【Contents】

  1. The appearance of symptoms of heat stroke
  • What’s heat stroke?
  • Do these symptoms appear?
  • About the severity level
  1. Actions to take when a person could have heat stroke
  • First Aid for heat stroke
  • First Aid at the scene
  1. How to call an ambulance (119)
  • How to call an ambulance
  • Actions to take until an ambulance arrives
  1. Actions to take when you arrive at the hospital
  • Information that medical team want to know when a person could have heat stroke

1．The appearance of symptoms of heat stroke　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　

  1. What’s heat stroke?
    When a person has heat stroke, the body temperature rises, a balance of body’s water and salt (sodium) loses and the body temperature control system fails. Then, it causes a variety of symptoms such as a rise of body temperature, dizziness, cramp and headache.

    Summer in Japan is very hot and humid, so it’s quite possible that you get heat stroke, even though you think that you take enough measures to prevent heat stroke.
  1. Do these symptoms appear?
    These symptoms may appear when a person gets heat stroke.
    You need pay attention when especially, children, elderly people and those with disabilities come down with these symptoms.
  • Dizziness, Fainting
  • Muscle pain, Muscle stiff
  • Heavy sweating
  • Altered mental stare
  • Numbness of limbs
  • Headache, Nausea, Vomiting, Tiredness, Weakness
  • Consciousness disorders, Cramp, Movement disorders of limbs
  • High body temperature

③ About the severity level
Symptoms of heat stroke appear depending on the severity level as follows.
If a person displays symptoms of moderate or severe, you should go to the hospital and get treatment immediately.

Table1. Symptoms of heat stroke ”By the severity level”
Level Ⅰ Mild：It is possible to perform first aid at the scene.
Dizziness, Fainting
When it has poor blood flow to the brain temporarily, a person gets “Light-headedness”.
Also, it is called “Heat Syncope”.
Muscle pain, Muscle stiff
These symptoms appear when it runs out of salt (sodium) caused by sweating.Numbness of limbs, Altered mental stare
Level Ⅱ Moderate：It needs to take a sick person to the hospital.
Headache, Nausea, Vomiting, Tiredness, Weakness
It occurs some symptoms such as getting exhausted and weakening, also, it might appear a touch of consciousness disorders like “It looks different from usual”. This condition is called “Heat exhaustion”.
Level Ⅲ Severe：It needs to be hospitalized and receive an intensive care.
Consciousness disorders, Cramp, Movement disorders of limbs
It occurs some symptoms such as unusual reaction to calls and stimulations, having a convulsion (full-body cramp) and being impossible to walk
High body temperature
When you touch a person’s body who is not feeling well, you feel heat. It means heat stroke or serious sun
Liver function disorders, Renal function disorders, Blood clotting disorders
These symptoms are found by drawing blood in the medical institution.
Made the table1 from the following information.
”Guideline for prevention of heat stroke on the summer event 2020” Ministry of the Environment
(https://www.wbgt.env.go.jp/pdf/gline/heatillness_guideline_full_high.pdf)

2．Actions to take when a person could have heat stroke　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　

Even If you take enough water or vitamins and avoid getting sunlight during indoor activities, it is quite possible that you get heat stroke.

  1. First Aid for heat stroke
    When you see a person who could have heat stroke, be calm down and check the person’s condition by the following ways.

Figure: “First Aid for Heat Stroke”
Source: “Heat Stroke Environmental Health Manual 2018” Ministry of the Environment

  1. First Aid at the scene
    Heat stroke is one of the diseases that it is possible to die, if left untreated.
    In severe cases, it is important to call an ambulance and take following measures at the scene immediately.
  • Move to a cool place：Move to a room where the air-conditioner works and the shade.
  • Cool the body：Loosen clothes, cool neck, armpits and groin.
  • Rehydrate：Take water, sodium and sports drinks.
Table２．First Aid at the scene
1. Take a sick person to a cool place Take the person to a cool and shaded place, if possible, a room where the air-conditioner is working.
If the person is a woman, we recommend that both of men and women give aid to the person taking Step.2 into consideration.
2. Remove clothes and cool the person Remove clothes and radiate heat through the skin. Loosen tight belt, tie or underwear and improve air flow.
Cool the person’s body by applying wet towels or handkerchiefs to the skin and fanning. Also, you can pour cold water on clothes or underwear little by little.
Buy a cool bottled water, ices in the plastic bag and ice packs at the vending machines or convenience stores, then apply these to the both side of base of neck, armpits and the groin (font of the base of thighs, hip joints). Cooling blood under the skin is effective. 
You need to cool the person’s body as soon as possible. It depends on cooling the body immediately whether you can help the severe patient.
In case of calling an ambulance, it requires starting to cool the body before arriving an ambulance.
3. Take water and sodium Have the person hold a cool bottled water and drink by oneself. Taking cool drinks takes the body heat from the surface of the stomach. When the person is sweating a lot, oral rehydration solutions and sports drinks are effective in taking sodium that was lost by sweating. Salt water (put 1-2g of salt in 1ℓ of water) is also good.
If the person can respond well and has a clear sensorium, please have the person drink cool water a lot.
When “The person doesn’t react to calls and stimulations well.” or “The person doesn’t respond (It appears consciousness disorders)”, it’s possible to flow water into the airway by mistake. Also, these symptoms such as “Complain of a nausea” or “Vomiting” mean that the gastrointestinal motility is not working very well. In these cases, do not have the person drink water from the mouth. It needs to be put on a drip in the hospital immediately.
4. Take the person to the hospital When the person can’t drink water by oneself, top priority is taking the person to the hospital immediately for rehydration and taking sodium by an intravenous drip.
In actuality, nearly 10％ of the patients of heat stroke that visit to the medical institution are diagnosed as levelⅢ or levelⅡ. Also, it needs to transfuse (administer water by intravenous injection), place strict controls (monitor blood pressure and the amount of urine) and check whether the person has liver disorders or renal disorders.
Made the table2 from the following information.
”Guideline for prevention of heat stroke on the summer event 2020” Ministry of the Environment
(https://www.wbgt.env.go.jp/pdf/gline/heatillness_guideline_full_high.pdf)

3．How to call an ambulance（119）　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　

Heat stroke is one of the diseases that it is possible to die, if it is untreated.
In severe cases, it is important to call an ambulance immediately and receive an appropriate treatment in hospital.

The number to call an ambulance is 119.

Anyone would be unsettled when you see a sick person and an injured person.
Calm down, don’t panic and slowly explain the situation and ask for help.
Also, if you are worried about your Japanese, don’t forget to ask someone nearby you for help.

  • In Japan, we can call an ambulance from a phone anytime and anywhere. You don’t have to pay the fee for taking someone to the hospital.
  • You call 119 when you need an ambulance, but 119 is the phone number of the fire station. You can call not only an ambulance but also a fire truck.
  • An ambulance is used to take a person who needs getting immediate medical care because of traffic accidents or sudden illnesses to an emergency hospital.
    Please call an ambulance only when you’re in an emergency situation.

①　How to call an ambulance

  1. Tell the dispatcher it’s an emergency.
    Dispatcher：「119番、火事ですか？救急ですか？」 (119 ban, kaji desuka? Kyukyu desuka?) 
    EN:”119, Fire or Emergency?”
    You：「救急です」 (Kyukyu desu.)
    EN:”It’s an emergency.”
  • 119 handles both fires and emergencies, so be clear ‘an emergency’.
  1. Tell the address of where you want an ambulance to be dispatched.
    Dispatcher：「住所はどこですか？」 (Jyusho wa doko desuka?)
    EN:” Where is the address?”
    You：「○○市□□町△丁目◇番地です」 (○○-shi □□chou/machi △choume ◇bannchi desu)
  • Be sure to tell the name of the city. If you don’t know the address, tell the nearest tall building, intersection, or landmark.
  1. Tell about symptoms of a person who is not feeling well.
    Dispatcher：どうしましたか？ (Doushimashita ka?)
    EN: “What happened?”
    You：イベントで友人が倒れました。熱中症のようです。意識はありますが、声を掛けても反応がおかしいです。
    （Event de yuujin ga, tawore mashita. Ishiki wa arimasuga, koe wo kaketemo hannou ga okashii desu.）
    EN: “My friend collapsed in the event venue. It looks like a heat stroke. She/He remains conscious but doesn’t react to my call well.”
  • Firstly, tell Who, How, What simply. Tell whether or not they are conscious or breathing as far as you know.
  • If there’s multiple sick people or injured people, tell the number as well.
  • In addition to that, they may ask about chronic illness and family doctor/hospital, detailed situation of time of collapsed. Tell them what you know.
  1. Tell the age of person who is not feeling well.
    Dispatcher：おいくつの方ですか？ (Oikutsu no kata desuka?)
    EN: “How old is he/she?”
    You：21歳です（Nijyuichi sai desu.）
    EN: “He/She is 21 years old.”
  • If you don’t know, “60s”, “about 30s or 40s”, “elementary school student” roughly are fine.
  1. Tell your name and contact information.
    Dispatcher：あなたの名前と連絡先を教えてください。 (Anata no namae to renraku saki wo oshiete kudasai.) 
    EN: “Tell me your name and contact information.”
    You：私の名前は○○○○です。電話番号は・・・・です。 (Watashi no namae wa ○○○○. Denwa bango ha…..desu.)
    EN: ”My name is ○○○○. My number is ….”
  • Provide a phone number that you can be reached at, such as a mobile phone number. Please do not turn off the power even after the report is over, you may be asked for direction to the location.

＜How to call an ambulance from a mobile phone.＞
Call 119.
Please don’t turn off the mobile phone. Because there are cases in which you get a phone call from the fire station after talking.

  • If there are the landline or the public phone near you, use these preferentially.

＜How to call an ambulance from a public telephone.＞
You can call 119 from a public telephone.

■Green public telephone

  1. Lift the receiver.
  2. Press the “Emergency Call Button”.
  3. Dial 119.

■Grey public telephone or card-type public telephone 

  1. Lift the receiver.
  2. Dial 119.

■Pink public telephone
・If there is an Emergency Call Button.

  1. Lift the receiver.
  2. Press the “Emergency Call Button”.
  3. Dial 119.

・If there is no Emergency Call Button.

  1. Lift the receiver.
  2. Dial 119.

②　Actions to take until an ambulance arrives.
If you call 119 from a mobile phone, wait on the site without turning off the power.
If there are enough people, when you hear the sound of an ambulance, send someone out of the scene to guide them.

(Attention) Ambulance crews choose and carry a person to an emergency hospital judging from the condition of illness or injury, the circumstance and the place. Please note that it is not always your choice which hospitals the person would be carried to.

If possible, have these in place.

  • Passport (Foreigner)
  • Residence card (Foreigner)
  • Insurance card
  • Hospital registration card
  • Cash
  • Medical information kit
  • Shoes (Especially when collapsed indoors such as home)
  • Medications and medicine notebook
  • Mother and child health handbook, paper diapers, baby bottle and towel (Infants)

When the ambulance is coming, give a signal to them like waving your arms.

Tell the following after that ambulance crews are arrived.

■The situation when the person was feeling bad.
■The change in the person’s physical condition before an ambulance arrived.
■Details about the treatment that you performed.
■The information of the sick person (e.g. chronic illness, regularly-taken medication, family doctor)

If the foreigner who can’t speak Japanese is carried to the hospital, have the person who can speak Japanese accompany as much as possible.

4．Actions to take when you arrive at the hospital　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　

If it is difficult for you to communicate in Japanese, ask a person who can speak Japanese to be an interpreter.
In the hospital, when a person who could have heat stroke is carried, the hospital staffs may ask you about following information.

  1. Situation before feeling sick.
  • Meals and drinking water: Did the person take enough water and sodium?
  • A place where the person did activities: What kind of place? How long did the person stay there?
  • Activities: What did the person do?
  • Clothes: Did the person put clothes that easy to accumulate heat? Did the person wear a hat?
  • Were there different points than usual?
  1. Situation when feeling sick.
  • Symptoms
  • Abnormal behavior
  • First Aid on the site
  1. Recent situation
  • The season of starting on an activity
  • Physical condition
  • Sleep
  • Cold
  • Hangover
  1. 　Others
  • Height and weight
  • Have the person had heat stroke before?
  • Have the person previously had any diseases?
  • Are there any medicines the person is currently taking?
  • Does the person drink alcohol and smoke?

Available to download about more detailed information.

  • Medical Questionnaire: For heat stroke (download)

Also, if you have chronic illness or regularly-taken medication, Medical information kit and a medical questionnaire are useful.

We recommend that you prepare them beforehand.

  • Medical information kit (download)
  • Medical Questionnaire (download)

Please refer this page about the prevention of heat stroke.

  • Prevention of heat stroke

・The above contents are created with reference to the following information. If there is a change in the contents of the reference source, it may take some time to be reflected on this site. Thank you for your understanding.

【Sources】

”The relevant information about heat stroke” Ministry of Health, Labour and Welfare
(https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/kenkou/nettyuu/index.html)

”For the prevention of heat stroke” Ministry of Health, Labour and Welfare
(https://www.mhlw.go.jp/file/04-Houdouhappyou-10901000-Kenkoukyoku-Soumuka/necchushoyobou.pdf)

“Heat Stroke Environmental Health Manual 2018” Ministry of the Environment
(https://www.wbgt.env.go.jp/heatillness_manual.php)

”Guideline for prevention of heat stroke on the summer event 2020” Ministry of the Environment
(https://www.wbgt.env.go.jp/pdf/gline/heatillness_guideline_full_high.pdf)

”When, how to call? The way to use an ambulance in case of emergency” Cabinet office-online
(https://www.gov-online.go.jp/useful/article/201609/1.html)

”Emergency Medical Care Handbook for Foreigners” (There are English, Chinese, Korean and Portuguese version. Available to download in PDF.) Hiroshima Prefecture
(https://www.pref.hiroshima.lg.jp/soshiki/53/qq-f-handbook.html)