When temperatures climb into the triple digits, the danger isn’t just the environment—it’s what happens underneath the gear.

Firefighters are responding to emergencies in bunker gear that traps heat and prevents sweat from cooling the body. Law enforcement officers spend hours in body armor, dark uniforms, and patrol vehicles that can quickly become ovens. Add in physically demanding calls, long shifts, and limited opportunities to hydrate or rest, and the risk of heat-related illness rises dramatically.

Heat stress isn’t just uncomfortable. It can quickly become life-threatening

Why First Responders Face a Higher Risk

Unlike the average person, first responders can’t simply avoid the heat. Their work requires heavy protective equipment, rapid physical exertion, and long periods outdoors.

Several factors increase the risk of heat illness, including:

• Bunker gear and body armor that trap heat and reduce sweat evaporation
• Intense physical activity during firefighting, foot pursuits, rescues, or physical confrontations
• Long shifts with missed meals, skipped water breaks, and limited recovery time
• Dark uniforms and hot pavement that increase heat absorption
• Increased cardiovascular strain from the combination of heat and physical exertion

By the time someone feels thirsty or notices symptoms, they’re often already behind.

Six Ways to Reduce Heat Stress on the Job

1. Build Mandatory Work and Recovery Periods

Recovery is part of the job—not a sign of weakness.

Departments should establish work/rest cycles during extreme heat, especially when temperatures exceed 100°F. Firefighters should remove or loosen PPE during rehabilitation whenever possible, while law enforcement officers should use air-conditioned patrol vehicles to cool down after physically demanding calls.

Waiting until someone says they need a break isn’t enough. Recovery periods should be built into operations.

2. Hydrate Before, During, and After the Shift

Hydration starts long before the first call.

Many responders begin their shifts already dehydrated from caffeine, alcohol, illness, or simply not drinking enough water the day before. Starting a shift dehydrated makes it much harder for the body to regulate temperature once physical activity begins.

Drink water consistently throughout the day instead of waiting until you’re thirsty. For most routine shifts, water is all that’s needed. Sports drinks should generally be reserved for prolonged periods of heavy sweating or extended operations.

3. Don’t Ignore Pre-Existing Dehydration

Even mild dehydration increases cardiovascular strain, reduces physical performance, and causes core body temperature to rise more quickly.

Combined with heavy gear and extreme heat, dehydration can contribute to serious conditions including:

• Heat exhaustion
• Heat stroke
• Acute kidney injury
• Rhabdomyolysis
• Sudden cardiac events

Hydration isn’t just a scene responsibility—it’s a daily habit.

4. Cool the Patient Immediately

When heat stroke occurs, every minute matters.

Heat stroke is a true medical emergency characterized by a core temperature of 104°F (40°C) or higher along with altered mental status such as confusion, slurred speech, or unusual behavior.

Rapid cooling should begin immediately. Cold water immersion remains the gold standard whenever possible. If that’s unavailable, use any available cold water methods such as ice slurries, hoses, or evaporative cooling techniques.

The faster cooling begins, the better the outcome.

5. Know the Difference Between Heat Exhaustion and Heat Stroke

Recognizing symptoms early can save a life.

Heat exhaustion often presents with:

• Heavy sweating
• Fatigue
• Dizziness
• Headache
• Nausea
• Cool or clammy skin

Heat stroke may include:

• Confusion
• Slurred speech
• Loss of coordination
• Hot skin
• Altered mental status

The biggest warning sign is a change in mental status. If someone seems confused, disoriented, or “not acting right,” treat it as a medical emergency.

6. Watch Out for Each Other

One of the strongest tools against heat illness is your crew.

Heat illness often develops gradually, and those experiencing it may not recognize how impaired they’ve become. That’s why active monitoring matters.

Check in with your partner. Watch for changes in behavior, coordination, or decision-making. Supervisors should proactively monitor crews instead of waiting for someone to report symptoms.

A simple conversation may prevent a medical emergency.

Additional Risk Factors

Some responders face an even greater risk during extreme heat, including those who:

• Recently recovered from an illness
• Have a higher body mass index (BMI)
• Take medications that affect hydration or temperature regulation
• Use medications or supplements that increase cardiovascular strain

Knowing these risk factors allows departments and individuals to make smarter operational decisions before an emergency occurs.

The Bottom Line

When temperatures exceed 100°F, every firefighter and law enforcement officer begins the shift at a disadvantage. Protective equipment, physical exertion, and environmental heat create conditions where heat illness can develop quickly.

Departments that prioritize hydration, recovery, active monitoring, and rapid cooling aren’t simply improving comfort—they’re protecting the health, performance, and lives of the people who serve their communities every day.

Heat injuries are largely preventable. Preparation, education, and a culture that values recovery are some of the most effective tools we have for keeping first responders safe throughout the summer.

Brandi Kamper, PA-C, Staff Provider/Office Manager, Front Line Mobile Health