Heat Stroke First Aid: What Torran Thomas's Inquest Teaches Us

Understanding the warning signs, the need for rapid cooling, and the lessons for Australian clubs, schools and workplaces.

By Britt Brennan, Regional Education and Career Help Australia (REACHAU)
Australian first aid guidance checked: 12 September 2026

Content note: This article discusses the death of a young person. It is written with respect for Torran, his family, and the people involved in his care.

Why this story deserves our attention

When someone becomes unwell during exercise, it can be easy to recognise that they need a break. Recognising that they need emergency treatment is sometimes harder.

They may be sweating. They may still make eye contact. They may answer a question, although the answer sounds different from normal. They may seem exhausted after an activity that would leave plenty of people exhausted.

That is where understanding the reason behind first aid matters.

We need to know which changes mean we should stop explaining the symptoms away and act. We also need practical ways to help with the people and equipment available.

The inquest into the death of 15-year-old Torran Jake Thomas examined precisely that problem. Torran developed heat stroke during rugby league training in Perth on 5 January 2015. He died in hospital three days later. Coroner Barry King delivered his findings on 6 February 2019. Coroner's Court of Western Australia, findings, paragraphs 1 and 61 to 66.

Those dates matter. This is an examination of an earlier inquest, with first aid advice checked against Australian guidance available today.

For me as a first aid trainer, the question is what a learner can take from these findings and use. Could they recognise a person whose condition is becoming dangerous? Would they know how to begin effective cooling? Would someone call for help while that treatment was happening?

There is a responsibility that comes with discussing someone's death. We can learn from the evidence while acknowledging the limits of hindsight, the efforts of the people present, and the loss experienced by a family.

Remembering Torran as a young person

The findings describe Torran as a talented young rugby league player with a close and loving family. Born in New Zealand, he moved to Western Australia with his family in 2012 and attended Atwell College.

He played as a front rower and earned a place in the West Coast Pirates Academy, a development program for promising young players. The evidence described his athletic ability, his capacity to learn new skills, and the effort he put into training. His fitness had improved during his time with the team. Inquest findings, paragraphs 13 to 20.

These details give us some understanding of the young person at the centre of the report. He had a family, teammates, a school community and opportunities ahead of him.

His family supported the inquest and wanted answers about what had happened and whether his death could have been avoided. The court's task required close examination of decisions, observations and treatment. Our responsibility when discussing that examination is to remain accurate and respectful.

The useful outcome for readers is greater understanding of heat illness and better preparation to respond. That is the purpose of this article.

What happened at training?

Perth reached a maximum temperature of 44.4°C on 5 January 2015. However, that was the day's maximum, not the temperature established for the later training session.

The adults organising training considered the heat. They reminded players to drink water, checked conditions, prepared water and ice, and applied the NRL heat guideline. They delayed the start, planned a shorter session with additional breaks, and used a shadier area. The physical session began at approximately 5:50 pm. Inquest findings, paragraphs 31 to 36.

During a running drill, Torran became visibly fatigued. Witnesses differed about some details of the sequence, which the coroner acknowledged. The findings establish that he had difficulty coordinating movement, needed assistance at some point, and eventually lay down near the drinks station and could not get up.

First aid was provided. Water was applied to his head, neck and body. At first, some observations appeared to improve. Over the following period, his responsiveness decreased. Ice was applied to areas including his armpits, groin and neck, and the adults continued trying to help him.

An ambulance was called at approximately 6:55 pm and arrived at 7:07 pm. Torran was taken to Princess Margaret Hospital, where he received intensive treatment. He died on 8 January 2015. The coroner found the cause of death was multiple organ failure associated with hyperthermia, or heat stroke, and recorded the death as misadventure. Inquest findings, paragraphs 39 to 63.

We do not need to reproduce every detail of his hospital treatment to understand the first aid lesson. The critical period for community learning is the time when he was becoming seriously unwell at the field.

A person was receiving attention and care, but the seriousness of the heat illness was not recognised early enough for the most effective cooling to begin promptly.

What the coroner found about the response

Several parts of the findings need to stay together when we discuss this case.

First, the coroner found the decision to proceed with modified training was justified. The relevant guideline had been applied appropriately. Describing the session simply as training held in 44.4°C heat would lose that context. Inquest findings, paragraphs 64 to 66.

Second, the coroner acknowledged the qualifications and experience of the coaching staff. He found that the adults responsible for Torran acted responsibly in the circumstances, but their training had not equipped them to readily recognise and appropriately treat heat stroke. The first aid provided broadly reflected the heat exhaustion advice in the training manual. Inquest findings, paragraphs 29, 79 to 82 and 116.

That is a significant finding for anyone who teaches first aid. People may remember and apply what they were taught while still lacking a clear enough understanding of a particular emergency.

Third, the coroner considered the delay in calling an ambulance undesirable. He also found that recognition and effective treatment at the field were of greater importance. This should encourage us to organise the call and cooling together. Current Australian guidance says cooling must not delay sending for an ambulance. Inquest findings, paragraphs 95 to 98; ANZCOR Guideline 9.3.4.

Finally, the findings were careful about the outcome. Earlier, more effective cooling would have improved Torran's chances. The coroner could not conclude that he would definitely have survived. The findings also identified no evidence that his hospital treatment was deficient. Inquest findings, paragraphs 94 and 99.

That distinction belongs in first aid education. We teach actions that give someone a better chance. We cannot promise the outcome, or use hindsight to claim certainty that the evidence does not provide.

The recommendation: make heat stroke training clearer

The coroner made one formal recommendation. It was directed to Sports Medicine Australia, St John Ambulance, and registered training organisations delivering the then-current Provide First Aid unit, HLTAID003.

He recommended that these organisations consider Professor Ian Rogers' guide and, where appropriate, incorporate its principles into the knowledge taught about first aid for hyperthermia. The guide appears as Attachment A to the findings. Inquest findings, paragraphs 110 to 112 and Attachment A.

Professor Rogers' advice focused on recognising changes in brain and nervous system function in someone who becomes unwell during exercise in heat. It also emphasised rapid cooling using practical methods available at the scene.

The teaching challenge was to make that knowledge accessible. A first aider needs to connect the circumstances and signs with an action they can begin.

The coroner also discussed the potential value of regularly refreshing heat illness training, drawing a comparison with CPR refreshers. However, he expressly did not make a formal recommendation about the frequency of refresher training because that issue had not been examined in the evidence. Inquest findings, paragraph 113.

It would therefore be inaccurate to say this inquest imposed annual heat stroke training.

What the Minister's response said

In her response dated 5 March 2019, the then WA Minister for Education and Training, Sue Ellery, outlined actions she had requested.

These included asking the Department of Training and Workforce Development to forward the recommendation to the relevant national organisations and seek amendments through the planned review of HLTAID003. She also requested a Training Accreditation Council bulletin to relevant registered training organisations. The department would ask the Australian Skills Quality Authority to issue a corresponding bulletin to providers it regulated. Minister's response, pages 1 and 2, available under Recommendations.

The letter shows a requested response to the findings. It does not, by itself, establish that every provider changed its materials, that every bulletin was issued, or that every first aider received updated instruction.

HLTAID011 Provide First Aid subsequently superseded HLTAID003. That course-code change should not be presented as proof that the inquest alone caused the replacement or that implementation was uniform. National Training Register, HLTAID011.

For trainers and organisations today, a useful next step is to look at what people actually learn. Can they recognise the warning signs? Can they explain why cooling matters? Can they demonstrate the response with their available resources?

What is heat stroke, and why does it need urgent cooling?

Heat stroke is a life-threatening illness in which the body becomes dangerously overheated. It can affect the brain and damage other organs. Exertional heat stroke is associated with physical activity, which produces heat inside the body. Healthdirect, heatstroke.

The temperature around us is only part of the picture.

Working muscles generate heat. The body must transfer that heat out while also managing heat from the environment. Clothing, airflow, humidity and the intensity of activity influence how well this can happen. This balance is relevant on a sporting field and during physical work. WorkSafe WA, working safely in hot conditions.

Sweating is one part of cooling. The useful cooling happens as moisture evaporates from the skin. This helps explain why wetting the skin and moving air across it can be effective. Professor Rogers highlighted the importance of fanning in his evidence to the inquest. Inquest findings, paragraph 86.

When someone develops heat stroke, moving them into shade reduces further exposure, but they also need active removal of the heat already in their body.

Think about the difference between taking a hot object out of the sun and placing it in water that carries heat away. Both change the situation, but they do different jobs. With a person, we must also protect their airway, monitor breathing and use cooling that can be carried out safely.

This is why the instruction to cool needs more explanation than “make them comfortable”. The purpose is to remove heat promptly. A damp cloth on the forehead may feel soothing, but it covers very little of the body. The inquest's discussion focused on effective cooling over a much larger surface area.

Recognise changes in the person, even if they are still sweating

Professor Rogers' guide directs attention to confusion, speech that does not make sense, abnormal walking, seizures and loss of consciousness. The evidence also highlighted Torran's inability to get up and his persistent, worsening change in responsiveness. Inquest findings, paragraph 81 and Attachment A.

In everyday language, ask yourself whether the person is thinking, speaking, moving and responding as they normally would.

They may be unable to follow a simple instruction. They may stagger, answer strangely, become unusually drowsy or appear unable to manage a movement they could normally perform easily.

Take those changes seriously in a setting involving heat or exertion. You do not need every possible symptom before suspecting an emergency. If confusion, poor coordination, collapse or reduced responsiveness is present, call 000 and begin appropriate first aid promptly.

Sweating does not rule it out

A person with exertional heat stroke may still be sweating. Professor Rogers specifically warned that the feel of the skin was not a reliable way to decide whether heat stroke was present. Inquest findings, Attachment A.

If your mental picture of heat stroke requires completely dry skin, change that picture. Sweaty skin cannot cancel out a concerning change in behaviour, movement or consciousness.

A thermometer must not become a reason to wait

The inquest also examined the limitations of temperature measurement at the field. Professor Rogers explained that ordinary on-field readings could not reliably establish core temperature. Inquest findings, paragraph 85 and Attachment A.

For a community first aider, the practical lesson is to respond to the person and circumstances. Do not delay treatment to find a thermometer, or use a reassuring forehead or ear reading to dismiss serious signs. Specialist core-temperature assessment belongs with appropriately trained clinicians.

Heat exhaustion and heat stroke can be difficult to distinguish

Heat exhaustion can involve weakness, dizziness, headache and nausea. Heat stroke is the dangerous emergency where overheating affects functions such as thinking and coordination. Symptoms can overlap. Healthdirect, heatstroke.

Professor Rogers was concerned that trying to fit someone into a neat label could delay treatment. That concern is still useful when teaching recognition.

This is an action guide drawn from the inquest's recognition lessons, not a diagnostic test. Other emergencies can also cause collapse. DRSABCD helps you respond to immediate threats while help is coming.

Heat stroke first aid: what to do in Australia

These steps explain how the recognition lessons translate into action. They should be practised in first aid training, with the cooling resources appropriate to your setting.

1. Stop activity and assess immediate threats

Follow DRSABCD: danger, response, send for help, airway, breathing, CPR and defibrillation.

Make the area safe and check responsiveness and breathing. Bring help to the person. Assist them to a nearby cooler place when safe, without making a collapsed or confused person walk. If moving them is unsafe, create shade and begin care where they are.

If they are unresponsive and breathing normally, place them on their side, maintain an open airway and watch their breathing. If they are unresponsive and not breathing normally, begin CPR and use an AED as soon as available. ANZCOR Guideline 8, cardiopulmonary resuscitation.

Do not allow the focus on heat to distract you from a breathing emergency.

2. Call 000 and organise cooling immediately

Ask for an ambulance and explain that you suspect heat stroke. Describe the person's condition, what they were doing, and your exact location.

If several people are present, give clear jobs. One person calls, another begins cooling, and another brings equipment and opens the access route. If alone with a phone, use speakerphone where practical so you can follow instructions while helping.

The historical guide attached to the inquest placed particular emphasis on establishing cooling before the call. For today's response, follow current ANZCOR guidance: cooling should start promptly and must not delay sending for an ambulance. ANZCOR Guideline 9.3.4, management.

Do not wait for the ambulance before cooling, or wait until a cooling setup is complete before calling.

3. Remove excess clothing and actively cool

Loosen and remove unnecessary clothing and equipment so heat can escape and water can reach the skin. Explain what you are doing if the person can understand, and protect their privacy while allowing effective treatment.

Professor Rogers used the practical sequence of removing clothing, soaking the person and fanning vigorously. If immersion is unavailable, start with water and airflow immediately. Use a hose, containers of water or a suitable shower where safe. Keep wetting the skin and keep the air moving. Inquest findings, paragraphs 86 to 92 and Attachment A.

Ice-water-soaked towels, replaced frequently as they warm, are another option described in the findings. A few small ice packs alone should not distract from cooling a larger area. Choose methods you can maintain while watching the person.

This is where preparation makes a difference. A hose behind a locked door is unavailable until someone can open it. A fan needs power or a practical manual alternative. A treatment plan should identify these details before an emergency.

4. Use cold-water immersion when it is safe and suitable

For people older than five years, current Australian guidance recommends immersion from the neck down in cold water for 15 minutes as the most effective cooling method. Continue monitoring and follow ambulance instructions. ANZCOR Guideline 9.3.4, cooling management.

An immersion setup needs enough assistance to keep the person's head and airway above water continuously and remove them promptly if required. A bath cannot safely be used as a place to leave someone unattended.

If reduced consciousness, vomiting, limited assistance or the environment makes airway protection unsafe, use other active cooling methods. An unresponsive person who is breathing normally needs airway care in the recovery position. Do not put them unsupported into water.

For children aged five years and under, the guidance differs: use a tepid bath with frequent sponging if safe, or repeatedly moisten the skin and fan. Do not automatically apply the older-child and adult cold-water immersion method. ANZCOR Guideline 9.3.4, cooling management.

Start available cooling while help is organised. Searching for a perfect bath or more ice must not hold up the care you can provide now.

5. Give drinks only when safe

Give cool water only if the person is fully alert and able to swallow safely. If they are confused, drowsy, vomiting or having difficulty swallowing, give nothing by mouth. ANZCOR Guideline 9.3.4, hydration management.

Being able to open their eyes or make a sound does not establish that drinking is safe. Do not force water into someone's mouth.

External cooling can continue even when the person cannot drink. That is another reason to understand the purpose of each first aid action.

6. Keep reassessing and prepare a clear handover

Stay with the person. Watch their breathing and responsiveness throughout treatment. Tell the ambulance call taker immediately if either changes.

If the person becomes unresponsive and stops breathing normally, safely remove them from water if necessary and start CPR on a firm surface. Quickly dry the chest so AED pads can stick, follow the device's prompts and keep everyone clear during a shock. Another person can assist with cooling if it does not interfere with CPR or AED use. ANZCOR Guideline 7, defibrillation.

A practical handover should include when symptoms began, the changes you observed, when cooling started, the methods used and any relevant information already known. Recording those details is useful, but it must not delay treatment.

If the person improves, continue following ambulance advice. Improvement after cooling does not establish that they can safely return to activity or no longer need assessment.

Drinking water matters, but it cannot carry the whole plan

Hydration was discussed directly in Torran's inquest. Professor Rogers did not believe dehydration contributed to Torran's death. He considered it likely that Torran arrived with normal hydration and body temperature. Inquest findings, paragraph 72.

That finding relates to Torran. It should not be turned into a claim that hydration is unimportant for everyone.

What it does show is why “he has been drinking water” cannot reassure us that heat stroke is impossible. A drink bottle is useful, but it cannot tell us what is happening inside a person's body.

Prevention needs to consider the workload and conditions as well as drinking water. Treatment needs to match the person's signs and their ability to swallow safely.

The same applies to the fact that everyone else appears well. Torran was the only player who developed heat stroke. The coroner considered several contributing factors, but the evidence did not establish one complete explanation for why it happened to him. Inquest findings, paragraphs 67 to 73.

One unwell person deserves assessment on their own presentation. The condition of the rest of the group does not make that person safe.

What clubs, schools and workplaces can prepare

My suggestion is to review the pathway from the first concerning sign to effective treatment. Walk through it at the actual oval, work area or activity site.

Where would the person lie? Where is the water? Who has access? What can provide airflow? Can someone direct an ambulance to the correct gate while others stay with the person?

These are ordinary questions with practical answers. They make a workplace emergency plan usable.

For prevention, consider the intensity and duration of activity, humidity, airflow, clothing, radiant heat and the people participating. WorkSafe WA identifies these among the factors relevant to heat risk and describes controls including shade, ventilation, changes to work timing and additional breaks. WorkSafe WA, working safely in hot conditions.

For the response, discuss who can stop the activity, who makes the emergency call and how cooling begins. Make those arrangements clear to relief staff, volunteers and new team members as well as the regular first aider.

A useful practice session might reveal that the water source is further away than people thought, that the gate key is missing, or that everyone assumes the coach will make the call. Those are problems you can solve before anyone is unwell.

Give people permission to speak up early

In a team, classroom or workplace, someone may hesitate to say they are struggling. They may want to finish the task, avoid attention or keep up with others.

I want the message around an activity to be clear: tell us when something feels wrong, and take a teammate's concern seriously.

A young person should not have to prove how unwell they are before an adult checks on them. A worker should be able to report a concern without the response becoming a judgement about effort.

That is a practical recommendation for the environments we create. It is not a claim about an individual person's motives in Torran's case.

Why regional and remote settings need preparation before departure

These lessons matter across Western Australia, including Perth and Peel, the South West, the Wheatbelt, the Goldfields, the Pilbara and the Kimberley. The activity might involve sport, farm work, ranger duties, construction or an equine event.

The planning question changes when assistance may take longer to reach you. What can your group actually do where it will be working or travelling?

Before departure, identify shade, suitable cooling water, communication arrangements and emergency access. Think through the conditions at the activity location, including the possibility that your main first aider becomes the person needing help.

Test the communication equipment and make sure more than one person can use it. Know how to describe your location and access route. Allocate who stays with the casualty and how essential information will reach emergency services.

Those are practical planning suggestions, rather than a separate treatment protocol. The first aid priorities remain recognition, early emergency contact, active cooling and ongoing assessment.

Water for drinking and water for cooling should both be considered in the plan. Do not build the response around equipment that will be unavailable at the point of need.

When I discuss remote first aid training with a group, this is the kind of practical context that matters: the work being done, the likely hazards, the resources on site and the support available while waiting for help.

What I want first aid training to help people do

Torran's inquest is a reminder of the responsibility carried by first aid education. The coroner's recommendation was about the content people were taught and their ability to recognise and respond to heat illness.

For me, a good explanation should connect an observation to its meaning and then to an action.

For example, if someone is staggering and answering strangely after strenuous activity in heat, the learner should understand why that combination is concerning. They should know that sweating does not remove the concern and that waiting for a particular thermometer reading can delay care.

Then they need to practise the response with realistic constraints. Who calls? Who starts cooling? What changes if there is no bath? How will the airway be protected? What happens if the person becomes unresponsive?

That practice also gives people a place to ask questions. If someone has always believed that dry skin is required for heat stroke, I want that belief discussed in training, where there is time to explain and correct it.

I focus on the why because understanding gives a learner something useful to draw on when the real situation looks different from an example.

The aim is calm, informed action. People need a simple starting point, the ability to keep reassessing, and the confidence to ask for help early.

In an emergency, the most important skill is staying calm and taking the first correct action.

A short practice scenario

Imagine an adult volunteer becomes unwell while helping set up an outdoor community event. They have been carrying equipment, are sweating, and begin stumbling. When you ask how they feel, their answer does not make sense.

This is a fictional training example.

The combination of exertion, heat exposure, poor coordination and confusion should prompt an emergency response. Stop the activity, check immediate threats, call 000 and begin safe active cooling. Allocate jobs, protect the airway and keep checking breathing and responsiveness.

Ask your group to demonstrate how they would get the water, provide shade and direct the ambulance. The exercise becomes useful when people identify what they would actually do at that location.

You can work through the same questions before a sports session, school activity or workplace task. Keep the scenario calm and constructive so people leave knowing how to help.

Frequently asked questions about heat stroke first aid

What are the warning signs of heat stroke during exercise?

Confusion, unusual speech, staggering, poor coordination, seizures or reduced responsiveness during heat exposure or exertion are serious warning signs. Stop activity, call 000 and start safe cooling. Someone who is unresponsive and not breathing normally needs CPR and an AED. You do not need every possible sign before acting.

Can someone have heat stroke if they are still sweating?

Yes. Sweating can continue during exertional heat stroke. The guide attached to Torran's inquest specifically warns against using the feel of the skin to rule it out. Pay attention to changes in thinking, speech, movement and responsiveness, along with the circumstances.

Is heat stroke simply severe dehydration?

No. Dehydration can increase heat illness risk, but dangerous overheating involves the balance between heat production, heat exposure and heat loss. In Torran's case, the expert evidence did not identify dehydration as a contributor. Drinking water does not rule out heat stroke or replace active cooling.

Should I wait for a temperature reading before treating heat stroke?

No. Ordinary on-field readings can be misleading and should not delay first aid or emergency contact. Serious changes in responsiveness or coordination in a heat or exertion setting warrant action. Specialist assessment of core temperature is a clinical task.

What if there is no ice bath available?

Begin with the cooling resources you have. Remove excess clothing, repeatedly wet the skin and fan continuously. Frequently replaced ice-water-soaked towels are another option. Call 000 early, keep checking breathing and responsiveness, and follow instructions. Do not delay available cooling while searching for ice or a bath.

Is cold-water immersion suitable for young children?

The guidance distinguishes age groups. For children five and under, use tepid bathing with sponging if safe, or skin wetting and fanning, while obtaining emergency help. Cold-water immersion guidance applies to people older than five and requires continuous airway protection and supervision. See the age-specific instructions above.

Should a confused person with suspected heat stroke drink water?

No. Give nothing by mouth unless the person is fully alert and can swallow safely. Continue external cooling and follow ambulance instructions. Being partly responsive does not establish that they can protect their airway while drinking.

Can someone return to sport if cooling makes them feel better?

A person with suspected heat stroke needs urgent medical assessment. Improvement is information to pass to the ambulance team, not permission to resume exercise. Continue monitoring and follow clinical advice about treatment and any later return to activity.

Did the coroner find that Torran would certainly have survived?

No. The coroner found that earlier effective cooling would have improved his chances and that he may have survived. He expressly stated that survival could not be established with certainty. That qualification should remain whenever the findings are discussed.

Did this inquest require annual heat stroke training?

No. The coroner discussed regular refreshers but made no formal recommendation about their frequency. His formal recommendation concerned reviewing and, where appropriate, incorporating Professor Rogers' principles into first aid teaching. Organisations can use the findings to review their training and practical readiness without presenting an annual requirement that the inquest did not impose.

The answers above draw on the inquest findings and Attachment A, ANZCOR Guideline 9.3.4, heat induced illness, and Healthdirect's heatstroke information. The linked sections earlier in this article provide the supporting detail.

Carry the learning into the next activity

Torran's family lost a young person they loved. Any discussion of the lessons needs to keep that human reality in view.

The findings give us a reason to examine what we teach, what we remember and what we have ready. A recommendation becomes useful in daily life when someone recognises a concerning change and knows how to respond.

Before your next training session, shift or community activity, take a few minutes to walk through the response with the people around you. Find the water. Check access. Allocate the call. Talk about the signs that mean activity stops and first aid begins.

That is a practical way to use this learning with care and purpose.

Training and Assessment is delivered by Britt at Regional Education and Career Help Australia on behalf of ABC First Aid RTO 3399.

Related reading

• Anaphylaxis or Asthma? Lessons from Max McKenzie’s Inquest
• DRSABCD: The Action Plan That Could Save a Life
• Workplace Emergency Plans: Australian Legal Requirements
• HLTAID013 vs HLTAID011: Do You Need Remote First Aid?

This article provides general first aid education. In an emergency, call 000 and follow the ambulance call taker's instructions. Current treatment guidance should be used alongside practical training.