Exertional heat stroke

1. Exertional heat stroke
Risk factors
• Strenuous activity during hot & humid weather
• Dehydration, poor acclimatization
• Lack of physical fitness, obesity
• Medications: anticholinergics, antihistamines, phenothiazines,
tricyclics, antipsychotics
Clinical
manifestations
• Core temperature >40 C (104 F) with CNS dysfunction (eg,
altered mental status, seizure)
• Organ or tissue damage: renal or hepatic failure, disseminated
intravascular coagulation, acute respiratory distress syndrome
Management
• Rapid cooling: ice water immersion preferred; can consider
high-flow cold water dousing, ice-wet towel rotation,
evaporative cooling
• Fluid resuscitation, electrolyte correction
• Management of end-organ complications
• No role for antipyretic therapy