Heat‑Related Illness in Outdoor Workers: Medications Used in Acute Treatment
Prodigy Care Services
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Prodigy Care Services 〰️
Heat-related illness is a growing concern for outdoor workers, particularly as rising temperatures and prolonged exposure increase the risk of heat stress, heat exhaustion, and heat stroke. These conditions are especially relevant in workers’ compensation due to their impact on worker safety, medical complexity, and claim severity.
While prevention remains the primary strategy, understanding the acute medical management of heat-related illness, including the role of medications, is critical for improving outcomes and reducing complications.
Understanding Heat-Related Illness
Heat-related illness exists on a spectrum that includes:
Heat cramps → muscle spasms due to electrolyte imbalance
Heat exhaustion → dehydration, weakness, and reduced tolerance to heat
Heat stroke → a medical emergency defined by elevated core body temperature and altered mental status
Outdoor workers are particularly vulnerable due to:
Prolonged exposure to high temperatures
Physical exertion
Limited access to hydration or cooling strategies
Severe cases can progress rapidly and require immediate medical intervention to prevent organ damage or death [1]. Fluid resuscitation plays a central role in preventing progression from heat exhaustion to more severe conditions [2].
Medications Used in Acute Treatment
IV fluids are the primary pharmacologic intervention in heat-related illness.
They are used to:
Correct dehydration
Restore circulatory volume
Address electrolyte imbalances
Common options include:
Normal saline
Electrolyte-containing solutions
Electrolyte Replacement
Electrolyte imbalances are common in heat-related illness, particularly due to excessive sweating.
Treatment may include:
Oral or IV sodium replacement
Correction of potassium abnormalities
Improper management of electrolytes can increase the risk of:
Muscle dysfunction
Cardiac complications
Neurologic symptoms
Targeted replacement is essential for stabilizing patients [2].
Benzodiazepines for Severe Symptoms
In cases of heat stroke with agitation or seizures, benzodiazepines may be used.
These medications help:
Control seizure activity
Reduce muscle rigidity or agitation
Decrease metabolic demand
Examples include:
Lorazepam
Diazepam
They are used cautiously and only when clinically indicated, particularly in severe presentations [1].
Prevention and Risk Management
Although acute treatment is critical, prevention remains the most effective strategy.
Key measures include:
Hydration protocols
Scheduled rest breaks
Climate acclimatization
Worker education on early symptoms
Employers and claims professionals play a role in ensuring that environmental risks are managed proactively, reducing the likelihood of high-cost and high-severity claims [3].
By Sarah Cirildo
PharmD
For questions, e-mail pharmd@prodigyrx.com
Citations
1. Centers for Disease Control and Prevention. Heat-related illness: prevention and treatment. Updated 2024.
https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html2. StatPearls. Heat stroke. Updated January 2024. Accessed May 13, 2026.
https://www.ncbi.nlm.nih.gov/books/NBK537135/3. Occupational Safety and Health Administration. Heat illness prevention campaign. Updated 2023.
https://www.osha.gov/heat