Are you experiencing heat stroke? UNC doctor explains how to tell, what to do

High temperatures and triple-digit heat index values mean more North Carolina residents could be at risk of heat-related illness.

Temperatures are expected to remain in the upper 90s over the next couple of days for much of the state, according to forecasts from the National Weather Service.

But heat index values (what the temperature feels like when humidity levels and temperature are combined) are projected to soar between 105 and 108 degrees in Charlotte and western North Carolina, and heat index values in the Triangle could reach 111 degrees.

Extreme heat causes an estimated 1,300 deaths each year in the U.S., according to the Environmental Protection Agency – but there are ways to stay safe.

The Charlotte Observer spoke to Dr. Christine Knettel, an emergency physician with UNC Health Rex in Raleigh, to learn more about heat exhaustion and heat stroke, including symptoms, who’s most at risk and how to prevent them.

Heat stroke vs. heat exhaustion

Both heat exhaustion and heat stroke result from high temperatures and share similar symptoms, but heat stroke is more serious.

If untreated, heat exhaustion can progress to heat stroke, potentially causing lasting damage to the brain, heart, kidneys, and muscles, according to the Mayo Clinic.

“It’s just a spectrum of the illness, so people can get overheated, and at some point heat exhaustion leads to fatigue and muscle shutting down,” Knettel said. “Heat stroke is when you start to get the neurological changes. That’s when we get to the final stage of the illness, and people die from that.”

While heat exhaustion often improves with rest and hydration, heat stroke requires immediate medical care.

Heat exhaustion symptoms

According to the Cleveland Clinic, other symptoms of heat exhaustion include:

• Cold, clammy skin

• Muscle cramps

• Headache

• Dizziness

• Feeling tired or weak

• Nausea or vomiting

• Fast heart rate

• Fast and weak pulse

• Fast, deep breathing

• Elevated body temperature, typically 101 to 104 degrees

Heat stroke symptoms

According to the Cleveland Clinic, symptoms of heat stroke include:

• High internal body temperature, typically over 104 degrees

• Behavior changes, such as agitation or aggression

• Blurred vision

• Confusion or delirium

• Dizziness and/or fainting

• Fast heart rate

• Fast, shallow breathing

• Low blood pressure

• Nausea and vomiting

• Seizures

• Slurred speech

• Skin color changes, either flushed or paler than usual

• Skin that’s dry or sweaty

• Weakness

Who is most likely to get heat stroke?

Children, people with mobility issues, older people and those with chronic illnesses are among groups that are most at-risk for heat-related illnesses, Knettel said.

“All those people have to be watched for in this weather,” she added. “I always make sure people know to not leave their kids in the car for even a minute, check on older family members, make sure their air conditioners are working and that they’ve got access to water and all those things.”

According to the National Integrated Heat Health Information System, the following groups are also have a high risk for heat-related illnesses:

• Athletes, due to prolonged exposure to high temperatures

• People who are pregnant

• Emergency responders

• People who work outdoor, or indoors without access to air conditioning

Can pets get heat stroke?

Yes. Hot pavement can raise a dog’s body temperature and lead to heat stroke, according to the American Kennel Club (AKC).

When the air hits 86 degrees or higher, asphalt can reach 135 degrees, which is dangerous for your pet’s paws.

Here are of signs of heat-related illness that you should watch for in your dog, according to the AKC:

• Seeking shade

• Limiting movement or restlessness

• Choosing to sit or lie down

• Uncontrolled panting

• Nausea and vomiting

• Skin reddening

• Excess saliva

Symptoms like bright red or purple gums, dizziness, seizures or loss of consciousness in dogs require immediate vet care, according to the AKC. To help cool them down, you can give them water, shade or a cooling mat.

Heat exhaustion treatment

Knettel said the best thing to do when you start to experience symptoms is to “just get out of the heat.”

“If you can’t be inside, then get in the shade,” said Knettel. “Hydrating, resting, not doing physical activity would be best.”

For those who work or have to spend a lot of time outside, Knettel recommended staying hydrated with nutrient-rich beverages.

“If you’re doing things outside all day, try to hydrate not just with plain water, but with some electrolytes too, because there are a lot of electrolytes in your sweat.”

How to prevent heat stroke

Here are some ways you can prevent heat stroke and other heat-related illnesses, according to the Centers for Disease Control and Prevention:

• Limit outdoor activity during extreme heat by staying in the shade, taking breaks and scheduling activities for cooler times of day.

• Use fans only if indoor temperatures are below 90 degrees; above that, they may raise body temperature instead of cooling you down.

• Seek air-conditioned spaces or find a nearby cooling center through 211 or local health resources.

• Stay hydrated by drinking plenty of fluids and refilling a water bottle throughout the day.

• Avoid drinks high in sugar, sodium, caffeine or alcohol when possible.

• Check on others, especially elderly or isolated people, and don’t forget to check on pets.

This story was originally published June 24, 2025 at 12:08 PM with the headline "Are you experiencing heat stroke? UNC doctor explains how to tell, what to do."

Evan Moore

The Charlotte Observer

Evan Moore is a service journalism reporter for the Charlotte Observer. He grew up in Denver, North Carolina, where he previously worked as a reporter for the Denver Citizen, and is a UNC Charlotte graduate.