Heat Stroke

Cool <39 °C rapidly

Red flags
  • Core temp >40 °C + CNS dysfunction
  • Multiorgan failure
  • DIC, rhabdomyolysis

First steps

  • ABCDE + rapid cooling (ice-water immersion preferred, or evaporative)
  • IV fluids
  • Monitor core temp continuously

Key investigations

  • CK, U&E, LFT, coag, glucose, ABG
  • Urinalysis

Differentials

  • Sepsis, malignant hyperthermia, NMS, serotonin syndrome

Initial management

  • Stop cooling at 39 °C
  • Treat rhabdomyolysis (fluids)
  • AVOID antipyretics (ineffective, hepatotoxic)
  • ICU admit for organ support

Referral

  • ICU
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