What constitutes a severe heat injury?

• A. Extremely high 108 rectal temperature, body hot to touch, vomiting, pale mucous membranes, abnormal mentation or abnormal level of consciousness, seizures, diarrhea, shock, death.
• B. Rectal temperature normal but lethargic.
• C. Slight panting and clear mucous membranes.
• D. Mild dehydration.

Answer: (A)

Severe heat injury is heat stroke, where the body loses its ability to regulate temperature and organ systems begin to fail. The best option shows extreme hyperthermia (a rectal temperature around 108°F), a body that’s hot to the touch, and multiple systemic and neurological signs—vomiting, pale mucous membranes, abnormal mentation or consciousness, seizures, diarrhea, shock, and possible death. This combination signals life-threatening heat stress with CNS involvement and likely multi-organ damage, which is what defines a severe case.

Less severe scenarios don’t meet that threshold: lethargy with a normal temperature could be an illness or fatigue; mild panting with clear mucous membranes indicates only mild heat stress; mild dehydration is a general sign and not specific to severe heat injury. In practice, a very high temperature plus altered mentation or other systemic signs is the red flag for emergency heat stroke.