Summer brings longer days, outdoor activities, vacations, sporting events, festivals, and plenty of opportunities to enjoy the sunshine. It can also bring an increase in heat-related illnesses. And as temperatures continue to rise around the world, the risk is growing.
New research estimates that the number of people experiencing extreme heat stress each year is up more than one billion since the 1970s. Emergency medical responders know just how quickly a fun day outdoors can turn into a medical emergency.
To better understand how EMS teams prepare for heat season and what you can do to stay safe, we spoke with three practicing paramedics who also work here at MASA. Their message was clear and consistent: while most heat-related emergencies are preventable, recognizing the warning signs early and taking prompt action can make all the difference.
The most common heat-related emergencies
Heat illness exists on a spectrum according to the American Red Cross. It often begins with heat stress or dehydration, can progress to heat exhaustion, and in severe cases, can develop into heat stroke — a life-threatening emergency.
Common symptoms include:
- Excessive sweating
- Fatigue or weakness
- Dizziness
- Headache
- Nausea
- Elevated heart rate
- Muscle cramps
- Confusion or changes in mental status
One key distinction EMS providers watch for is a person's level of consciousness. If someone becomes confused, disoriented, unable to answer basic questions, or stops sweating despite continued heat exposure, those can be signs that heat exhaustion is progressing toward heat stroke.
Paramedic and Regional Sales Director for MASA Group Benefits, Ken Euler, says, "Don't tough it out yourself. And if you see someone overheating, call 911. If you notice that they are confused, stumbling, or not making sense — making that call is critical."
Related article: Why we hesitate to call 911
Are there regional differences?
Heat emergencies occur everywhere. In fact, according to the National Resources Defense Council, nearly two-thirds of Americans live in areas with a greater-than-expected number of dangerous extreme heat days. However, the risk factors can vary by region.
In southern states where extreme heat is common, residents are often more accustomed to managing high temperatures and staying hydrated. However, that doesn't eliminate risk. Outdoor workers, athletes, festival attendees, and people spending long periods in the sun remain vulnerable.
In northern regions, the danger can sometimes be even more surprising. Extreme events, such as the 2021 Pacific Northwest heat wave demonstrated how unaccustomed populations suffer massive spikes in sudden deaths. When a sudden heat wave pushes temperatures into the 90s, people may be less prepared because they aren't accustomed to prolonged heat exposure.
Vacationers can also face increased risk, since they may spend more time outdoors than usual, underestimate local conditions, or overlook the fact that sightseeing, beach days, and outdoor recreation can significantly increase fluid loss and heat exposure.
Whether you're a resident or visitor, the body's response to heat is the same: dehydration and overheating can happen faster than many people realize.
How EMS prepares for summer heat
For emergency medical services, preparation begins long before a heat-related call comes in.
One of the first priorities is maintaining a cool treatment environment. Ambulances are often kept plugged in at the station so air conditioning systems can keep the patient compartment cool and ready for use.
"When someone is suffering from a heat-related emergency, getting them out of the heat immediately is one of the most important things we can do," EMS Battalion Chief and Senior Regional Sales Executive Jaran Floyd explained.
EMS agencies also adjust their readiness during the summer months, especially when large outdoor gatherings are expected. Community festivals, sporting events, Fourth of July celebrations, and outdoor concerts often require additional planning and supplies.
In rural areas, crews must also consider longer transport times and greater distances to advanced medical care, making early intervention even more important.
Related article: What to expect when you call 911
Special equipment for heat emergencies
Many ambulances carry equipment specifically intended to help cool patients quickly.
Supplies may include:
- Instant ice packs
- Cooling towels
- Cold bottled water
- Chilled IV fluids
- Extra hydration supplies
Some EMS systems have also begun using specialized cooling bags designed for rapid cold-water immersion. These portable devices function much like a cold plunge and allow responders to aggressively cool patients experiencing severe heat stroke.
The emphasis on rapid cooling reflects evolving medical research. Techniques that were once viewed cautiously are now recognized as highly effective when used appropriately for severe heat illness.
Related article: What EMS teams wish every caller knew
How paramedics train for heat emergencies
Heat-related care isn't treated as a seasonal specialty — it's built into routine EMS education and operational planning.
One important technique is known as axillary cooling, which focuses on placing ice packs or cooling devices in areas where major blood vessels run close to the skin, including:
- Armpits
- Neck
- Groin
Cooling these areas helps lower body temperature more efficiently.
Beyond hands-on treatment skills, EMS agencies work closely with medical directors to develop protocols and standard operating procedures that guide heat-related care. These protocols are reviewed and updated as new research and best practices emerge.
For many experienced paramedics, heat emergencies are simply another part of everyday readiness.
"It's baked into the way we prepare," responder Jaran Floyd explained. "Every call is different, and heat emergencies are one of the situations we're always ready for."
Why timing matters
When it comes to heat illness, timing can make a significant difference in outcomes.
Heat exhaustion is serious, but heat stroke is a true medical emergency that can rapidly affect multiple organ systems, including the brain, heart, and kidneys.
Delayed treatment can lead to:
- Neurological complications
- Cardiovascular stress
- Organ dysfunction
- Long-term health consequences
The longer the body's core temperature remains elevated, the greater the risk of permanent damage.
That's why EMS providers stress early intervention. The goal is to identify symptoms before they progress to heat stroke and begin cooling immediately.
Related article: Why timely care is important
What you can do before 911 arrives
Bystanders who can recognize heat illness symptoms can play an important role.
Take these Red Cross and CDC recommended steps:
- Move the person into shade or an air-conditioned environment.
- Encourage hydration if they are conscious and able to drink.
- Apply ice packs or cool towels to the neck, armpits, and groin.
- Loosen or remove excess clothing.
- Call 911 if symptoms are severe or worsening.
Children, older adults, people with chronic health conditions, and pets require special attention because they may be less able to recognize or communicate symptoms.
The bottom line
The advice from EMS professionals is remarkably simple: stay hydrated, pay attention to warning signs, and don't ignore symptoms.
Whether you're attending a community event, working outdoors, traveling, or simply enjoying a summer afternoon, taking regular breaks, seeking shade, wearing protective clothing, and replacing fluids can help prevent heat-related illness before it starts.
As flight paramedic and MASA Vice President of Broker and Strategic Partnerships, Will Winters summarized: "Don’t try to push through symptoms. Be sure to hydrate, hydrate, hydrate. And overall, just take the heat seriously."
A little prevention today can help keep a hot summer day from becoming a trip to the emergency room.
