Heat Stroke and Heat Exhaustion Treatment in Patong, Phuket: Same-Day Cooling, IV Fluids and Emergency Care 24/7
Rapid cooling, IV rehydration and emergency stabilisation for heat exhaustion and heat stroke, in our Patong clinic or at your hotel, 24 hours a day. Clinically reviewed by the Doctor Patong Takecare Clinic medical team.
WhatsApp now, urgent heat illness help | Call +66 81 718 9080 | Find the clinic on Google Maps
Patong runs a UV index of 11 or 12 for most of the year, and from May to October the combination of air temperature, humidity and unbroken sun puts arriving tourists at real risk on day one or two. We see heat exhaustion almost every week from runners who tried Karon viewpoint at midday, families who walked Phromthep Cape unshaded, and long-haul travellers who landed jet-lagged and dehydrated, then drank alcohol in the heat. A small number of these are heat stroke, and those need cooling started in the first minutes, not the first hour.
The spectrum: cramps, exhaustion and stroke
Heat illness is a spectrum, and recognising which end of it you are on changes everything about the response. Heat cramps are painful muscle spasms from electrolyte loss with heavy sweating, treated with rest, oral rehydration salts and gentle stretching. Heat exhaustion sits in the middle: core temperature 38 to 40°C, heavy sweating, weak rapid pulse, cool clammy skin, headache, nausea and dizziness, with mental status mostly normal. Heat stroke is the emergency: core temperature above 40°C plus altered mental status (confusion, agitation, seizure or coma), with risk of multi-organ failure if cooling is delayed.
| Condition | Key features | First action |
|---|---|---|
| Heat cramps | Painful muscle cramps after heavy sweating. Normal mental status. Temperature normal or mildly raised. | Rest in shade, oral rehydration salts, gentle stretching. Usually settles within an hour. |
| Heat exhaustion | Core temperature 38 to 40°C, heavy sweating, weakness, headache, nausea, dizziness, weak rapid pulse, cool clammy skin. Mental status mostly normal. | Move to cool environment, fan, oral rehydration, monitor. IV fluids at our clinic if not tolerating oral. Recovery 30 to 60 minutes. |
| Heat stroke (emergency) | Core temperature above 40°C plus altered mental status (confusion, agitation, seizure, coma). Skin can be hot dry or still sweating. | Call 1669 or come to clinic immediately. Aggressive cooling starts in the first minute. ICU transfer for severe cases. |
Two types of heat stroke we see in Phuket
Exertional heat stroke happens in young, otherwise healthy people doing intense exercise in the heat: runners, hikers up to Big Buddha, fitness tourists on outdoor sessions, military and athletes. Skin is often still sweating, onset is rapid, and the trigger is unacclimatised exertion in midday sun. Classical heat stroke happens in the elderly, infants, and people on diuretics, anticholinergics, beta-blockers, antipsychotics or antidepressants. Skin tends to be hot and dry, onset is slower, and a heat wave or poor air conditioning is often the trigger. Both kill if untreated, and both respond to the same principle: cool fast.
How we treat heat stroke
The goal is to bring core temperature below 39°C within 30 minutes, because survival is directly linked to how fast cooling happens. For exertional heat stroke in young patients, cold water immersion is the gold standard and gives the best survival, and where immersion is not available we use ice packs to neck, groin and axilla combined with tepid water spray and a powerful fan. For classical heat stroke in the elderly or frail, evaporative and convective cooling (tepid water plus fan) is preferred, with ice packs as an adjunct. We stop active cooling at 38.5°C to avoid overshooting into hypothermia.
Alongside cooling we give cooled IV crystalloid (normal saline or Ringer’s lactate) titrated to blood pressure and urine output, manage the airway if the patient is obtunded, and monitor continuous core temperature (rectal), ECG, blood pressure, oxygen saturation and glucose. Blood tests check kidney and liver function, creatine kinase (for rhabdomyolysis, muscle breakdown), clotting, lactate and arterial blood gas. Complications we actively look for and treat include rhabdomyolysis, disseminated intravascular coagulation, acute kidney injury, hepatic injury, acute respiratory distress and seizures. Severe cases are stabilised and transferred to ICU at Bangkok Hospital Phuket or Vachira Phuket.
How we treat heat exhaustion
Most heat exhaustion is manageable at our clinic or in your hotel room without hospital admission. We move you into air conditioning, remove excess clothing, start oral rehydration salts (a sachet dissolved in water), cool with a fan and tepid sponging, and use IV fluids if you cannot keep oral fluids down. Most patients feel back to normal within an hour, and we then ask for 24 to 48 hours of rest, shade and steady fluid intake to prevent relapse. We will also screen for the things that mimic heat illness so we do not miss them: dehydration alone, hyponatraemia (low sodium from over-drinking water without electrolytes, common in endurance athletes), hypoglycaemia, thyroid storm, sepsis, drug effects (sympathomimetics, anticholinergics, serotonin syndrome), severe alcohol withdrawal, and in returned travellers, cerebral malaria.
Core temperature above 40°C. Confusion, agitation, seizure or coma. Unable to keep oral fluids down. Symptoms getting worse despite cooling. Dark cola-coloured urine or severe muscle pain (suggests rhabdomyolysis). Pregnancy with any signs of heat illness. A child with floppy weakness, vomiting or altered behaviour after sun exposure. Known heart disease with chest pain or breathlessness. These features point to heat stroke or a serious complication that needs IV fluids, active cooling and possible ICU care, not waiting it out at the hotel.
You feel dizzy, nauseated or headachey after sun exposure and it is not settling with shade and water in 30 minutes. You are elderly, pregnant, taking diuretics or psychiatric medication, or caring for a child or infant who has been overheating. You are not sure whether what you are experiencing is heat exhaustion, dehydration, food poisoning or something else. WhatsApp +66 95 073 5550 for a same-day clinic appointment or hotel-room visit. See our related pages on emergency care, IV drip and sunburn treatment.
Prevention for Patong visitors
Most heat illness in Phuket is preventable with a handful of habits. Drink water steadily through the day, and add an oral rehydration salt sachet whenever you have been sweating heavily or had alcohol the night before, aiming for pale yellow urine. Acclimatise for five to seven days if you have arrived from a cool climate, easing into outdoor activity rather than booking a midday hike on day one. Wear light, loose, light-coloured clothing, use shade and air conditioning between 10am and 4pm, and apply sunscreen because sunburn impairs the skin’s ability to regulate temperature. Schedule runs and hikes before 8am or after 5pm, watch elderly relatives and small children closely, and ask us to review your medications if you are taking diuretics, antidepressants, antipsychotics or anticholinergics, because all of these raise the risk.
Summary
Heat exhaustion is common, recoverable and usually manageable at our clinic or your hotel with cooling, oral rehydration and a short course of IV fluids when needed. Heat stroke (core temperature above 40°C with altered mental status) is a true emergency where survival depends on how fast core temperature is brought down. Call 1669 or come straight to us if you are worried, and start cooling on the way in: shade, ice or cold water on neck, groin and underarms, and fluids if the patient can drink safely.
“In heat stroke, time is brain, kidney and liver. We start cooling on the doorstep, not after the paperwork. If you are even uncertain whether what you are looking at is heat exhaustion or heat stroke, treat it as the worse one until proven otherwise.”
Doctor Patong Takecare Clinic medical team
Frequently asked questions
How do I tell heat stroke from heat exhaustion?
The two signs that flip heat exhaustion into heat stroke are core temperature above 40°C and altered mental status (confusion, agitation, slurred speech, seizure or coma). In heat exhaustion the patient is sweaty, weak and headachey but lucid. In heat stroke they are confused or worse, and the skin may be hot and dry (classical) or still sweating (exertional). Either pattern with confusion is an emergency.
What is the first thing to do if someone collapses in the heat?
Move them into shade or air conditioning, call 1669 or our clinic immediately, remove excess clothing, and begin cooling. Ice packs (or any cold pack, even bagged frozen vegetables) to the neck, armpits and groin work fast, and tepid water sprayed on the skin with a fan blowing over them is highly effective. If they are alert and able to swallow, give sips of water with an oral rehydration salt sachet. Do not give fluids to anyone who is confused or unconscious.
Is cold water immersion safe for heat stroke?
For exertional heat stroke in young, otherwise healthy patients, cold water immersion is the gold standard and gives the best survival rates. For classical heat stroke in the elderly or frail, we prefer evaporative cooling (tepid water plus fan) with ice packs as an adjunct, because the cardiovascular stress of immersion can be too much. Either way, cooling stops at a core temperature of 38.5°C to avoid overshooting.
Are children and elderly relatives at higher risk?
Yes. Infants and young children do not regulate temperature efficiently and dehydrate quickly, and any floppy weakness, vomiting or behavioural change after sun exposure should be seen the same day. Elderly people, especially those with cardiac disease, diabetes, or on diuretics and psychiatric medication, are at high risk of classical heat stroke during heat waves. We are happy to do hotel-room reviews for both groups.
When can I safely exercise outdoors in Phuket?
Schedule runs, hikes and outdoor workouts before 8am or after 5pm during the hot months (March to October), carry water with electrolytes, and build up gradually over five to seven days if you have arrived from a cool climate. The Karon viewpoint, Big Buddha and Phromthep Cape routes are scenic but unshaded, and we see preventable heat illness from these almost weekly. Skip alcohol before and during exertion, and turn back if you start to feel unwell rather than pushing through.
How long does recovery take after heat exhaustion or heat stroke?
Heat exhaustion typically resolves fully within a few hours once cooling and rehydration are underway, with another 24 to 48 hours of rest and shade recommended to prevent relapse. Heat stroke is different: even after cooling, patients can have persistent kidney, liver or neurological effects, and most need observation in hospital for at least 24 to 48 hours. Full recovery from severe heat stroke can take weeks, and you should not return to full exertion in the heat without medical clearance.
Sources
Centers for Disease Control and Prevention. Heat-Related Illnesses: Heat Stroke and Heat Exhaustion. cdc.gov/extreme-heat.
National Health Service (NHS). Heat exhaustion and heatstroke. nhs.uk/conditions/heat-exhaustion-heatstroke.
World Health Organization. Heat and health. who.int.
American Heart Association / Wilderness Medical Society. Exertional heat stroke: cold water immersion as first-line treatment.
Get help now
WhatsApp: urgent heat illness help
Call +66 81 718 9080 to speak to a doctor
Find Doctor Patong Takecare Clinic on Google Maps
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