Heat stroke is a medical emergency — not a home remedy situation. If someone has stopped sweating, has very hot skin, is confused, or has lost consciousness in the heat, call Rescue 1122 (or 115) immediately, move them to shade, and cool them with wet cloths on the neck, armpits, and groin while you wait.
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Heat stroke occurs when the body's ability to regulate its own temperature fails and core body temperature rises above 40°C. Unlike heat exhaustion — which causes heavy sweating, weakness, and dizziness but rarely leads to unconsciousness — heat stroke is a medical emergency that can cause damage to the brain, kidneys, heart, and other organs if not treated immediately.
In Pakistan, heat stroke is a serious seasonal concern, particularly in southern Punjab, Sindh, and arid regions including Bahawalpur, Rahim Yar Khan, Multan, and Jacobabad. Summer temperatures in these areas regularly exceed 45°C and the hot, dry wind locally known as "Lo" (لُو) significantly increases risk, particularly during May and June.
There are two recognised types. Classic (non-exertional) heat stroke typically affects elderly individuals, people with chronic illness, or those unable to keep themselves cool during a heat wave. Exertional heat stroke affects younger, otherwise healthy people engaged in intense physical activity in the heat — outdoor labourers, farmers, construction workers, and athletes.
Both types are medical emergencies. Anyone suspected of having heat stroke must receive emergency medical attention as quickly as possible — not home remedies, not traditional treatments, and not rest alone.
Call Rescue 1122 (in Punjab) or 115 (national) IMMEDIATELY — do not delay to attempt home treatment
Move the person to shade, a cool room, or air-conditioned space without delay
Remove excess clothing to allow heat to escape from the skin
Apply cool (not ice-cold) wet cloths to the neck, armpits, and groin — these areas carry blood vessels close to the skin
Fan the person to increase evaporative cooling if possible
Do NOT give water or any fluid to someone who is confused or unconscious — this can cause choking or aspiration
Do NOT give paracetamol, aspirin, or other fever medicines — these are not effective for heat stroke and may cause harm
Stay with the person and monitor their breathing until emergency services arrive
Active heat stroke is treated by emergency medical services and hospital care — physiotherapy has no role during the acute phase of heat stroke management. However, once a patient has been medically treated and cleared by their doctor for discharge and rehabilitation, physiotherapy supports recovery in several important ways.
Gradual Return to Physical Activity — Some heat stroke survivors, particularly those who experienced exertional heat stroke, develop prolonged heat intolerance and reduced exercise capacity. A physiotherapist can design a structured, progressive return-to-activity programme that rebuilds physical capacity safely while avoiding conditions that could trigger a recurrence.
Strength and Endurance Rehabilitation — Hospitalisation and reduced activity can lead to muscle weakness and reduced cardiovascular fitness. A physiotherapist can address this with a progressive exercise programme appropriate to the patient's recovery stage and overall health.
Heat Acclimatisation Guidance — For patients returning to outdoor work or physical training, a physiotherapist can provide supervised acclimatisation guidance — structured exposure to heat at increasing intensity to help the thermoregulatory system adapt.
Education and Prevention — A physiotherapist can educate patients on recognising the early warning signs of heat illness, safe exercise timing (avoiding peak heat hours of 11 AM to 4 PM in summer), fluid intake guidance, and appropriate workwear — significantly reducing the risk of future episodes.
If you are looking for help supporting a patient who has already been discharged from hospital after heat stroke, speak to your treating doctor first, then WhatsApp RehabNow at +923175091390 to discuss what physiotherapy support is appropriate.
Heat stroke recovery timelines vary widely depending on the severity of the episode, how quickly cooling began, the patient's age and baseline health, and whether there was any organ involvement during the acute phase. Some individuals recover fully within days of discharge from hospital. Others experience fatigue, reduced exercise tolerance, or heat intolerance that persists for weeks or months after the episode.
No specific recovery timeline can be stated for individuals without clinical assessment by the treating medical team. All heat stroke survivors should receive medical clearance before resuming physical activity or returning to outdoor work. Your doctor and, subsequently, your physiotherapist will guide a safe return to activity at a pace appropriate to your specific recovery.
Yes. Heat stroke — particularly when it involves confusion, loss of consciousness, or body temperature above 40°C — is a medical emergency requiring urgent hospital treatment. Call Rescue 1122 in Punjab or 115 anywhere in Pakistan. Do not attempt to manage heat stroke at home with rest, traditional remedies, or over-the-counter medicines.
Heat exhaustion causes heavy sweating, weakness, a fast but weak pulse, headache, and nausea — the person is usually still conscious and responsive. With rest in a cool place and careful fluid intake, many cases of heat exhaustion can be managed. Heat stroke is far more serious: the person may stop sweating despite extreme heat, develop a rapid strong pulse, become confused or disoriented, or lose consciousness. Heat stroke requires emergency medical care — not rest at home.
"Lo" is the term for the hot, dry wind that blows from the Thar Desert across Punjab and Sindh during April, May, and June. Prolonged exposure to this wind — particularly when combined with physical activity, inadequate fluid intake, or being in an enclosed space — can rapidly overwhelm the body's cooling mechanisms and lead to heat exhaustion or heat stroke. Outdoor workers, farmers, children, and elderly individuals are at greatest risk during Lo season.
Only if the person is fully conscious and able to swallow safely. Do not give fluids to anyone who is confused, drowsy, or unconscious — there is a risk of choking or aspiration into the lungs. For a person who is conscious and can drink normally, cool water in small amounts is reasonable while you wait for emergency services. Do not give sugary drinks, tea, or oral rehydration salts as a substitute for emergency care.
Very cold water or ice applied directly to the skin can cause sudden constriction of blood vessels near the skin, which paradoxically reduces the rate at which heat is lost. Cool (not ice-cold) water and cloths on the neck, armpits, and groin are the recommended approach for lay first-aiders. Emergency services may use ice-water immersion in a controlled setting, but this should be left to trained responders.
Physiotherapy does not treat active heat stroke — that is the role of emergency medicine and hospital care. Once a patient has been discharged from hospital and cleared by their doctor, physiotherapy can support recovery through structured return-to-activity programmes, strength rehabilitation, heat acclimatisation guidance, and education to reduce the risk of recurrence. WhatsApp RehabNow at +923175091390 to ask about post-heat-stroke physiotherapy support in your area.
Outdoor agricultural workers and construction labourers face the highest occupational risk, particularly in southern Punjab and Sindh in the summer months. Other high-risk groups include elderly individuals (especially those without access to air conditioning), young children, people with heart or kidney conditions, those taking certain medications that affect sweating or fluid balance, and individuals exercising in hot conditions without adequate preparation or hydration.
Ensure the home is kept cool during peak heat hours (11 AM to 4 PM). Encourage regular fluid intake — do not wait for thirst. Avoid outdoor activity or travel during the hottest part of the day. Keep electric fans or air conditioning operational. Have someone check on them daily. For parents with mobility limitations, a home physiotherapy programme can help maintain the physical conditioning that makes heat illness more likely to be a minor episode rather than a dangerous one.
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For active heat stroke — confusion, loss of consciousness, or very high body temperature in the heat — call emergency services immediately. Do not attempt home treatment.
For post-heat-stroke recovery physiotherapy, WhatsApp RehabNow at +923175091390 once your doctor has cleared you for rehabilitation.