Which signs indicate a heat-related illness requiring rapid cooling and transport?

• A. Sudden onset chest pain with sweating.
• B. Altered mental status with hot dry skin (stroke-like) or sweating with heat exhaustion.
• C. Malaise without temperature change.
• D. Cough with sputum production.

Answer: (B)

Heat stroke is the urgent heat-related illness that requires rapid cooling and transport. When the body's temperature regulation fails, core temperature climbs quickly and the nervous system becomes impaired, so changes in mental status show up—confusion, irritability, agitation, or even unconsciousness. The skin can be extremely hot and may be dry (classic heat stroke) or sweaty if it’s an exertional type. That combination—altered mental status plus extreme heat, with or without dry skin—signals a medical emergency that needs immediate cooling and rapid transport to a hospital.

In contrast, chest pain with sweating usually points to a cardiac event, malaise without a temperature rise isn’t a heat injury, and a cough with sputum suggests a respiratory infection.