement within 30 minutes or condition worsens, seek medical assistance immediately — heat exhaustion can progress to heat stroke.

Heat stroke — medical emergency (para 17-14, 17-15): Heat stroke is characterized by a rapid rise in body temperature above 104°F (40°C), often with hot dry skin (lack of sweating), altered mental state, difficulty breathing, seizures, and rapid strong heartbeat. Reduce body temperature as quickly as possible: immerse in cold water, apply cold water with wet towels, fan while misting. Apply ice/cold packs to neck, axilla (armpit), and groin — these sites allow rapid cooling of major blood vessels. Call for MEDEVAC immediately. Monitor vital signs continuously.

Source: ATP 4-02.11, Chapter 17, para 17-9 through 17-17

Critical Notes
  • Heat stroke is a MEDICAL EMERGENCY — begin cooling IMMEDIATELY.
  • 100% accuracy for heat cramps. At least 3 correct for exhaustion and stroke.
  • Always request MEDEVAC for heat stroke.

PERFORMANCE MEASURES

0/4 GO
  1. 1

    Identify: Heat Cramps

    • Signs: Muscle cramps of arms, legs, and/or abdomen.
    • Treatment: Move to shade and rest. Loosen clothing. Oral rehydration.
  2. 2

    Identify: Heat Exhaustion

    • Signs: Profuse sweating, pale/gray/moist/cool skin. Headache. Weakness. Dizziness. Temperature up to 104°F.
    • Treatment: Move to shade. Oral rehydration (unless nauseated). Loosen/remove clothing and boots. Pour water and fan. Cover with ice sheet, elevate legs.
  3. 3

    Identify: Heat Stroke CRITICAL

    • Signs: Core temperature above 106°F within 15 min. Hot, dry skin. Headache. Dizziness. Nausea. Confusion. Weakness. Weak/rapid pulse and respirations.
    • Treatment: Call for evacuation. Cool by ANY means available (even before removing clothes). Remove outer garments. Lay down, elevate legs. Ice sheets/packs to groin, armpits, neck. Immerse in cold water if available. Cover all but face with soaked ice sheet. Evacuate.
  4. 4

    Treat for heat stroke (hands-on)

    • Call for evacuation (verbalize).
    • Begin aggressive cooling immediately.
    • Remove outer garments and protective clothing.
    • Lay casualty down, elevate legs.
    • Apply ice packs to groin, armpits, and around neck.
    • Immerse in cold water if available.
    • Cover all but face with soaked ice sheet.
    • Evacuate (verbalize).

Go Deeper — ATP 4-02.11 Reference

Detailed doctrine from the Army Techniques Publication: