Excerpted from Medicine For the Backcountry by Buck Tilton M.S. & Frank Hubbell D.O.

Saturday finally arrived and they managed to get off to an early start. The hike they had planned was about three miles long, with an elevation gain of 3,500 feet. It would lead them to an exposed ridge covered with blueberry bushes. Since they had been on this trail before, they knew that there would not be any surface water. They each carried a full liter bottle. The day was spectacular -- clear, warm and sunny with a gentle breeze higher up.

Reaching their destination by noon, they were soaked with sweat from the exertion of the climb. They sat like bears among the blueberries, enjoying the water from their bottles and the taste of the ripe fruit. For several hours they nibbled and collected blueberries, reveling in the summer warmth and surrounding beauty.

Towards mid-afternoon, David started complaining of thirst. They decided to descend in search of more water. Normally it would have taken about an hour to cover the three miles, but on this day it took several hours and required an unexpected amount of effort for all three.

Once down, they sat next to the car, exhausted. John and Jan felt slightly nauseous and light-headed. David, on the other hand, was beginning to act strange -- slightly disoriented and very argumentative. He kept insisting that he was hot, tired, and very thirsty. With that, they loaded up the car and headed home.

As they drove towards home, David became more disoriented and combative. His skin was red and hot. He began to rant, and appeared to be hallucinating. Appropriately, his companions drove him to a local emergency room where he was admitted to the intensive care unit.

Quick action on the part of his friends saved David's life. This incident involves all three of the common heat-related emergencies: dehydration, heat exhaustion and heat stroke.

Move on to Dehydration

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