What are the immediate wilderness first aid steps for severe heat exhaustion?

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Immediate action for severe heat exhaustion is to cool the person and rehydrate safely. Move them to shade or a cooler spot, loosen any tight clothing, and have them lie down with their legs raised slightly to help circulation. Cool their skin with cool, damp cloths on the neck, armpits, and groin where heat escapes most quickly. If they are fully conscious and can swallow, give small sips of cool water. Monitor for changes or worsening symptoms, and seek medical help if confusion, vomiting, fainting, or symptoms persist. Avoid heating blankets, hot drinks, ice-cold immersion, or withholding fluids.