Which statement best differentiates heat stroke from heat exhaustion, and what is the immediate field intervention?

• A. Heat exhaustion is marked by sweating, weakness, and dizziness; heat stroke presents with confusion or hot, dry skin; both require rapid cooling and fluids; heat stroke does not require evacuation.
• B. Heat stroke is characterized by hot, dry skin and confusion; immediate rapid cooling and urgent evacuation.
• C. Heat stroke involves sweating and cramps; treat with rest.
• D. Heat stroke is always caused by dehydration and requires only hydration.

Answer: (B)

Heat stroke is an emergency characterized by central nervous system dysfunction (such as confusion) and very hot, often dry skin due to failure to sweat. The defining action in the field is rapid cooling to bring down the body temperature as quickly as possible, paired with urgent evacuation to a hospital for definitive care. This combination—signs of CNS involvement plus the need for immediate cooling and rapid transport—distinguishes heat stroke from heat exhaustion, which typically includes sweating, weakness, dizziness, and cooler or moist skin, and responds to rest, shade, and fluids rather than urgent hospital-level cooling and transport.