Sunstroke in Spain: Symptoms, First Aid & When to Call 112

What is sunstroke (heat stroke)?

Sunstroke is the lay term for what doctors call heat stroke or, in Spanish, golpe de calor. It is the most severe of the heat-related illnesses on a spectrum that runs from heat cramps (mildest) through heat exhaustion to heat stroke (life-threatening).

Clinically, sunstroke is defined by two criteria occurring together:

• Core body temperature of 40°C (104°F) or higher — measured rectally or by an internal thermometer, since skin temperature is unreliable in a heat stroke casualty.
• Altered mental status — confusion, agitation, slurred speech, irritability, delirium, seizures or coma.

The condition occurs in two forms. Classic (non-exertional) heat stroke affects mostly elderly people, infants and the chronically ill — it builds over several days of high ambient temperature without adequate hydration. Exertional heat stroke hits otherwise healthy adults during physical exertion in the heat — typical Costa Blanca cases involve cyclists on the inland climbs, runners in summer races and construction workers on coastal roofs without shade.

The body normally cools itself by sweating. Once core temperature exceeds 40°C, the hypothalamus loses its ability to regulate, sweating may stop entirely and every additional degree damages the brain, heart, kidneys and liver. Time is critical: each minute above 41°C compounds the organ damage.

Why Spain — and the Costa Blanca — are high-risk for heat stroke

Spain is one of the European countries with the highest annual heat-related mortality, and the situation is worsening. Recent figures published by the Carlos III Health Institute (ISCIII) attribute 2,000–4,000 heat-related deaths a year to summer extreme temperatures, with peaks of 6,000+ during severe heatwave years like 2022 and 2023.

• The Mediterranean climate regularly produces July–August daytime temperatures of 35–42°C in inland Alicante, Valencia, Murcia and Andalucía, with night-time temperatures that no longer drop below 25°C ("noches tropicales").
• The Costa Blanca coast is cooler in absolute terms (28–34°C on a typical summer day in Jávea, Dénia or Torrevieja) but the combination of high humidity, strong sun, salt air and pavement reflection still produces dangerous heat exposure.
• AEMET (the Spanish Met Office) issued red heat alerts on a record number of days during the summer of 2025. Red alerts mean an "extreme" risk of heat stroke for the entire population, not just vulnerable groups.
• Tourist hot-spots are the most dangerous for visitors who are not yet acclimatised — Madrid (44°C+ recorded), Sevilla (47°C recorded August 2023) and the Costa del Sol coast.

British, Irish and Northern-European expats and tourists are at disproportionately high risk because they arrive un-acclimatised, often misjudge their tolerance and over-exert in the first 48 hours. The British Embassy in Madrid issues annual heat-safety guidance for this reason.

Symptoms of sunstroke: signs to watch for

The classic symptoms of sunstroke divide into three groups. If you see any red-flag symptom together with a hot, flushed casualty, treat it as sunstroke and call 112 immediately.

Red-flag symptoms (call 112 now)

• Confusion or altered mental state — disorientation, slurred speech, agitation, behaving "drunk".
• Very high body temperature — 40°C / 104°F or higher (if you can measure it).
• Hot, flushed, dry skin — in classic heat stroke, sweating often stops; the skin feels hot and dry.
• Rapid, strong pulse — typically 130+ bpm at rest.
• Rapid, shallow breathing.
• Seizures.
• Loss of consciousness — fainting, collapse, unresponsiveness.

Warning symptoms (escalate fast)

• Severe headache.
• Nausea and vomiting.
• Muscle cramps that don't respond to rest and water.
• Dizziness or feeling faint when standing.
• Heavy sweating that suddenly stops.

Early warning symptoms (heat exhaustion stage — act now to prevent escalation)

• Heavy sweating with cool, clammy skin.
• Weakness, fatigue.
• Fast, weak pulse.
• Light-headedness.
• Muscle cramps.
• Dark, concentrated urine.
• Thirst (a poor indicator — by the time you feel thirsty in 40°C heat you are already dehydrated).

The single most important diagnostic sign of sunstroke versus heat exhaustion is mental status. A confused, disoriented or unresponsive casualty in the heat is having a heat stroke until proven otherwise.

Heat exhaustion vs sunstroke — the difference matters

These two are routinely confused, but they require completely different responses.

If a casualty deteriorates from heat exhaustion (sweating, weak, dizzy) to sunstroke (confused, hot, dry) over 10–20 minutes, that is the classic progression. Do not wait — call 112 the moment the confusion or unresponsiveness appears.

First aid for sunstroke: the first 15 minutes

What you do in the first 15 minutes determines the outcome. The two priorities are aggressive cooling and calling 112.

Step 1 — Call 112 immediately

Spain's universal emergency number is 112. It is free, operates 24/7 and English-language service is available throughout Spain. Tell them clearly: "golpe de calor" or "heat stroke — possible", your location and the casualty's age and condition. Stay on the line.

Step 2 — Move to shade or a cooler space

Get the casualty out of direct sun and into the coolest available space — an air-conditioned car, a shop, the ground floor of a building. Lay them down with legs slightly raised.

Step 3 — Remove excess clothing

Strip outer layers, shoes and socks. Loosen anything tight. Maximum skin exposure helps cooling.

Step 4 — Cool aggressively

This is the single most important intervention. Use whatever cold water and ice you can find:

• Best: Ice-water immersion (cold-water bath) — drops core temperature fastest. Used by Spanish hospitals on confirmed exertional heat stroke.
• Excellent: Soak the casualty with cold water and fan vigorously. Evaporative cooling is highly effective.
• Good: Wet cloths or ice packs on the neck, armpits, groin and forehead (sites with large blood vessels close to the skin).
• If beach or pool nearby: partial-body submersion to the neck (head clear of water) is appropriate while you wait for 112.

Goal: bring core temperature down to 38.5°C within 30 minutes. The window for preventing major organ damage is short.

Step 5 — Hydration (only if fully conscious)

If the casualty is fully alert and can swallow, offer small sips of cool (not ice-cold) water or an oral rehydration solution. Never give fluids to a confused, drowsy or unconscious casualty — risk of choking.

What NOT to do

• Do not give aspirin, ibuprofen or paracetamol — they don't reduce heat-stroke fever and can worsen kidney and liver damage.
• Do not give alcohol or caffeinated drinks — both worsen dehydration.
• Do not delay the 112 call while you try other things.
• Do not use rubbing alcohol on the skin — outdated advice; risk of cardiac arrhythmia in some patients.
• Do not assume the casualty has recovered if they wake up — heat stroke causes hidden organ damage that needs hospital assessment.

When to call 112: red-flag symptoms

Call 112 immediately if a casualty in the heat shows any of the following:

• Confusion, slurred speech, agitation or disorientation.
• Loss of consciousness, even briefly.
• Seizure.
• Body temperature 40°C / 104°F or higher (if you can measure).
• Vomiting that prevents the casualty from keeping any fluid down.
• Hot, dry skin with absent sweating in extreme heat.
• Rapid, strong pulse with rapid shallow breathing.
• Severe headache that worsens or is accompanied by neck stiffness.
• Any heat-related symptoms in a child under 5 or an adult over 65.

For a deeper guide to the Spanish emergency-call system, our Emergency Numbers in Spain guide explains 112, the regional health emergency lines (061), the Guardia Civil (062) and the Local Police (092).

Spanish emergency response: what happens after you call 112

Once you've called 112, the operator dispatches the regional emergency medical service — SAMU 061 in the Comunidad Valenciana, SUMMA 112 in Madrid, EPES 061 in Andalucía. Typical response times on the Costa Blanca are 8–14 minutes in urban areas and 15–25 minutes in rural urbanisations.

The crew will:

• Confirm core body temperature (typically with a rectal thermometer).
• Begin active cooling — cold IV fluids, ice packs, evaporative cooling with fans.
• Establish IV access and rehydrate with cold saline.
• Monitor cardiac rhythm and oxygen saturation.
• Transport to the nearest hospital (urgencias) for blood tests, kidney/liver function, neuro evaluation and observation.

Confirmed heat stroke is almost always admitted to a high-dependency unit (UCI) for 24–48 hours. Full recovery from severe cases can take days to weeks.

Treatment costs in Spain & insurance cover

Spain's public emergency services (SAMU, Cruz Roja, hospital A&E) treat acute emergencies free of charge regardless of whether the patient is insured, a tourist or undocumented. You will not be turned away at the door of a Spanish A&E with suspected sunstroke.

The cost questions arise after stabilisation:

• UK GHIC / EU EHIC holders: the card covers medically necessary public-emergency treatment in Spain at no charge.
• UK retirees with an S1 form: full public coverage including any follow-up.
• Tourists without GHIC/EHIC: face billing from the regional health authority — typically €600–€1,500 for a single A&E visit and €1,200–€2,500/night in a UCI bed.
• Private health insurance: covers ambulance, A&E, hospital admission and follow-up at private clinics with no public-queue wait. Most Costa Blanca expat policies include 24/7 medical telephone advice in English.
• Travel insurance: tourists should travel with a policy covering medical evacuation — air-ambulance repatriation from Alicante to the UK can exceed €25,000 if it's clinically necessary.

Our Spanish private health insurance products (Generali Salud, Generali Premium) include emergency hospitalisation cover, 24/7 English-language medical advice and direct private-clinic admission — relevant if you live an hour from the nearest public hospital, as many Costa Blanca expats do.

Who is at highest risk of sunstroke?

The risk profile is well-established. The Spanish Ministry of Health (Ministerio de Sanidad) targets its summer heat-warning system at exactly these groups:

• Adults over 65 — reduced thermoregulation, higher use of diuretics and beta-blockers, often live alone.
• Infants and children under 5 — surface-to-mass ratio makes them heat up quickly; can't tell you they're overheating.
• People with chronic illness — heart disease, diabetes, kidney disease, respiratory disease, dementia.
• People on certain medications — diuretics, beta-blockers, antidepressants, antipsychotics, anticholinergics, decongestants — all reduce heat tolerance.
• Outdoor workers — construction, agriculture, deliveries, hospitality. Spain has tightened heat-protection rules for outdoor work since 2023.
• Athletes and exercisers — particularly the first week of arrival, before heat acclimatisation.
• Recently arrived tourists and new arrivals — full heat acclimatisation takes 10–14 days.
• People drinking alcohol in the sun — beach drinkers are a major Costa Blanca A&E case.

Prevention — daily routine for Spanish summer

The Spanish public-health authorities and AEMET issue heat-prevention guidance every summer. The practical version for Costa Blanca residents and visitors:

• Avoid sun exposure between 12:00 and 17:00 — peak UV and peak temperature. Adopt the Spanish habit of an indoor siesta block.
• Drink water proactively — 2.5–3 litres a day in summer; don't wait for thirst.
• Add electrolytes on hot exertion days — sports drinks, oral rehydration salts, or a pinch of salt in water with a squeeze of citrus.
• Wear loose, light, breathable clothing — natural fibres (cotton, linen) over synthetics.
• Hat and high-factor sunscreen — broad-brim hat covers neck and ears; SPF 30+ minimum.
• Keep the bedroom below 25°C overnight — air conditioning is no longer a luxury, it's a Spanish summer survival tool. Set timers if you don't want it on all night.
• Plan exercise for 06:30–08:30 or after 20:00 — never midday, even in autumn.
• Don't drink alcohol in direct sun — particularly on a beach with no shade.
• Check on neighbours over 75 — elderly-alone is the largest single category of Spanish heat fatality.
• Never leave children, pets or adults in a parked car — interior temperatures climb 10°C in 10 minutes.

Sunstroke in dogs and pets

Heat stroke is the second-largest emergency presentation in Costa Blanca veterinary clinics in summer (after road-traffic injury). Dogs cannot sweat; they cool by panting and through their paw pads, which is hopelessly inadequate above 32°C.

Signs of heat stroke in dogs:

• Excessive panting that won't settle.
• Drooling and thick, ropey saliva.
• Bright red gums and tongue.
• Unsteady gait, collapse, seizure.
• Vomiting (sometimes with blood).
• Core temperature above 40°C (normal canine is 38.0–39.2°C).

First aid is essentially identical: shade, cool water (not ice-cold — risks shock), wet towels on belly and paw pads, and an immediate call to the nearest vet (veterinario). For night-time emergencies, our Emergency Numbers in Spain guide lists the regional 24-hour vet hotlines.

Costa Blanca breeds most at risk: brachycephalic dogs (French Bulldog, English Bulldog, Pug, Boxer), all heavy-coated northern breeds (Husky, Malamute, Bernese), overweight dogs, puppies and senior dogs. Our Spanish pet insurance products cover emergency vet treatment, hospitalisation and even repatriation in the unhappy event of death abroad.

The AEMET heat-alert system explained

AEMET (Agencia Estatal de Meteorología) issues four-colour heat warnings on its public app and website. Knowing how to read them is the simplest way to plan your summer in Spain:

• Green — no warning, normal summer conditions.
• Yellow — risk level. Take basic precautions; vulnerable groups stay indoors midday.
• Orange — significant risk. Reduce outdoor activity 12:00–18:00; public events restricted; schools modify break times.
• Red — extreme risk. All non-essential outdoor activity suspended; sports events cancelled; increased ambulance pre-positioning; regional government activates emergency protocols. Sunstroke risk is high across the general population, not just vulnerable groups.

The Ministerio de Sanidad's Plan Nacional para la Prevención de los Efectos del Calor sobre la Salud runs from 1 June to 30 September and triggers automatic actions whenever AEMET issues orange or red alerts — including text alerts, public-broadcast warnings and reinforced primary-care staffing.

Frequently asked questions: sunstroke in Spain

What are the first signs of sunstroke?

The earliest signs are heat exhaustion, not yet full sunstroke: heavy sweating, weakness, light-headedness, headache, nausea and muscle cramps. The transition from heat exhaustion to sunstroke is marked by mental-status changes — confusion, slurred speech, agitation or fainting — and by a body temperature climbing through 39–40°C. Treat any mental change in a hot casualty as sunstroke and call 112 immediately.

What temperature is sunstroke?

The clinical definition of sunstroke (heat stroke) is a core body temperature of 40°C / 104°F or higher combined with altered mental status. Heat exhaustion ranges from 37–40°C without significant mental-status change. Skin-surface temperature is a poor proxy; rectal or core thermometers are the reliable measure used in Spanish A&E.

How long does it take to recover from sunstroke?

Mild cases treated within an hour typically recover in 24–48 hours with hospital observation. Severe cases — those who developed seizures, lost consciousness or had core temperatures above 41°C — can take days to weeks to recover fully, and a minority suffer permanent kidney, liver or neurological damage. The first week after hospital discharge is the most vulnerable; aggressive hydration, avoidance of further heat exposure and follow-up bloods are standard.

Can you die from sunstroke?

Yes. Untreated heat stroke has a mortality rate of 10–50% depending on age, comorbidities and how long the patient was hyperthermic. Even with prompt hospital treatment, mortality remains 5–10% in severe cases. Spain attributes 2,000–6,000 deaths per summer to heat-related illness, with the elderly and outdoor workers the most frequent victims.

What is the difference between sunstroke and heat stroke?

In British and Irish English the two terms are used interchangeably. Strictly, "heat stroke" is the medical term for the life-threatening hyperthermic emergency we describe in this guide. "Sunstroke" historically meant heat stroke specifically caused by direct sun exposure, but in modern usage the two are synonymous. The Spanish term is golpe de calor.

What is the difference between sunstroke and sunburn?

Sunburn is skin damage from UV radiation — painful, red, peeling skin. Sunstroke is a systemic emergency involving core body-temperature dysregulation, mental-status change and organ damage. You can have one without the other. Severe sunburn does increase sunstroke risk because damaged skin cannot dissipate heat or sweat effectively.

Can you get sunstroke without being in direct sun?

Yes. Classic (non-exertional) heat stroke can develop simply from prolonged exposure to high ambient temperature — sitting indoors in a flat with no air conditioning during a Spanish heatwave, particularly if elderly or chronically ill. Many of the elderly fatalities in Spain's August heatwaves occur indoors in stuffy, poorly ventilated flats. Hot, humid environments without sun are still dangerous.

What should I drink for sunstroke?

Cool water in small sips, only if the casualty is fully conscious and able to swallow. Oral rehydration solutions (ORS) — pharmacy-bought sachets, or the WHO recipe of 1 litre water, 6 teaspoons sugar and 1/2 teaspoon salt — replace both water and electrolytes. Avoid: ice-cold drinks (can cause vomiting), alcohol, caffeinated drinks, sugary fizzy drinks. Do not give anything to a confused or unconscious casualty.

How can I prevent sunstroke in Spanish summer?

Stay indoors or in shade between 12:00 and 17:00, drink 2.5–3 litres of water daily, wear loose light clothing and a hat, use SPF 30+ sunscreen, keep your bedroom below 25°C overnight, and time exercise to early morning or after 20:00. Avoid alcohol in direct sun. Check daily AEMET warnings on the AEMET app, and look in on neighbours over 75 on orange and red alert days.

What is the Spanish emergency number for sunstroke?

Dial 112 from any phone in Spain. It is free, operates 24/7 and English-language operators are available. Say "golpe de calor" (heat stroke). Regional health-emergency lines are also available — 061 in Comunidad Valenciana and most of Spain — but 112 is the universal number and dispatches everything (ambulance, fire, police).

Does private health insurance in Spain cover heat stroke?

Yes. Spanish private health insurance policies (Generali Salud and similar) cover emergency hospital admission, A&E, ambulance, hospitalisation and follow-up consultations for heat-related illness, exactly as for any other emergency. We can review your policy or arrange a new one in English — see our Spanish private health insurance page.

What do I do if a child has sunstroke?

Children under 5 are at high risk and deteriorate fast. Move to shade, remove excess clothing, sponge with tepid (not ice-cold) water, and call 112 immediately. Do not give aspirin or ibuprofen. Do not give large drinks if the child is vomiting. Stay with the child constantly — children can deteriorate from "tired and grumpy" to seizure in 10 minutes in extreme heat.

Sources & references

• Ministerio de Sanidad — Plan Nacional para la Prevención de los Efectos del Calor sobre la Salud.
• AEMET (Agencia Estatal de Meteorología) — national heat-alert system and daily forecasts.
• Instituto de Salud Carlos III (ISCIII) — Spanish heat-mortality monitoring (MoMo).
• NHS UK — heat exhaustion and heatstroke clinical guidance.
• World Health Organization (WHO) — heat and health information.
• Cruz Roja Española — Spanish Red Cross first-aid guidance.
• Boletín Oficial del Estado (BOE) — official text of all Spanish health legislation.

Related guides & insurance products

• Spanish Private Health Insurance (Generali Salud)
• Public vs Private Healthcare Spain — Expat Guide
• Emergency Numbers in Spain
• Pet Insurance Spain (heat-stroke vet cover for dogs)
• Moving to the Costa Blanca — 2026 Expat Guide
• Pine Processionary Caterpillars in Spain
• Non-Lucrative Visa Insurance
• Digital Nomad Visa Insurance

This guide is general information, not personalised medical or insurance advice. If you suspect sunstroke or any medical emergency, call 112 immediately. Heat-related medical guidance changes; always follow the most recent advice from the Ministerio de Sanidad, AEMET, the NHS and your treating doctor.