Chart — Emergency Nursing
Heat Exhaustion vs Heat Stroke Chart
One finding sorts these two: mental status. A clear-headed, sweaty, weak patient has heat exhaustion; an altered patient with a soaring core temperature has heat stroke — and needs cooling now.
Educational use only. Heat stroke is a medical emergency. Cooling methods and complication management follow provider orders. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Side by Side
| Feature | Heat exhaustion | Heat stroke |
|---|---|---|
| Core temperature | Normal to mildly elevated (< 40°C / 104°F) | > 40°C (104°F) |
| Mental status (KEY) | Intact — alert, oriented | ALTERED — confusion, seizures, coma |
| Skin | Pale, cool, clammy | Hot; DRY (classic) or sweaty (exertional) |
| Sweating | Heavy/profuse | Often absent (classic); may persist (exertional) |
| Other signs | Weakness, headache, nausea, dizziness, tachycardia, orthostasis | Tachycardia, hypotension, tachypnea; organ dysfunction |
| Severity | Urgent — can progress to heat stroke | Life-threatening emergency |
| Treatment | Cool environment, rest, external cooling, oral/IV rehydration | RAPID active cooling, IV fluids, ABC support; stop cooling ~38–39°C; NO antipyretics |
Exam Traps
- ✦ALTERED mental status + high core temp = heat stroke (emergency); intact mentation = heat exhaustion.
- ✦Classic heat stroke = hot, DRY skin; exertional may still sweat — don't let sweating fool you.
- ✦Heat stroke priority = rapid active cooling; stop ~38–39°C; antipyretics DON'T work.
- ✦Use a core (rectal) temperature, not oral or axillary.
- ✦Heat exhaustion can progress to heat stroke — reassess mental status.
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with Emergency Nurses Association (ENA) · AHA ACLS / PALS Guidelines · Advanced Trauma Life Support (ATLS). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →