Materiały źródłowe

• #1 Nonexertional (classic) heat stroke in adults – UpToDate

  https://www.uptodate.com/contents/nonexertional-classic-heat-stroke-in-adults

  Nonexertional (classic) heat stroke in adults […] The evaluation of severe hyperthermia in adults and the management of nonexertional heat stroke are reviewed here. […] Heat stroke is defined as an elevated core body temperature, usually in excess of 40.5°C (105°F), with associated central nervous system (CNS) dysfunction in the setting of a large environmental heat load that cannot be dissipated. […] The diagnosis of nonexertional (classic) heat stroke is made clinically based upon an elevated core body temperature (generally >40.5°C [105°F]), central nervous system (CNS) dysfunction (eg, altered mental status), and exposure to severe environmental heat. […] Patients with classic heat stroke generally have increased susceptibility to the heat due to age or underlying medical conditions, manifest characteristic examination findings, and lack an alternative explanation for their hyperthermia (eg, infection).

• #2 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Heatstroke is a severe heat-related illness involving an elevation in body temperature, typically but not always greater than 40 C. The patient has clinical signs of central nervous system dysfunction that may include confusion, ataxia, delirium, or seizures brought on after strenuous physical exertion or exposure to hot weather. […] The workup of patients presenting with possible heat stroke should include frequent monitoring of vital signs and rectal temperature and laboratory studies of CBC, CMP, PT/PTT, blood gasses, serum CPK, and urine myoglobin. […] Management of heat stroke includes ensuring adequate airway protection, breathing, and circulation. After ABCs, rapid cooling becomes the mainstay of treatment with ancillary management in response to other end-organ damage. […] Patients presenting with heat stroke have high mortality depending on the etiology of the presentation. However, the death rate from exertional heat stroke is relatively low (3 to 5%) compared to classic heat stroke (10 to 65%).

• #3 Heat stroke in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/849

  Patients are at risk of multi-system organ failure, so careful monitoring is essential even after return to normothermia. […] Heat stroke is defined as a core temperature 40C with central nervous system dysfunction (e.g., altered level of consciousness ranging from confusion to coma [encephalopathy], seizures). […] Key diagnostic factors include history of exposure to severe environmental heat or strenuous physical exercise, central nervous system dysfunction, hyperthermia (40C), and hot skin (dry or wet). […] 1st investigations to order include rectal temperature, FBC, liver function tests, renal function tests, glucose, electrolytes, arterial blood gases, creatine kinase, clotting profile, urinalysis, and ECG.

• #4 Heat stroke – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/849

  Heat stroke is generally associated with core temperatures 104F (40C). […] Diagnosis rests on the observation of profound central nervous system dysfunction in the presence of hyperthermia. […] Heat stroke is defined as central nervous system (CNS) dysfunction in the setting of hyperthermia. It is associated with core temperature 104F (40C), and typically ranges from 104F to 111.2F (40C to 44C), although higher core temperatures have been reported. […] Key diagnostic factors include profound central nervous system disturbance and hyperthermia. […] Diagnostic tests include core temperature measurement, serum electrolytes, CBC, LFTs, metabolic profile, renal function tests, creatine kinase, prothrombin time, activated PPT, and INR, lactic acid, urinalysis, chest x-ray, arterial blood gas, medication/toxicology screen, thyroid function tests, and plasma glucose.

• #5 Heatstroke – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heatstroke

  Heatstroke is hyperthermia accompanied by a systemic inflammatory response causing multiple organ dysfunction that may result in death. Diagnosis is clinical. […] Diagnosis is usually clear from a history of exertion and environmental heat. Heatstroke is differentiated from heat exhaustion by presence of the following: CNS dysfunction, Temperature 40 C. […] When the diagnosis of heatstroke is not obvious, other disorders that can cause CNS dysfunction and hyperthermia should be considered. […] Laboratory testing includes complete blood count, prothrombin time, partial thromboplastin time, electrolytes, blood urea nitrogen, creatinine, calcium, creatine kinase (CK), and hepatic profile to evaluate organ function. […] Diagnosis of Heatstroke: Clinical evaluation, including core temperature measurement, Laboratory testing for organ dysfunction.

• #6 Expert consensus on the diagnosis and treatment of heat stroke in China | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-019-0229-2

  Heat stroke (HS) is a fatal disease caused by thermal damage in the body, and it has a very high mortality rate. […] In 2015, the Peoples Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China, Expert consensus on standardized diagnosis and treatment for heat stroke. […] It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage, is more practical and is more in line with Chinas national conditions. […] This new expert consensus includes new concept of HS, recommendations for laboratory tests and auxiliary examinations, new understanding of diagnosis and differential diagnosis, On-site emergency treatment and In-hospital treatment, translocation of HS patients and prevention of HS.

• #7 Diagnosis and Management of Heatstroke – PubMed

  https://pubmed.ncbi.nlm.nih.gov/32291378/

  Heatstroke is a life-threatening and the most severe form of heat-related illnesses, characterized by body temperature 40C and central nervous system dysfunction. […] The diagnosis of heatstroke based on Bouchama’s definition or Japan Association of Acute Medicine (JAAM) criteria. […] The basic principle of heatstroke management is early resuscitation and immediate cooling.

• #8 Expert consensus on the diagnosis and treatment of heat stroke in China | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-019-0229-2

  Currently, a unified standard for the diagnosis of HS is still lacking, and clinical diagnosis is largely based on medical history and clinical presentations. […] HS should be considered if the patient meets any of the medical history information together with any of the clinical presentations and if the symptoms cannot be explained by other reasons. […] The progression of patients from mild heat illness to HS is a continuous process of gradual aggravation. […] This consensus does not use core temperature as a necessary condition for the clinical diagnosis of HS to avoid a delay in necessary cooling treatments resulting from diagnostic issues. […] However, it does not mean that body temperature is not important. Body temperature is still one of the most important indicators of HS. […] If conditions allow, the patients body temperature, preferably the core temperature should be measured as soon as possible. […] The diagnosis of HS should not be delayed based on this.

• #9 Nonexertional (classic) heat stroke in adults – UpToDate

  https://www.uptodate.com/contents/nonexertional-classic-heat-stroke-in-adults

  A rectal, bladder, or esophageal temperature should be obtained in all patients suspected of heat stroke. […] The differential diagnosis of severe hyperthermia is extensive and includes infectious, endocrine, central nervous system (CNS), toxic, and oncologic etiologies. […] No single diagnostic test definitively confirms or excludes heat stroke. […] Rapid improvement with active cooling suggests that heat stroke is the primary diagnosis. […] The management of nonexertional (classic) heat stroke requires early diagnosis, rapid cooling, correction of electrolyte abnormalities, and supportive care. […] Rapid cooling is the key to improving outcomes in patients with heat stroke and should not be delayed. […] Continuous core temperature monitoring with a rectal or esophageal probe is mandatory for all patients regardless of the cooling method.

• #10 Heat stroke – Wikipedia

  https://en.wikipedia.org/wiki/Heat_stroke

  A core body temperature (such as a rectal temperature) is the preferred method for monitoring body temperature in the diagnosis and management of heat stroke as it is more accurate than peripheral body temperatures (such as an oral or axillary temperatures). […] Other conditions which may present similarly to heat stroke include meningitis, encephalitis, epilepsy, drug toxicity, severe dehydration, and certain metabolic syndromes such as serotonin syndrome, neuroleptic malignant syndrome, malignant hyperthermia and thyroid storm.

• #11 Nonexertional (classic) heat stroke in adults – UpToDate

  https://www.uptodate.com/contents/severe-nonexertional-hyperthermia-classic-heat-stroke-in-adults

  Nonexertional (classic) heat stroke is defined as an elevated core body temperature, usually in excess of 40.5°C (105°F), with associated central nervous system (CNS) dysfunction in the setting of a large environmental heat load that cannot be dissipated. […] The diagnosis of nonexertional (classic) heat stroke is made clinically based upon an elevated core body temperature (generally >40.5°C [105°F]), central nervous system (CNS) dysfunction (eg, altered mental status), and exposure to severe environmental heat. […] Patients with classic heat stroke generally have increased susceptibility to the heat due to age or underlying medical conditions, manifest characteristic examination findings, and lack an alternative explanation for their hyperthermia (eg, infection). […] Core temperature—A rectal, bladder, or esophageal temperature should be obtained in all patients suspected of heat stroke.

• #12 Hyperthermia – Wikipedia

  https://en.wikipedia.org/wiki/Hyperthermia

  Hyperthermia is generally diagnosed by the combination of unexpectedly high body temperature and a history that supports hyperthermia instead of a fever. […] Most commonly this means that the elevated temperature has occurred in a hot, humid environment (heat stroke) or in someone taking a drug for which hyperthermia is a known side effect (drug-induced hyperthermia). The presence of signs and symptoms related to hyperthermia syndromes, such as extrapyramidal symptoms characteristic of neuroleptic malignant syndrome, and the absence of signs and symptoms more commonly related to infection-related fevers, are also considered in making the diagnosis. […] If fever-reducing drugs lower the body temperature, even if the temperature does not return entirely to normal, then hyperthermia is excluded.

• #13 Diagnosis and management of heat stroke : Virtual Library

  https://resources.wfsahq.org/atotw/diagnosis-and-management-of-heat-stroke/

  Cardinal features are core body temperature of 40C and central nervous system dysfunction. […] Patients suffering from heat stroke may have a normal core temperature on arrival at hospital if effective pre-hospital cooling has occurred. […] A history of exposure to hot weather or vigorous activity in the absence of other symptoms may help to make the diagnosis, but important causes such as sepsis, drug reactions and tropical diseases should all be excluded. […] All patients with heat stroke will have an altered mental status which can be wide ranging from mild confusion and irritability to coma. […] Hypotension is multifactorial in nature. It is often due to a combination of dehydration and peripheral vasodilation, the latter of which is due to increased production of nitric oxide. […] The mainstays of treatment after alternative diagnoses have been ruled out is rapid cooling and, where indicated, multi-organ support. […] Rapid cooling and resuscitative treatments are the mainstays of treatment.

• #14 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-and-treatment-of-heat-stroke.aspx

  Early diagnosis of heat exhaustion and heat stroke is of vital importance as these conditions may progress to fatal complications. […] In most cases diagnosis is made clinically. This involves taking the temperature and assessing the symptoms of heat exhaustion and heat stroke. […] Steps to diagnosis of the condition include assessment of core body temperature, blood tests and so forth. […] A temperature of 40C (104F) or above is often a major sign of heatstroke. […] Heatstroke however can be diagnosed at lower temperatures and these temperatures are not always indicative of heat stroke as they may be reached by athletes during physical exercise. […] A routine blood test is done. This detects other problems like anemia, diabetes and presence of infections. […] The blood electrolytes like Sodium, Potassium and bicarbonates are disturbed in heat related health conditions. These are assessed on blood tests.

• #15 Heatstroke – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heatstroke

  Heatstroke is hyperthermia accompanied by a systemic inflammatory response causing multiple organ dysfunction that may result in death. Diagnosis is clinical. […] Diagnosis is usually clear from a history of exertion and environmental heat. Heatstroke is differentiated from heat exhaustion by presence of the following: CNS dysfunction, Temperature 40 C. […] When the diagnosis of heatstroke is not obvious, other disorders that can cause CNS dysfunction and hyperthermia should be considered. […] Laboratory testing includes complete blood count, prothrombin time, partial thromboplastin time, electrolytes, blood urea nitrogen, creatinine, calcium, creatine kinase (CK), and hepatic profile to evaluate organ function. […] Diagnosis of Heatstroke: Clinical evaluation, including core temperature measurement, Laboratory testing for organ dysfunction.

• #16 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Heatstroke is a severe heat-related illness involving an elevation in body temperature, typically but not always greater than 40 C. The patient has clinical signs of central nervous system dysfunction that may include confusion, ataxia, delirium, or seizures brought on after strenuous physical exertion or exposure to hot weather. […] The workup of patients presenting with possible heat stroke should include frequent monitoring of vital signs and rectal temperature and laboratory studies of CBC, CMP, PT/PTT, blood gasses, serum CPK, and urine myoglobin. […] Management of heat stroke includes ensuring adequate airway protection, breathing, and circulation. After ABCs, rapid cooling becomes the mainstay of treatment with ancillary management in response to other end-organ damage. […] Patients presenting with heat stroke have high mortality depending on the etiology of the presentation. However, the death rate from exertional heat stroke is relatively low (3 to 5%) compared to classic heat stroke (10 to 65%).

• #17 Hyperthermia Causes, Symptoms, Diagnosis and Treatment – Cura4U

  https://cura4u.com/conditions/hyperthermia

  Your healthcare provider diagnoses hyperthermia by examining your symptoms, conducting a physical examination, and testing your temperature. Blood or urine tests may also be ordered. […] Heatstroke is usually apparent to doctors, but laboratory tests can confirm the diagnosis, rule out other possible causes, and assess organ damage. They may order the following tests: […] Blood Tests: To check your blood sodium or potassium levels, as well as the content of gases in your blood, to determine if your central nervous system has been damaged. […] Urine Tests: To examine the color of your urine, which will be darker if you have a heat-related disorder, as well as your kidney function, which might be affected by heatstroke. […] Muscle Function Tests: To determine whether or not your muscle tissue has been seriously damaged (rhabdomyolysis). […] Imaging: To see if your internal organs have been damaged.

• #18 Expert consensus on standardized diagnosis and treatment for heat stroke | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-015-0056-z

  Heat stroke is a life-threatening disease characterized clinically by central nervous system dysfunction and severe hyperthermia (core temperature rises to higher than 40 C). […] Rapid cooling to reduce core temperature as quickly as possible is the primary and most effective treatment, as it has been shown that the major determinant of outcome in heatstroke is the degree and duration of hyperthermia. […] This is a guideline for the management of heat stroke, developed by the Peoples Liberation Army Professional Committee of Critical Care Medicine launched in June 2006. […] The classic clinical manifestations of heat stroke are high fever, lack of sweat, and loss of consciousness. […] Patients exposed to a hot and humid environment to engage in high intensity exercise may also have the following clinical presentation: severe manifestations of central nervous system dysfunction (such as loss of consciousness, convulsions, and delirium), a core temperature above 40 C, elevated skin temperature and/or continual sweating, significant increase in liver transaminases significant decrease in platelets and rapid appearance of DIC, muscle weakness, pain, tea-colored urine, and CK greater than 5 times the normal value.

• #19 Diagnosis and Prevention of Heat-Related Illness | Encyclopedia MDPI

  https://encyclopedia.pub/entry/31607

  Heatstroke differs because there are evident manifestations of central nervous system alteration, the temperature exceeds 41 °C and transaminases increase after 24 h. […] Heat stroke is a medical emergency caused by failure of thermoregulation and acclimatization mechanisms. […] It is characterized by a rapid increase in internal body temperature that exceeds 40.5 °C, resulting in multi-organ dysfunction. […] The researchers distinguish two types of heatstroke: classic heatstroke and stress heatstroke. […] In both cases, it is possible to detect leukocytosis, thrombocytopenia, impaired coagulation, liver damage, renal damage, and rhabdomyolysis in the blood chemistry. […] Where there is a suspicion of heat stroke, it is necessary to reduce the temperature as quickly as possible. […] Continuous monitoring of core rectal temperature is recommended during rapid cooling. […] For inpatient treatment of heat stroke, emergency room procedures will apply.

• #20 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-and-treatment-of-heat-stroke.aspx

  Other tests performed to diagnose heat stroke include: Urine is tested to detect indications of muscle damage by rhabdomyolysis or damage to the kidney due to heat stroke complications. […] ECG is performed to see the activity of the heart. […] Chest X ray is prescribed to check for aspiration of fluids and lung edema etc. […] MRI and CT scan is advised to detect major abnormalities in the large organs. […] Other conditions that must be ruled out in diagnosis as they mimic heat stroke include: blood poisoning or sepsis, malaria, cancers that may manifest with malignant hyperpyrexia or fever etc. […] There may be a history of intake of antipsychotics leading to side effects like neuroleptic malignant syndrome or antidepressants leading to serotonin syndrome. Both manifest with features like heat stroke.

• #21 Nonexertional (classic) heat stroke in adults – UpToDate

  https://www.uptodate.com/contents/severe-nonexertional-hyperthermia-classic-heat-stroke-in-adults

  Diagnostic testing—A chest radiograph should be obtained and may demonstrate pulmonary edema, possibly despite severe dehydration. The electrocardiogram (ECG) may reveal dysrhythmias, conduction disturbances, nonspecific ST-T wave changes, or heat-related myocardial ischemia or infarction. […] Laboratory studies may reveal rhabdomyolysis, elevated lactic acid or low standard base excess, coagulopathy, acute kidney injury (acute renal failure), acute hepatic necrosis, elevated serum troponin, and a leukocytosis as high as 30,000 to 40,000/mm³. […] No single diagnostic test definitively confirms or excludes heat stroke. […] Rapid improvement with active cooling suggests that heat stroke is the primary diagnosis.

• #22 Heat Stroke: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/166320-overview

  Heat stroke is defined as a body temperature higher than 40C (104F) associated with neurologic dysfunction. […] Heat stroke is defined as hyperthermia exceeding 40C (104F) associated with an altered sensorium. […] A high index of suspicion is needed to avoid delays in diagnosis and treatment. […] Computerized tomography scans may be helpful in ruling out CNS injury in patients with altered mental status. […] Chest radiographs may show atelectasis, pneumonia, pulmonary infarction, or pulmonary edema. […] On electrocardiography, sinus tachycardia of 130-140 beats per minute and nonspecific and ischemic ST-T wave abnormalities are common.

• #23 Heatstroke – Symptoms, Causes, Prevention and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/heatstroke

  Heatstroke is a medical emergency that can lead to severe complications such as organ failure, damage, or even death if there is a delay in the diagnosis and treatment. […] Heatstroke is usually evident from the physical examination. However, corroboration with laboratory tests for organ damage and ruling out other possible causes are indicated. […] Rectal temperature is a more reliable way to check body temperature than oral and ear temperatures. […] Blood tests evaluate organ damage by obtaining blood gases, electrolytes, liver enzymes, clotting studies, etc. […] A urine test to assess if your kidney or muscle is affected; a heat-related illness usually causes the urine to be darker. […] Muscle function tests measuring creatine kinase can determine if you develop rhabdomyolysis or muscle damage. […] A brain imaging study to rule out other suspected central nervous system causes of altered mental status.

• #24 Heat Stroke Differential Diagnoses

  https://emedicine.medscape.com/article/166320-differential

  Other problems to be considered include the following: […] Diagnostic Considerations […] Sepsis […] Diabetic ketoacidosis […] Closed head trauma […] Malignant hyperthermia […] Encephalitis […] Cerebral malaria […] Cerebral hemorrhage […] Amphetamine and cocaine toxicity […] Strychnine poisoning […] Differential Diagnoses […] Cocaine Toxicity […] Delirium […] Delirium Tremens (DTs) […] Hepatic Encephalopathy […] Hyperthyroidism and Thyrotoxicosis […] Hyponatremia […] Meningitis […] Neuroleptic Malignant Syndrome […] Salicylate Toxicity […] Tetanus […] Uremic Encephalopathy.

• #25 Heat stroke – Wikipedia

  https://en.wikipedia.org/wiki/Heat_stroke

  A core body temperature (such as a rectal temperature) is the preferred method for monitoring body temperature in the diagnosis and management of heat stroke as it is more accurate than peripheral body temperatures (such as an oral or axillary temperatures). […] Other conditions which may present similarly to heat stroke include meningitis, encephalitis, epilepsy, drug toxicity, severe dehydration, and certain metabolic syndromes such as serotonin syndrome, neuroleptic malignant syndrome, malignant hyperthermia and thyroid storm.

• #26 Heat stroke differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Heat_stroke_differential_diagnosis

  Heat stroke must be differentiated from other disease that may cause alteration in mental status and hyperthermia including: Neuroleptic malignant syndrome, Malignant hyperthermia, Serotonin syndrome, cocaine use and sepsis. […] Differentiation between 2 types of heat stroke (Classic vs Exertional) is based on history, clinical findings, and laboratory findings. […] Heat stroke must be differentiated from other conditions that may cause hyperthermia and altered mental status.

• #27 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-and-treatment-of-heat-stroke.aspx

  Other tests performed to diagnose heat stroke include: Urine is tested to detect indications of muscle damage by rhabdomyolysis or damage to the kidney due to heat stroke complications. […] ECG is performed to see the activity of the heart. […] Chest X ray is prescribed to check for aspiration of fluids and lung edema etc. […] MRI and CT scan is advised to detect major abnormalities in the large organs. […] Other conditions that must be ruled out in diagnosis as they mimic heat stroke include: blood poisoning or sepsis, malaria, cancers that may manifest with malignant hyperpyrexia or fever etc. […] There may be a history of intake of antipsychotics leading to side effects like neuroleptic malignant syndrome or antidepressants leading to serotonin syndrome. Both manifest with features like heat stroke.

• #28 Nonexertional (classic) heat stroke in adults – UpToDate

  https://www.uptodate.com/contents/nonexertional-classic-heat-stroke-in-adults

  A rectal, bladder, or esophageal temperature should be obtained in all patients suspected of heat stroke. […] The differential diagnosis of severe hyperthermia is extensive and includes infectious, endocrine, central nervous system (CNS), toxic, and oncologic etiologies. […] No single diagnostic test definitively confirms or excludes heat stroke. […] Rapid improvement with active cooling suggests that heat stroke is the primary diagnosis. […] The management of nonexertional (classic) heat stroke requires early diagnosis, rapid cooling, correction of electrolyte abnormalities, and supportive care. […] Rapid cooling is the key to improving outcomes in patients with heat stroke and should not be delayed. […] Continuous core temperature monitoring with a rectal or esophageal probe is mandatory for all patients regardless of the cooling method.

• #29 Nonexertional (classic) heat stroke in adults – UpToDate

  https://www.uptodate.com/contents/severe-nonexertional-hyperthermia-classic-heat-stroke-in-adults

  Diagnostic testing—A chest radiograph should be obtained and may demonstrate pulmonary edema, possibly despite severe dehydration. The electrocardiogram (ECG) may reveal dysrhythmias, conduction disturbances, nonspecific ST-T wave changes, or heat-related myocardial ischemia or infarction. […] Laboratory studies may reveal rhabdomyolysis, elevated lactic acid or low standard base excess, coagulopathy, acute kidney injury (acute renal failure), acute hepatic necrosis, elevated serum troponin, and a leukocytosis as high as 30,000 to 40,000/mm³. […] No single diagnostic test definitively confirms or excludes heat stroke. […] Rapid improvement with active cooling suggests that heat stroke is the primary diagnosis.

• #30 Diagnosis and Prevention of Heat-Related Illness | Encyclopedia MDPI

  https://encyclopedia.pub/entry/31607

  Heatstroke differs because there are evident manifestations of central nervous system alteration, the temperature exceeds 41 °C and transaminases increase after 24 h. […] Heat stroke is a medical emergency caused by failure of thermoregulation and acclimatization mechanisms. […] It is characterized by a rapid increase in internal body temperature that exceeds 40.5 °C, resulting in multi-organ dysfunction. […] The researchers distinguish two types of heatstroke: classic heatstroke and stress heatstroke. […] In both cases, it is possible to detect leukocytosis, thrombocytopenia, impaired coagulation, liver damage, renal damage, and rhabdomyolysis in the blood chemistry. […] Where there is a suspicion of heat stroke, it is necessary to reduce the temperature as quickly as possible. […] Continuous monitoring of core rectal temperature is recommended during rapid cooling. […] For inpatient treatment of heat stroke, emergency room procedures will apply.

• #31 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Heatstroke is a severe heat-related illness involving an elevation in body temperature, typically but not always greater than 40 C. The patient has clinical signs of central nervous system dysfunction that may include confusion, ataxia, delirium, or seizures brought on after strenuous physical exertion or exposure to hot weather. […] The workup of patients presenting with possible heat stroke should include frequent monitoring of vital signs and rectal temperature and laboratory studies of CBC, CMP, PT/PTT, blood gasses, serum CPK, and urine myoglobin. […] Management of heat stroke includes ensuring adequate airway protection, breathing, and circulation. After ABCs, rapid cooling becomes the mainstay of treatment with ancillary management in response to other end-organ damage. […] Patients presenting with heat stroke have high mortality depending on the etiology of the presentation. However, the death rate from exertional heat stroke is relatively low (3 to 5%) compared to classic heat stroke (10 to 65%).

• #32 Heat stroke: diagnosis and treatment

  https://www.dvm360.com/view/heat-stroke-diagnosis-and-treatment

  Heat stroke is a life-threatening condition characterized by an elevated core body temperature and central nervous system dysfunction. […] The classic definition of heat stroke is an elevated core body temperature 41 C in dogs, accompanied by central nervous system dysfunction. […] Data on incidence of heat stroke in veterinary patients are lacking, but it is a commonly recognized condition in dogs, especially in hot, humid environments. […] Nonpyrogenic hyperthermia occurs when heat production cannot be adequately dissipated by normal thermoregulatory mechanisms. […] Predisposing factors for the development of heat stroke can be categorized into conditions decreasing heat dissipation and those increasing heat production. […] Heat stroke causes an altered heat-shock response and an exaggerated acute-phase response that leads to the production of reactive oxygen species, increased vascular and intestinal permeability, culminating in direct cellular injury and enzyme destruction.

• #33 Heat stroke – Wikipedia

  https://en.wikipedia.org/wiki/Heat_stroke

  Heat stroke is a clinical diagnosis, based on signs and symptoms. It is diagnosed based on an elevated core body temperature (usually above 40 degrees Celsius), a history of heat exposure or physical exertion, and neurologic dysfunction. However, high body temperature does not necessarily indicate that heat stroke is present, such as with people in high-performance endurance sports or with people experiencing fevers. In others with heatstroke, the core body temperature is not always above 40 degrees Celsius. Therefore, heat stroke is more accurately diagnosed based on a constellation of symptoms rather than just a specific temperature threshold. Tachycardia (or a rapid heart rate), tachypnea (rapid breathing) and hypotension (low blood pressure) are common clinical findings. Those with classic heat stroke usually have dry skin, whereas those with exertional heat stroke usually have wet or sweaty skin.

• #34 Heat Stroke: Symptoms, Treatment & Recovery

  https://my.clevelandclinic.org/health/diseases/21812-heatstroke

  Heat stroke diagnoses usually happen in the emergency room. Providers quickly need to get a sense of what you were doing when symptoms started and what exactly you’re experiencing. They’ll check your internal (core) body temperature (typically using a rectal thermometer) and other vital signs. They’ll talk to you, if you’re able, and learn more from anyone who’s with you. […] There’s no single diagnostic test for heat stroke. But providers can rule out other conditions with similar symptoms and check for heat stroke complications by doing: Blood tests. Urine (pee) tests. Electrocardiogram (EKG). Chest X-ray. […] If providers suspect heat stroke, they’ll start treatment immediately, even if they’re still ruling out other conditions. That’s because prompt treatment is vital to survival.

• #35 Heat exhaustion – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/diagnosis-treatment/drc-20373253

  If you need medical attention due to heat exhaustion, the medical staff that may take your rectal temperature to confirm the diagnosis and rule out heatstroke. […] If your health care team suspects your heat exhaustion may have progressed to heatstroke, you could need further tests, including: […] A blood test, to check for low blood sodium or potassium and the content of gases in your blood. […] A urine test, to check the concentration and makeup of your urine. This test can also check your kidney function, which can be affected by heatstroke. […] Muscle function tests, to check for rhabdomyolysis serious damage to your muscle tissue. […] X-rays and other imaging, to check for damage to your inner organs.

• #36 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. […] Untreated heat exhaustion can progress to heatstroke, a much more serious illness involving central nervous system dysfunction such as delirium and coma. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] If a patient is suffering from heat-stroke, rapid diagnosis and effective cooling are crucial, because the condition triggers a series of metabolic events that may progress to irreversible injury or death. […] The diagnosis of heatstroke rests on two critical factors: hyperthermia and central nervous system dysfunction. […] It is essential that clinicians recognize the signs of heatstroke and initiate cooling rapidly. […] Initial evaluation of a patient with suspected heatstroke should include an assessment of the airway, breathing, and circulation.

• #37 Heat-related illnesses – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/heat-related-illnesses/

  Heatstroke is a life-threatening heat-related illness characterized by severe hyperthermia (with a body temperature typically 40C) and severe CNS dysfunction. […] The cornerstone of treatment is aggressive active cooling to reduce core body temperature to less than 40C. […] Heatstroke is a clinical diagnosis. Diagnostic studies can support the diagnosis, help rule out alternative causes, and assess for complications (e.g., AKI). […] If there is diagnostic uncertainty about heat exhaustion vs. heatstroke, immediately begin empiric treatment for heatstroke. […] Diagnostics for dehydration: BMP, CBC, UA, urine electrolytes. […] CPK: to assess for rhabdomyolysis. […] If heatstroke cannot be excluded clinically, begin intensive active cooling without delay. […] Active cooling is the highest priority for patients with heatstroke and should be considered even before initiating transport. […] All patients require hospital admission. […] Most patients require ICU admission to monitor for and manage organ failure.

• #38 Heat stroke in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/849

  Heat stroke is a medical emergency. Clinical features include a core body temperature 40C and central nervous system dysfunction (e.g., altered level of consciousness ranging from confusion to coma [encephalopathy], seizures) in the context of passive exposure to severe environmental heat (classic heat stroke) or strenuous exercise (exertional heat stroke). […] Use a rectal thermometer to measure core body temperature and monitor continuously. In practice, consider using an oesophageal probe in intubated patients. […] Start rapid active cooling immediately, based on clinical suspicion regardless of degree of hyperthermia and measuring technique. Aim to achieve a target temperature of no less than 39C. Stop cooling once this temperature is reached. […] Cold or ice water immersion is the preferred method for patients with exertional heat stroke. Use wetting and fanning the skin in patients with classic heat stroke and consider wetted ice packs or chemical cold packs as adjunctive cooling.

• #39 Hyperthermia & heat stroke – EMCrit Project

  https://emcrit.org/ibcc/hyperthermia/

  Disease caused by an imbalance of heat generation versus heat clearance from the body (without another primary underlying cause). […] Clinically defined on the basis of: (a) Temperature 40C (104F). (b) Neurologic manifestations (e.g. altered mental status, ataxia, seizure). (c) Caused primarily by exertion or exposure. […] Diagnosis is generally reasonably obvious based on history. […] Presentation may be less obvious than exertional heat stroke (should have high index of suspicion during a heat wave). […] Examination may show dry skin, delirium, and abnormal vital signs (e.g. hyperthermia, tachycardia, hypotension). […] Immediate fingerstick glucose if mental status alteration. […] These complications should be treated using standard supportive measures. Consider monitoring laboratory studies (especially creatinine kinase and liver function tests) over the first 24 hours to watch for the emergence of these problems.

• #40 Heatstroke in Dogs | Today’s Veterinary Practice

  https://todaysveterinarypractice.com/emergency-medicine-critical-care/todays-technician-heatstroke-in-dogs/

  Heatstroke in dogs is defined as a nonpyrogenic increased body temperature above 104°F (40°C), with a spectrum of systemic signs. […] The ability to rapidly recognize and begin treatment of heatstroke is vital to maximize the chances of saving the animal’s life. […] History often includes recent exercise or confinement in an area without access to water or shade. […] The most common clinical signs in one study were collapse, tachypnea, shock, inappropriate mentation, and signs of coagulopathy, but may also include tachycardia, hyperemia, and hyperdynamic to nonexistent pulses. […] Common findings in patients with heatstroke are listed in Table 4. […] Upon presentation, perform a urinalysis and blood analysis, including serum biochemical profile, complete blood count and differential, and coagulation panel.

• #41 Heatstroke in Dogs | Today’s Veterinary Practice

  https://todaysveterinarypractice.com/emergency-medicine-critical-care/todays-technician-heatstroke-in-dogs/

  The goal of active cooling is to return the dog to a normal body temperature, while avoiding further organ damage. […] Implementing treatment as soon as possible—even before the patient reaches the hospital—significantly improves the patient’s prognosis. […] Active cooling is the most important aspect of treatment, although it may not prevent deleterious effects of heatstroke. […] Serial monitoring during hospitalization should include neurologic status assessment, heart rate, pulse quality, respiratory rate and effort, blood pressure, and ECG. […] Prognosis is most dependent on length of time the patient was hyperthermic and highest body temperature experienced.

• #42 Heat stroke: diagnosis and treatment

  https://www.dvm360.com/view/heat-stroke-diagnosis-and-treatment

  A complete physical examination and thorough history should be performed on all cases, because certain changes have been associated with a poor prognosis. […] The goal of emergency treatment is to safely lower core body temperature as soon as heat stroke is suspected. […] There are limited studies evaluating the prognosis and outcome for patients with heat stroke. The largest study identified an overall mortality rate of 50 percent. […] Heat stroke can result in multi-organ dysfunction that can be life-threatening. […] The key to successful treatment includes rapid recognition and protocols aimed at rapid cooling and support of the affected body systems. […] Collection of laboratory values helps determine the prognosis.

• #43 Diagnosis and Prevention of Heat-Related Illness | Encyclopedia MDPI

  https://encyclopedia.pub/entry/31607

  Heatstroke differs because there are evident manifestations of central nervous system alteration, the temperature exceeds 41 °C and transaminases increase after 24 h. […] Heat stroke is a medical emergency caused by failure of thermoregulation and acclimatization mechanisms. […] It is characterized by a rapid increase in internal body temperature that exceeds 40.5 °C, resulting in multi-organ dysfunction. […] The researchers distinguish two types of heatstroke: classic heatstroke and stress heatstroke. […] In both cases, it is possible to detect leukocytosis, thrombocytopenia, impaired coagulation, liver damage, renal damage, and rhabdomyolysis in the blood chemistry. […] Where there is a suspicion of heat stroke, it is necessary to reduce the temperature as quickly as possible. […] Continuous monitoring of core rectal temperature is recommended during rapid cooling. […] For inpatient treatment of heat stroke, emergency room procedures will apply.

• #44 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  The sequelae of the insult may persist beyond the initial CNS dysfunction, involving injury to the gut, kidney, skeletal muscle, or other organ systems. Complications of heat stroke include acute respiratory distress syndrome, disseminated intravascular coagulation, acute kidney injury, hepatic injury, hypoglycemia, rhabdomyolysis, and seizures. […] Optimal treatment in heatstroke patients relies on early recognition and expedition of rapid cooling.

• #45 Expert consensus on standardized diagnosis and treatment for heat stroke | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-015-0056-z

  Early effective treatment is the key to determining the prognosis. […] The crucial points in effective treatment are rapid lowering of the core temperature, blood purification, and DIC prevention. […] Rapid cooling is the most important treatment measure. […] If cooling is delayed, the fatality rate increases significantly. […] The case fatality rate can reach more than 50 % if effective treatment is not received in a timely manner.

• #46 Heatstroke (sunstroke): Signs, Symptoms, First Aid, and Treatment

  https://www.webmd.com/a-to-z-guides/heat-stroke-symptoms-and-treatment

  Heatstroke happens when your body temperature rises very high, usually because of being in a hot environment. It can damage your brain and other internal organs and be fatal. […] If you think that someone has heatstroke, immediately call 911 or take the person to a hospital. Any delay in seeking medical help can be fatal. […] Heatstroke is a medical emergency that requires immediate treatment. Call 911 if you or someone you’re with is showing signs of the illness, including headache, muscle weakness, dizziness, confusion, nausea and vomiting, and rapid breathing and heart rate. […] Heatstroke is a medical emergency that cannot be treated at home. Call 911 if you think you or someone else has heatstroke.

• #47 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html

  Signs of central nervous system dysfunction such as irritability, ataxia, and confusion are essential to the diagnosis of heatstroke. […] Prompt reversal of hyperthermia is the cornerstone of heatstroke treatment. […] Immediate initiation of rapid and effective cooling is crucial in a patient with heatstroke. […] Cooling methods generally are categorized as external or internal. […] Medications have shown little efficacy in treating heatstroke. […] Heatstroke must be viewed as multisystem failure.

• #48 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Heatstroke is a severe heat-related illness involving an elevation in body temperature, typically but not always greater than 40 C. The patient has clinical signs of central nervous system dysfunction that may include confusion, ataxia, delirium, or seizures brought on after strenuous physical exertion or exposure to hot weather. […] The workup of patients presenting with possible heat stroke should include frequent monitoring of vital signs and rectal temperature and laboratory studies of CBC, CMP, PT/PTT, blood gasses, serum CPK, and urine myoglobin. […] Management of heat stroke includes ensuring adequate airway protection, breathing, and circulation. After ABCs, rapid cooling becomes the mainstay of treatment with ancillary management in response to other end-organ damage. […] Patients presenting with heat stroke have high mortality depending on the etiology of the presentation. However, the death rate from exertional heat stroke is relatively low (3 to 5%) compared to classic heat stroke (10 to 65%).

• #49 Heat Stroke

  https://mobile.fpnotebook.com/ER/Environ/HtStrk.htm

  Heat Stroke is the third leading cause of death among high school athletes. […] Heat Stroke is a time-sensitive, life threatening condition (treat aggressively as a code). […] First priority is to initiate definitive cooling without delay. […] Core Temperature exceeds 40 C (104 F) for Heat Stroke diagnosis. […] Nearly all patients will require hospitalization (typically ICU). […] Mortality: 10% (if treated appropriately). […] Indicators of Poor Prognosis include Core Temperature exceeds 42 degrees Celsius.

• #50 Heat stroke: Symptoms, Diagnosis and Treatment | Clínica Universidad de Navarra

  https://www.cun.es/en/diseases-treatments/diseases/heat-stroke

  „Heat stroke treatment is a vital emergency, since its mortality is lower if the patient is cooled down as soon as possible.” […] „Heat stroke is an uncontrolled rise in temperature due to a failure of the thermoregulatory mechanisms, and can lead, if not treated early and properly, to severe multi-organ failure and death.” […] „The treatment of heat stroke is a vital emergency, as mortality is lower if the patient is cooled as soon as possible.” […] „It is therefore very important to diagnose the syndrome early and to suspect it in any patient with high fever and neurological alteration.” […] „If you suspect that you have any of the above symptoms, you should consult a medical specialist for a diagnosis.”

• #51 (PDF) Heatstroke: Pathogenesis, diagnosis and Treatment

  https://www.academia.edu/14356639/Heatstroke_Pathogenesis_diagnosis_and_Treatment

  Heatstroke is a severe condition characterized by hyperthermia, neurological abnormalities, and dry skin, typically following heat exposure or strenuous activity. Diagnosis relies on clinical features and requires immediate cooling to prevent multi-organ failure. […] Effective cooling methods, such as evaporative cooling, are essential, as no pharmacological treatment has proven beneficial. […] Classic heat stroke may demonstrate a rapidly worsening organ dysfunction course leading to death even though cooling procedures and intensive care management are promptly started. […] Patients with heat stroke are usually acutely ill with multi organ involvement. While the prognosis has improved with modern medical care, septic shock or renal impairment can carry mortality risk.

• #52 Heat stroke – WikEM

  https://wikem.org/wiki/Heat_stroke

  Severe end of heat-related illness spectrum characterized by severe hyperthermia and neurologic dysfunction. […] True emergency – universally fatal if left untreated. […] Hallmark is multisystem organ dysfunction from heat-induced damage resulting in systemic inflammatory response. […] Clinical diagnosis. […] Exposure to hot environment and high index of suspicion. […] Rapid cooling – mainstay of treatment. […] Reduces morbidity/mortality, should be started in prehospital setting if no other life-threats exist. […] All patients require admission.

• #53 Heat Exhaustion: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21480-heat-exhaustion

  Heat exhaustion is the most common type of heat-related illness. […] Without treatment, heat exhaustion can turn into the most severe form of heat-related illness: heat stroke. […] If you have signs or symptoms of heat exhaustion, do these things right away: […] Heat exhaustion treatment involves cooling your body, hydrating and monitoring for signs of heat stroke. […] When emergency services personnel arrive, theyll immediately look for any signs of heat stroke. […] If your heat exhaustion progresses to heat stroke, youll need to stay a couple nights or longer at the hospital. […] Heat exhaustion itself doesnt have three stages, but its often considered the second stage of heat-related illness.

• #54 Heat-related illnesses – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/heat-related-illnesses/

  Heatstroke is a life-threatening heat-related illness characterized by severe hyperthermia (with a body temperature typically 40C) and severe CNS dysfunction. […] The cornerstone of treatment is aggressive active cooling to reduce core body temperature to less than 40C. […] Heatstroke is a clinical diagnosis. Diagnostic studies can support the diagnosis, help rule out alternative causes, and assess for complications (e.g., AKI). […] If there is diagnostic uncertainty about heat exhaustion vs. heatstroke, immediately begin empiric treatment for heatstroke. […] Diagnostics for dehydration: BMP, CBC, UA, urine electrolytes. […] CPK: to assess for rhabdomyolysis. […] If heatstroke cannot be excluded clinically, begin intensive active cooling without delay. […] Active cooling is the highest priority for patients with heatstroke and should be considered even before initiating transport. […] All patients require hospital admission. […] Most patients require ICU admission to monitor for and manage organ failure.

• #55 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. […] Untreated heat exhaustion can progress to heatstroke, a much more serious illness involving central nervous system dysfunction such as delirium and coma. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] If a patient is suffering from heat-stroke, rapid diagnosis and effective cooling are crucial, because the condition triggers a series of metabolic events that may progress to irreversible injury or death. […] The diagnosis of heatstroke rests on two critical factors: hyperthermia and central nervous system dysfunction. […] It is essential that clinicians recognize the signs of heatstroke and initiate cooling rapidly. […] Initial evaluation of a patient with suspected heatstroke should include an assessment of the airway, breathing, and circulation.

• #56 Heat-related Illness: Causes, Symptoms, and Treatment

  https://patient.info/doctor/heat-related-illness

  An increase in body temperature can cause symptomatic illness. […] There is a spectrum of heat-related illness ranging from heat cramps, through heat exhaustion to heatstroke. […] Signs of heat-related illness in an individual often begin with heat exhaustion, which, if left untreated, might progress to heatstroke. […] This is a combination of hyperthermia (classically defined as a core body temperature of at least 40.6C), often with loss of the capacity to dissipate heat, and CNS impairment. […] The history of exposure to an adverse environment physical exertion usually confirms the diagnosis, but sepsis and alternative causes of fever should be considered as a cause or precipitant. […] Monitor temperature regularly, using a rectal thermometer. […] The Wilderness Medical Society has developed a set of evidence-based guidelines for the recognition, prevention, and treatment of heat-related illness. […] Patients with heatstroke should be taken to a medical facility capable of critical care management of patients with multiple organ failure. […] With rapid cooling, sufficient rehydration and careful management of complications survival rates for heatstroke approach 85-90% in most modern centres.

• #57

  https://journals.lww.com/cmii/fulltext/2018/16010/heat_stroke_and_heat_exhaustion__an_update.2.aspx

  Heat stroke is an illness caused by failure of thermoregulation with elevation of core temperature to 40C (104F) or more, associated with central nervous system dysfunction. […] Diagnosis is clinical […] History of exposure to hot environment […] Elevated core temperature […] Neurological symptoms/signs. […] Heat stroke is the more severe and dangerous form of heat-related illness. The diagnosis is clinical and is based on two features: an elevated core body temperature (generally 40C [104F]) and central nervous system dysfunction. Signs of central nervous system dysfunction are essential to the diagnosis of heatstroke. […] The two important principles in management of heat stroke are as follows: Lower core temperature (measured using a rectal thermometer ideally) immediately to 38.9 C (102.2 F) […] Support organ systems injured by heat, hypotension, inflammation, and coagulopathy.

• #58 Heat stroke in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/849

  Patients are at risk of multi-system organ failure, so careful monitoring is essential even after return to normothermia. […] Heat stroke is defined as a core temperature 40C with central nervous system dysfunction (e.g., altered level of consciousness ranging from confusion to coma [encephalopathy], seizures). […] Key diagnostic factors include history of exposure to severe environmental heat or strenuous physical exercise, central nervous system dysfunction, hyperthermia (40C), and hot skin (dry or wet). […] 1st investigations to order include rectal temperature, FBC, liver function tests, renal function tests, glucose, electrolytes, arterial blood gases, creatine kinase, clotting profile, urinalysis, and ECG.

• #59 Heatstroke – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heatstroke

  Heatstroke is hyperthermia accompanied by a systemic inflammatory response causing multiple organ dysfunction that may result in death. Diagnosis is clinical. […] Diagnosis is usually clear from a history of exertion and environmental heat. Heatstroke is differentiated from heat exhaustion by presence of the following: CNS dysfunction, Temperature 40 C. […] When the diagnosis of heatstroke is not obvious, other disorders that can cause CNS dysfunction and hyperthermia should be considered. […] Laboratory testing includes complete blood count, prothrombin time, partial thromboplastin time, electrolytes, blood urea nitrogen, creatinine, calcium, creatine kinase (CK), and hepatic profile to evaluate organ function. […] Diagnosis of Heatstroke: Clinical evaluation, including core temperature measurement, Laboratory testing for organ dysfunction.

• #60 Heatstroke

  https://healthlibrary.wjmc.org/library/TestsProcedures/LabTests/3,85291

  Your body stays cool by sweating. This releases heat through your skin. But spending a long time in high temperatures can cause this cooling system to fail. When this happens, you stop sweating. Your body temperature may rise to very high levels. In severe cases, your brain and other vital organs may shut down. This is known as heatstroke. […] Heatstroke is a medical emergency. […] To cool the body, lukewarm water may be sprayed over the body and large fans may be used to blow air over the damp skin. Ice packs wrapped in cloth may be put on the neck, armpits, and groin. Cooling blankets may be used. Or the person may be put in an ice water bath. […] Blood and urine tests will likely be done. These can help find damage to organs, especially the kidneys.

• #61 Diagnosis and management of heat stroke : Virtual Library

  https://resources.wfsahq.org/atotw/diagnosis-and-management-of-heat-stroke/

  Cardinal features are core body temperature of 40C and central nervous system dysfunction. […] Patients suffering from heat stroke may have a normal core temperature on arrival at hospital if effective pre-hospital cooling has occurred. […] A history of exposure to hot weather or vigorous activity in the absence of other symptoms may help to make the diagnosis, but important causes such as sepsis, drug reactions and tropical diseases should all be excluded. […] All patients with heat stroke will have an altered mental status which can be wide ranging from mild confusion and irritability to coma. […] Hypotension is multifactorial in nature. It is often due to a combination of dehydration and peripheral vasodilation, the latter of which is due to increased production of nitric oxide. […] The mainstays of treatment after alternative diagnoses have been ruled out is rapid cooling and, where indicated, multi-organ support. […] Rapid cooling and resuscitative treatments are the mainstays of treatment.

• #62 Expert consensus on standardized diagnosis and treatment for heat stroke | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-015-0056-z

  Early effective treatment is the key to determining the prognosis. […] The crucial points in effective treatment are rapid lowering of the core temperature, blood purification, and DIC prevention. […] Rapid cooling is the most important treatment measure. […] If cooling is delayed, the fatality rate increases significantly. […] The case fatality rate can reach more than 50 % if effective treatment is not received in a timely manner.

• #63 Heat Exhaustion and Heat Stroke Among Active Component Members of the U.S. Armed Forces, 2019-2023 | Health.mil

  https://health.mil/News/Articles/2024/04/01/MSMR-Heat-Illness-2024

  Heat stroke is a debilitating and potentially life-threatening condition characterized by severe hyperthermia. During a period of heat exposure or exertion, a probable case of heat stroke requires 1) evidence of elevated core body temperature and 2) central nervous system dysfunction (e.g., change in mental status, delirium, stupor, loss of consciousness, or coma). […] Ongoing surveillance of heat illnesses is necessary to determine if prevention guidelines and countermeasures are working, in addition to identifying high-risk groups and activities that may lead to heat illness. […] Maintaining regular heat illness surveillance helps identify the magnitude of the impact these conditions have on service member health, training, and force readiness.

• #64 (PDF) Heatstroke: Pathogenesis, diagnosis and Treatment

  https://www.academia.edu/14356639/Heatstroke_Pathogenesis_diagnosis_and_Treatment

  Heatstroke is a severe condition characterized by hyperthermia, neurological abnormalities, and dry skin, typically following heat exposure or strenuous activity. Diagnosis relies on clinical features and requires immediate cooling to prevent multi-organ failure. […] Effective cooling methods, such as evaporative cooling, are essential, as no pharmacological treatment has proven beneficial. […] Classic heat stroke may demonstrate a rapidly worsening organ dysfunction course leading to death even though cooling procedures and intensive care management are promptly started. […] Patients with heat stroke are usually acutely ill with multi organ involvement. While the prognosis has improved with modern medical care, septic shock or renal impairment can carry mortality risk.

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