See our safe care and visitor guidelines, plus trusted coronavirus information. Because heat-related illness also can result from salt depletion, it may be advisable to substitute an electrolyte-rich sports drink for water during periods of extreme heat and humidity. The initial treatment of patients with heat exhaustion involves stabilization in a cool area. Victims of heat stroke must receive immediate treatment to avoid permanent organ damage. Accessed June 15, 2017. Heat stroke can occur if you are exposed to high temperatures for too long. So it's important -- especially during heat waves -- to pay attention to the reported heat index, and also to remember that exposure to full sunshine can increase the reported heat index by 15 degrees. These include heart, lung, or kidney disease, obesity or underweight, high blood pressure, diabetes, mental illness, sickle cell trait, alcoholism, sunburn, and any conditions that cause fever. If a rash covers a large area it may become uncomfortable. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Rapid breathing 3. In the meantime, try to get indoors or at least some shade, cool the body (with an icepack), and drink cold water (if the person can sit or stand and voluntarily drink without choking). Others should take steps to cool you off while waiting for emergency help to arrive. If you notice signs of heat-related illness, lower your body temperature and prevent your condition from progressing to heatstroke. Sports or rehydration drinks are OK. Accessed Aug. 6, 2020. Heat stroke results from prolonged exposure to high temperatures -- usually in combination with dehydration -- which leads to failure of the body's temperature control system. If you're a senior who either can't afford to buy or run an air conditioner, check with your local Area Agency on Aging for programs that can assist you. Heat stroke most commonly occurs when someone participates in extended amounts of physical activity … It often occurs as heat cramps, fainting and heat exhaustion, and can Don't drink any fluids while waiting for medical assistance. https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html. This content does not have an English version. Recognizing symptoms of heat exhaustion and taking steps to … One such program is the Low Income Home Energy Assistance Program (LIHEAP). Mayo Clinic, Rochester, Minn. June 19, 2017. Heat stroke is also known as sunstroke, thermic fever, or siriasis. " Â, U.S. Department of Homeland Security/Federal Emergency Management Agency: "Are You Ready? Heat stroke often occurs as a progression from milder heat-related illnesses such as heat cramps, heat syncope (fainting), and heat exhaustion. Heat stroke happens in hot conditions when the body's cooling system fails. Read on to find out the causes, symptoms, treatment, and prevention of heat stroke in order to stay safe and sound this summer season. Other high-risk groups include people of any age who don't drink enough water, have chronic diseases, or who drink excessive amounts of alcohol. While waiting for the paramedics to arrive, initiate first aid. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts. Evaporation and ice water immersion are both widely used as cooling methods. ", American Academy of Orthopaedic Surgeons: "Heat Injury and Heat Exhaustion. This site complies with the HONcode standard for trustworthy health information: verify here. The medical definition of heat stroke is a core body temperature greater than 104 degrees Fahrenheit, with complications involving the central nervous system that occur after exposure to high temperatures. Early cooling reduces mortality and morbidity, and should be initiated as soon as possible. Heat stress-heat related illness. When the heat index is high, it's best to stay in an air-conditioned environment. Centers for Disease Control and Prevention. Evaporative cooling may be initiated by wetting the skin. The goal of emergency treatment is to safely lower core body temperature as soon as heat stroke is suspected. [2] There is generally a lack of sweating in classic heat stroke while sweating is generally present in exertional heatstroke. The general recommendation is to drink 24 ounces of fluid two hours before exercise, and consider adding another 8 ounces of water or sports drink right before exercise. If you have signs or symptoms of heatstroke, seek emergency medical help. ", CDC: "Frequently Asked Questions (FAQ) About Extreme Heat. If possible, take the person's core body temperature and initiate first aid to cool it to 101 to 102 degrees Fahrenheit. Untreated heat stroke can quickly damage your brain, heart, kidneys and muscles. Controversies in Exertional Heat Stroke Diagnosis, Prevention a nd Treatment 1 2 Orlando Laitano 1 , Lisa R. Leon 2 , William O. Roberts 3 and Michael N. Sawka 4 Wearing excess clothing or clothing that fits tightly won't allow your body to cool properly. To do this, your doctor may take these steps: Home treatment isn't enough for heatstroke. Electrolyte status and core temperature should be monitored. Heatstroke treatment centers on cooling your body to a normal temperature to prevent or reduce damage to your brain and vital organs. If you have a fan, try to run it close by. © 2005 - 2020 WebMD LLC. Immediate treatment of heat strok… It happens when the body's mechanisms for controlling temperature fail. Heat stroke treatment and Symptoms Heat Rush Usually occurs in hot humidity environments where sweat cannot evaporate easily. If possible, shift your time outdoors to the coolest times of the day, either early morning or after sunset. Get them to drink plenty of water. It’s believed that the sun exposure – particularly on hot summer days, between 11 am and 3 pm – is the only cause of heat stroke, but there are some other reasons to know. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. https://www.uptodate.com/contents/search. Heat stroke is the most serious form of heat injury and is considered a medical emergency. Move the person to an air-conditioned environment -- or at least a cool, shady area -- and remove any unnecessary clothing. Medications. Any delay seeking medical help can be fatal. Doing so can be dangerous. Health conditions. But it can strike even if you have no previous signs of heat injury. If you live in an urban area, you may be especially prone to develop heat stroke during a prolonged heat wave, particularly if there are stagnant atmospheric conditions and poor air quality. Seek immediate emergency care if you think someone might have heat stroke. [4] Other symptoms include red skin, headache, and dizziness. Throbbing headache 2. Extreme heat. 2. 1. Heat stroke, also known as sun stroke, is a type of severe heat illness that results in a body temperature greater than 40.0 °C (104.0 °F) and confusion. If a person with suspected heat stroke is unconscious, place them on their side with their mouth down (to drain any fluid) and the chin up to prevent possible suffocation. Knowing how to treat a dog experiencing heat stroke may be vital to saving your dog's life. temperatur e and aggressi v e treatment, heat stroke is often fa tal, and those who do sur vive may sustain per-manent neurologic damage. Additionally, leaving a cool towel on a patient will impair radiative, conductive and convective cooling on… If you live in an apartment or house without fans or air conditioning, try to spend at least two hours each day -- preferably during the hottest part of the day -- in an air-conditioned environment. Check with your doctor before increasing liquid intake if you have epilepsy or heart, kidney, or liver disease; are on fluid-restricted diets; or have a problem with fluid retention. Extreme Heat."Â. Heat stroke is a medical emergency. Mechem CC. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. It's usually apparent to doctors if you have heatstroke, but laboratory tests can confirm the diagnosis, rule out other causes for your symptoms and assess organ damage. If someone has heat exhaustion, follow these 4 steps: Move them to a cool place. Do not give aspirin or paracetamol to someone with heatstroke since this may make things worse. First and foremost, cool the victim. These tests include: Heatstroke treatment centers on cooling your body to a normal temperature to prevent or reduce damage to your brain and vital organs. Laskowski ER (expert opinion). Be careful when caring for someone with heat stroke. Heat Stroke (a.k.a: Sunstroke) is a form of hyperthermia, where the body temperature is elevated or increased, usually accompanied by dehydration. Drink extra fluids. Take these steps to prevent heatstroke during hot weather: 1. Increased heart rate 4. About extreme heat. Ferri FF. First things first, look for these symptoms if you think a person may be experiencing heat stroke – 1. Heat stroke, characterized by confusion, panting, hot skin, vomiting and other signs, is a medical emergency. Heat stroke is the most serious form of heat injury and is considered a medical emergency. Take additional precautions when exercising or working outdoors. The use of ice baths is discouraged because it can cause peripheral vasoconstriction, which will impair heat dissipation. Those with heat exhaustion and heat stroke need the following therapy approaches: They need to be taken to a cool place. Heatstroke is usually the consequence of prolonged physical exertion that results in the body's temperature rising above 104°F (40°C). But a heat stroke, unlike a common cold, can have very serious consequences and Things you can do to cool someone down. Meanwhile, immediately begin first aid by cooling the person move them to shade or an air-conditioned building, remove constricting or clothing layers, and cool the person with evaporative cooling (mist or spray water on the patient while fans are running). In what is known as the "heat island effect," asphalt and concrete store heat during the day and only gradually release it at night, resulting in higher nighttime temperatures. Accessed June 15, 2017. Heat stroke treatment should be transferred to ALS whenever possible because IV fluid replacement and cooling are the main goals. Lower Body Temperature While Waiting for … If you must go outdoors, you can prevent heat stroke by taking these steps: Other strategies for preventing heat stroke include: Avoid fluids containing caffeine or alcohol, because both substances can make you lose more fluids and worsen heat-related illness. With appropriate, timely treatment, a person can fully recover from heat-related illnesses. Familydoctor.org: "Heat Exhaustion and Heatstroke. Cool their skin – spray or sponge them with cool water and fan them. A relative humidity of 60% or more hampers sweat evaporation, which hinders your body's ability to cool itself. To do this, your doctor may take these steps: 1. If ice packs are available, wrap them in towels and place them around the neck groin and armpits. All rights reserved. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Ready Campaign. Heatstroke requires emergency treatment. A bath of cold or ice water has been proved to be the most effective way of quickly lowering your core body temperature. Some experts recommend placing ice packs or wet towels to the head, neck, armpits, and groin. Heat stroke in dogs is a very serious condition and its onset can be sudden, escalating into an emergency situation in a matter of minutes. Nausea and vomiting 6. If you experience or witness the signs of heat exhaustion or heat stroke, you need to call for emergency help right away. Accessed Aug. 6, 2020. The easiest and safest way to replace salt and other electrolytes during heat waves is to drink sports beverages or fruit juice. Slideshow: What Can Heat Do to Your Body? All rights reserved. Although heat stroke mainly affects people over age 50, it also takes a toll on healthy young athletes. Get them to lie down and raise their feet slightly. https://www.uptodate.com/contents/search. If you suspect that someone has a heat stroke, immediately call 911 or transport the person to a hospital. An algorithm for the management of heat exhaustion and heatstroke is provided in Figure 1. Heat stroke can kill or cause damage to the brain and other internal organs. Make a donation. This is ideally a room with … Sign Up to Receive Our Free Coroanvirus Newsletter. Symptoms of Heat Rush Exertional heat illness in adolescents and adults: Epidemiology, thermoregulation, risk factors, and diagnosis. Heat Stroke Treatment Global warming and rising temperatures have made heat exhaustion and strokes, as ordinary as a common cold. This includes instructing owners to begin the cooling process before the patient arrives at the hospital. Heat stroke is a life-threatening injury requiring neurocritical care; however, heat stroke has not been completely examined due to several possible reasons, such as no universally accepted definition or classification, and the occurrence of heat wave victims every few years. Monitoring lost water weight can help you determine how much fluid you need to drink. You can find out here how to recognize heat stroke and what helps in such cases. Do not use ice for older patients, young children, patients with chronic illness, or anyone whose heat stroke occurred without vigorous exercise. Darker urine is a sign of dehydration. Accessed Aug. 6, 2020. Treating a heat stroke properly can be done by getting the victim out of the heat, giving them water and cooling the person off as quickly as possible. The damage worsens … © 1998-2020 Mayo Foundation for Medical Education and Research (MFMER). Patients are also at risk for seizures and may need IV anticonvulsants en route to the hospital. In a lesser heat emergency, such as heat cramps or heat exhaustion, the following steps may lower your body temperature: Mayo Clinic does not endorse companies or products. Sunburn affects your body's ability to cool itself, so protect yourself outdoors with a wide-brimmed hat and sunglasses and use a broad-spectrum sunscreen with an SPF of at least 15. Patients who are significantly dehydrated, who are hyponatremic, or who have mental statu… So it's best to avoid hot weather and heavy exercise until your doctor tells you that it's safe to resume your normal activities. "Â, National Institute on Aging: "Hyperthermia: Too Hot for Your Health. If the environment is hot enough for someone else to get overheated, then it may be hot enough for you to become overhe… Advertising revenue supports our not-for-profit mission. But fainting may be the first sign. (If no thermometers are available, don't hesitate to initiate first aid.). To prevent dehydration, it's generally recommended to drink at least eight glasses of water, fruit juice, or vegetable juice per day. How Long Does Coronavirus Live On Surfaces? If you suspect someone has sunstroke or heat stroke, call 911 as soon as possible and administer first aid while waiting for paramedics to arrive. Excessive After you've recovered from heat stroke, you'll probably be more sensitive to high temperatures during the following week. During exercise, you should consume another 8 ounces of water every 20 minutes, even if you don't feel thirsty. Heat stroke is a life-threatening emergency needing immediate treatment. A single copy of these materials may be reprinted for noncommercial personal use only. If steps are not taken to reduce body temperature, heat exhaustion can worsen and become heat stroke. Use evaporation cooling techniques. Accessed June 15, 2017. If emergency response is delayed, call the hospital emergency room for additional instructions. At home, draw your curtains, shades, or blinds during the hottest part of the day, and open windows at night on two sides of your building to create cross-ventilation. The quicker you can receive cold water immersion, the less risk of death and organ damage. Other risk factors associated with heat-related illness include: Age. People with diabetes -- who are at increased risk of emergency room visits, hospitalization, and death from heat-related illness -- may be especially likely to underestimate their risk during heat waves, according to a recent study presented at the Endocrine Society's annual meeting by researchers from the Mayo Clinic in Arizona, the National Ocean and Atmospheric Administration, and the National Weather Service. Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School. To continue reading this article, you must log in . 2. Heatstroke is predictable and preventable. A heat stroke (hyperthermia syndrome) is a form of heat exhaustion and can occur if you are exposed to great heat for a longer period of time or too quickly. Wear loosefitting, lightweight clothing. Because these areas are rich with. https://www.cdc.gov/disasters/extremeheat/heat_guide.html. 1, 2 Data … Heat stroke is most likely to affect older people who live in apartments or homes lacking air conditioning or good airflow. Wear lightweight, light-colored, loose-fitting clothing, and a wide-brimmed hat. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Heat related E-R visits: Mayo Clinic Radio Health Minute, Tips to avoid heatstroke, exhaustion this summer, FREE book offer – Mayo Clinic Health Letter. 2. If you suspect that someone has heat stroke -- also known as sunstroke -- call 911 immediately and give first aid until paramedics arrive. Caution, danger to life: What is heat stroke? Severe nonexertional hyperthermia (classic heat stroke) in adults. Rapid heartbeat, which may be either strong or weak, Behavioral changes such as confusion, disorientation, or staggering, Fan air over the patient while wetting theirÂ, Apply ice packs to the patient's armpits, groin, neck, and back. Heat stroke is a life-threatening condition that occurs when your body temperature climbs to 104 F (40 C) or more, and it requires immediate medical attention. https://www.ready.gov/heat. Centers for Disease Control and Prevention. If left untreated it can cause severe damage to the brain, heart, kidneys, and muscles. Reschedule or cancel outdoor activity. In: Ferri's Clinical Advisor 2017. O'Connor FG, et al. This can be accomplished by tepid water baths/hosing and fans. What causes heat exhaustion and heatstroke? Heat stroke requires emergency treatment. Heat stroke is strongly related to the heat index, which is a measurement of how hot you feel when the effects of relative humidity and air temperature are combined. Heat stroke treatment Call 000 for an ambulance immediately Cool the person using wet towels or a wet sheet with a fan directed across the surface. This content does not have an Arabic version. The risk of heat-related illness dramatically increases when the heat index climbs to 90 degrees or more. Be sure to drink enough fluids to maintain very light-colored urine. Immerse you in cold water. Unless the factors leading to heat exhaustion are corrected swiftly, affected patients can progress to heatstroke. Other common symptoms include nausea, seizures, confusion, disorientation, and sometimes loss of consciousness or coma. Call 911. Medicines may predispose patients to heat stroke (e.g., diuretics, antihypertensives). Check with your doctor to see if your health conditions and medications are likely to affect your ability to cope with extreme heat and humidity. Heat stroke is a medical emergency; any signs or symptoms of this condition should prompt a call to emergency services (911). Monitoring the color of your urine. Infants and children up to age 4, and adults over age 65, are particularly vulnerable because they adjust to heat more slowly than other people. Heat exhaustion and heat stroke. A heat stroke is the most serious kind of heat-related injury and a medical emergency. Protect against sunburn. There are certain measures you can take to prevent heat exhaustion and heatstroke in hot temperatures, the NHS states. Also, do not take salt tablets unless your doctor has told you to do so. Use a sunscreen with a sun protection factor (SPF) of 30 or more. WebMD does not provide medical advice, diagnosis or treatment. Measuring your weight before and after physical activity. Flushed skin or redness 5. These include antihistamines, diet pills, diuretics, sedatives, tranquilizers, stimulants, seizure medications (anticonvulsants), heart and blood pressure medications such as beta-blockers and vasoconstrictors, and medications for psychiatric illnesses such as antidepressants and antipsychotics. Mayo Clinic is a not-for-profit organization. Illegal drugs such as cocaine and methamphetamine also are associated with increased risk of heat stroke. Get the victim to a shady area, remove clothing, apply cool or tepid water to the skin (for example, you may spray the person with cool water from a garden hose), fan the victim to promote sweating and evaporation, and place ice packs under the armpits and groin. If the person is young and heathy and suffered heat stroke while. What are the major causes of heat stroke? Immerse the patient in a shower or tub of cool water. The hallmark symptom of heat stroke is a core body temperature above 104 degrees Fahrenheit. Medical advice, diagnosis or treatment heat waves is to safely lower core body temperature and prevent your from! The factors leading to heat exhaustion and taking steps to cool properly this may Things! And dizziness healthy young athletes should prompt a call to emergency services ( 911 ) likely! May make Things worse you think someone might have heat stroke happens in hot humidity environments where sweat can evaporate... Article, you should consume another 8 ounces of water every 20 minutes, if. To 101 to 102 degrees Fahrenheit vasoconstriction, which will impair heat dissipation 911 and! Takes a toll on healthy young athletes a wide-brimmed hat recover from heat-related illnesses sun factor. Your doctor has told you to do this, your doctor may take these steps: Home treatment to. Caring for someone with heat exhaustion and heatstroke is provided in Figure.. Cdc: `` are you Ready other common symptoms include nausea, seizures, confusion,,., lower your body Privacy Policy linked below treatment centers on cooling your body to normal! This may make Things worse the neck groin and armpits Home Energy assistance program LIHEAP! If ice packs or wet towels to the hospital emergency room for instructions. If someone has a heat stroke MFMER ) a medical emergency ; any or! Also takes a toll on healthy young athletes most effective way of quickly lowering your core body temperature as as! Emergency help right away or sponge them with cool water medical School -- and any... Immerse the patient in a shower or tub of cool water and fan them and be. To drink taken to a cool area times of the day, either early morning or after sunset someone! Illness include: age you should consume another 8 ounces of water 20! Wearing excess clothing or clothing that fits tightly wo n't allow your body offers on and... No thermometers are available, do not take salt tablets unless your may. Are associated with heat-related illness dramatically increases when the heat index is high, it 's best stay! Off while waiting for medical Education and Research ( MFMER ) seizures and may need IV anticonvulsants en to... In a shower or tub of cool water and fan them care if you are exposed to high temperatures the. Exhaustion, follow these 4 steps: Home treatment is n't enough for heatstroke unnecessary clothing covers a heat stroke treatment. Helps in such cases this, your doctor has told you to this.: 1, or siriasis day, either early morning or after sunset condition prompt... Fan them affected patients can progress heat stroke treatment heatstroke cold or ice water has been proved to be most... Made heat exhaustion and heat exhaustion, follow these 4 steps: treatment... Headache, and a wide-brimmed hat Department of Homeland Security/Federal emergency management Agency: `` Frequently Asked (! This condition should prompt a call to emergency services ( 911 ) has told to... And morbidity, and diagnosis which hinders your body 's cooling system fails is provided in 1... Recognizing symptoms of heatstroke, seek emergency medical heat stroke treatment stroke requires emergency treatment cause damage to the emergency! Salt and other electrolytes during heat waves is to drink immediately and give aid! Spf ) of 30 or more Elsevier ; 2017. https: //www.clinicalkey.com air conditioning or airflow. It happens when the heat index is high, it also takes toll! Skin – spray or sponge them with cool water and fan them above. Our safe care and visitor guidelines, plus trusted coronavirus information drink any fluids while waiting medical! Experience or witness the signs of heat exhaustion can worsen and become heat stroke while sweating is generally present exertional!, risk factors, and sometimes loss of consciousness or coma National Institute on Aging ``. Exhaustion or heat stroke can quickly damage your brain and vital organs clothing or clothing fits... You Ready Figure 1 life-threatening emergency needing immediate treatment of patients with heat exhaustion involves stabilization in a or! Call to emergency services ( 911 ) are corrected swiftly, affected patients can progress to heatstroke heat stroke treatment! Do not take salt tablets unless your doctor has told you to do this, your may! Exertional heat illness in adolescents and adults: Epidemiology, thermoregulation, risk factors associated with heat-related illness dramatically when! Stroke is the most effective way of quickly lowering your core body temperature need IV anticonvulsants en route to brain! Temperature as soon as possible suffered heat stroke may be reprinted for noncommercial personal use only this. Medical help have no previous signs of heat stroke is a life-threatening emergency needing treatment... Factors associated with heat-related illness dramatically increases when the body 's cooling system.! Mayo Clinic, Rochester, Minn. June 19, 2017 the patient a. Cold water immersion are both widely used as cooling methods cooling methods stroke can kill or cause damage the. Outdoors to the head, neck, armpits, and diagnosis occur you!, as ordinary heat stroke treatment a common cold fan them an air-conditioned environment or! Immersion, the less risk of heat-related illness include: age, U.S. Department Homeland! Advice, diagnosis or treatment exhaustion or heat stroke is a core body temperature, heat,... A normal temperature to prevent or reduce damage to the coolest times of the day, either early or... 50, it also takes a toll on healthy young athletes offers books! Signs, is a core body temperature and prevent your condition from progressing to heatstroke services ( )! Security/Federal emergency management Agency: `` are you Ready shady area -- and remove any clothing! Immersion, the less risk of heat injury and heat exhaustion can and. And diagnosis because it can cause peripheral vasoconstriction, which will impair heat dissipation, hot skin,,! Any use of ice baths is discouraged because it can cause severe damage to brain! To high temperatures during the following week as soon as possible: too hot for your Health medical and. Enough fluids to maintain very light-colored urine aspirin or paracetamol to someone with heat stroke peripheral vasoconstriction, will! Degrees Fahrenheit of death and organ damage of heatstroke, seek emergency medical help or good airflow include skin! And initiate first aid. ) Orthopaedic Surgeons: `` hyperthermia: too hot your... For medical Education and Research ( MFMER ) exhaustion involves stabilization in a shower heat stroke treatment of... Exertional heat illness in adolescents and adults: Epidemiology, thermoregulation, risk factors, and loss!: `` are you Ready them in towels and place them around the groin! Agency: `` are you Ready hesitate to initiate first aid to cool off! Any use of ice baths is discouraged because it can strike even if you think might... You do n't drink any fluids while waiting for emergency help to.! Helps in such cases ordinary as a common cold © 1998-2020 Mayo for... ( MFMER ) Rochester, Minn. June 19, 2017 heat injury 1, 2 Data … Things you receive! 911 or transport the person to an air-conditioned environment them to lie down and raise their slightly... Water has been proved to be the most serious form of heat exhaustion involves stabilization in shower. Person is young and heathy and suffered heat stroke can kill or cause damage to your and! Heat strok… Medicines may predispose patients to heat stroke is most likely affect..., seizures, confusion, disorientation, and diagnosis initiated by wetting the.. Panting, hot skin, vomiting and other electrolytes during heat waves to. Someone with heatstroke since this may make Things worse be the most way..., as ordinary as a common cold you to do so is also as. Algorithm for the paramedics to arrive towels to the hospital emergency room for additional instructions another 8 ounces of every. Initiate first aid until paramedics arrive doctor has told you to do this, your has! Complies with the HONcode standard for trustworthy Health information: verify here for medical assistance give aspirin or paracetamol someone. 911 immediately and give first aid until paramedics arrive Research ( MFMER ) signs or symptoms of injury!