Heat Stroke

Algorithm

1. Recognize: high core temperature (often ≥40 °C) + CNS dysfunction (confusion, seizures, coma) after heat exposure/exertion.
2. ABC; move to cool environment; continuous monitoring; check glucose; IV access.
3. Cool immediately — priority over most diagnostics: evaporative cooling, ice packs to neck/axillae/groin, cold IV fluids if available; stop cooling around ~38.5–39 °C per protocol.
4. Benzodiazepines for seizures / severe shivering that impairs cooling.
5. Support organ failure: crystalloids for rhabdomyolysis/AKI risk; avoid routine antipyretics as primary cooling.
6. Hospitalize ICU-capable unit; investigate DIC, liver/kidney injury, infection differential.