You are leading a two week backpacking and canyoneering trip in the desert canyons of southwestern Utah for a Seattle-based youth group. The weather in the pacific northwest has been cool and the desert heat challenging with relief coming mainly at night. While most students are slowly acclimatizing, one of the teachers, an overweight 53 year-old man named Carl, has been struggling since day one. During the first week of the trip the temperatures hovered in the low 90s. Yesterday it jumped to 105º F and last night was unusually warm. During the afternoon siesta at a small sheltered seep, Carl seems lethargic and out of it. He is unable to respond coherently to your questions. At 3 PM in the afternoon Carl's pulse is 92 and regular, his respiratory rate is 26 and slightly labored, and his oral temperature is 104.2º F. You are carrying a satellite phone. What is Carl's problem and what should you do about it?
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