What is in the SOP
Nine sections in one editable Word file. Your site fills in names, local work/rest rules and who to call. The field procedure uses plain steps: move, cool, request ALS.
Look inside: real pages from the kit
5. Field recognition and emergency action
5.1 Spectrum (field categories, not diagnoses)
Cramps, exhaustion, and stroke are a spectrum. Workers can move down that spectrum in minutes. When in doubt, treat as the more serious problem and call for ALS. You are not required to name the condition correctly to start cooling.
| Field category | What you may see | What you do |
|---|---|---|
| Heat cramps | Painful spasms; worker usually alert; may still want to work. | Stop the task. Shade. Oral fluids if airway protected. Recovery. Do not send straight back to heavy work. |
| Heat exhaustion | Heavy sweat, weakness, headache, nausea, dizziness, thirst, rapid pulse; still mostly with it. | Stop work. Recovery. Cool. Evaluate per local EMS. Hold in recovery. Tell the area owner. |
| Heat stroke (emergency) | Confusion, collapse, seizure, combativeness, or unresponsive. Skin hot/dry OR still sweating. | This is Section 5.3. Cool now. ALS. Do not wait for dry skin or a thermometer. |
5.2 Red flags (treat as an emergency until proven otherwise)
- Confusion, bizarre behavior, combativeness, or “not tracking”
- Collapse, inability to stand, or a worker found down
- Seizure
- Unresponsiveness
- Vomiting that prevents oral fluids
- Hot skin with altered mental status, with or without sweat
- A worker who was working in heat and now “just doesn’t look right,” even if they deny symptoms
Any red flag: start Section 5.3. Do not debate the label. Do not put the worker back in PPE to “finish the assignment.”
5.3 Field procedure (suspected serious heat illness)
| 1. Call it. | Notify the area owner. Request EMS/ALS. Use plain language: suspected heat emergency, unit, location, mental status. Do not delay the call for a perfect assessment. |
| 2. Protect rescuers. | If the worker is in an IDLH atmosphere, another hazard zone, or traffic, use the site rescue plan. Do not become a second patient. Once in a safe area, continue. |
| 3. Move out of the heat. | Shade, vehicle A/C, building, or the cool-down area. Get solar load off the worker. |
| 4. Strip heat load. | Remove hard hat, hood, coat, gloves, and as much PPE as the situation allows. Loosen clothing. Keep dignity in mind in public, but cooling comes first. |
| 5. Airway, breathing, circulation. | If the worker is not breathing or has no pulse, start CPR and AED per local protocol. Heat illness does not change that order. |
| 6. Cool now. | For altered mental status, begin aggressive cooling with what you have: cold water, ice sheets or towels, ice at neck/axilla/groin, evaporative cooling and fans if available. Do not wait for ALS to start cooling. Do not delay an ALS-ready transport solely to finish a cooling setup. |
| 7. Oral fluids: limited. | Oral fluids only if the worker is fully conscious, protecting the airway, and not vomiting. No oral fluids if mental status is altered. This SOP does not authorize salt tablets or medications unless local occupational health direction says otherwise. |
| 8. ALS / BLS per local protocol. | Heat stroke is a load-and-go medical emergency. Tell the receiving facility this is suspected heat stroke and that cooling has started. Follow local EMS for oxygen, monitoring, and any other care. |
| 9. Stay assigned. | One worker stays with the patient until EMS has them. The supervisor tells the area owner who is off the job. |
| 10. Document. | Time noticed, time cooling started, mental status, fluids, destination, and who was notified. Use Attachment A. Complete your site’s injury / near-miss reporting after the patient is moving. |
| Occupational health provider reviewed / modified this section (name, date, changes). || |
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