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• #1 Heat Stroke Treatment & Management: Medical Care

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

  Heat stroke is a medical emergency and continues to be one of the leading causes of preventable death in sports. Rapid reduction of the core body temperature is the cornerstone of treatment because the duration of hyperthermia is the primary determinant of outcome. Patients diagnosed with exertional heat stroke (EHS) or nonexertional heat stroke (NEHS) should be admitted to the hospital for at least 48 hours to monitor for complications. […] Once heat stroke is suspected, cooling must begin immediately and must be continued during the patient’s resuscitation. The American College of Sports Medicine recommends that cooling be initiated at the scene, before transporting the patient to an emergency department for further evaluation and treatment. […] Controversy still exists over what therapeutic modality is most effective in the treatment of heat stroke. However, the basic premise of rapidly lowering the core temperature to about 39C (to avoid overshooting and rebound hyperthermia) remains the primary goal. Rehydration therapy alone is insufficient for heat stroke patients and should be combined with active cooling.

• #1 Heatstroke – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/heat-stroke/diagnosis-treatment/drc-20353587

  Heatstroke treatment centers on cooling the body to a standard temperature to prevent or reduce damage to the brain and vital organs. To do this, a healthcare professional may take these steps: […] A bath of cold or ice water has been proved to be the most effective way of quickly lowering the core body temperature. The quicker someone with heatstroke receives cold water immersion, the less risk of death and organ damage. […] If cold water immersion is not available, healthcare professionals may try to lower body temperature using an evaporation method. Cool water is misted on the body while warm air is fanned over the person, causing the water to evaporate and cool the skin. […] Another method is to wrap a person in a special cooling blanket and apply ice packs to the groin, neck, back and armpits to lower temperature. […] If treatments to lower body temperature make you shiver, your doctor may give you a muscle relaxant, such as a benzodiazepine. Shivering increases your body temperature, making treatment less effective.

• #1

  https://www.healthxchange.sg/head-neck/skin-health/what-doctors-treat-heat-stroke

  What Can Doctors Do to Treat Heat Stroke? […] One of the fastest ways of removing heat from the body is by spraying it with a fine mist of lukewarm water. […] A fan blows to evaporate this water off the skin. […] The bigger the area that is misted, the faster the body is able to lose heat, Dr Phua added. […] When rushed to the intensive care unit (ICU), heatstroke patients may have low blood pressure and may not be breathing adequately, so a breathing tube and an intravenous drip are usually used. […] For very severe cases of heatstroke, a device known as an endovascular cooler is inserted into the large blood vessel in the thigh, much like dialysis, to cool the blood. […] Another method is to run water through a tube inserted either through the nose to the stomach, or surgically to cool the body. […] For milder forms of heat disorders, special cooling blankets (cooled to low temperatures), cooling pads or ice packs are used.

• #1 How is Heat Stroke Treated in the Emergency Room?

  https://mhehc.com/blog/how-is-heat-stroke-treated-in-the-emergency-room/

  Heat stroke is a severe heat-related illness that requires immediate medical attention. […] Heat stroke is the most risky heat illness, marked by a body temperature of 104°F (40°C) or higher, confusion, seizures, rapid breathing, rapid heartbeat, and potential loss of consciousness. Heat stroke is a medical condition that requires immediate treatment. […] When a patient with heat stroke arrives at the ER, the medical team will take swift action to provide effective treatment. The following treatment options may be employed: Rapid Cooling: The primary goal of treating heat stroke is quickly lowering body temperature. The ER staff will initiate cooling measures, such as ice packs or cold water immersion, to reduce the core body temperature. […] Intravenous Fluids: Dehydration is a standard complication of heat stroke. The ER team will administer intravenous fluids to replenish fluid and electrolyte levels, ensuring proper hydration and preventing further complications.

• #1 Heat Stroke Treatment & Management: Medical Care

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

  Antipyretics (eg, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heat stroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heat stroke. […] Immediate administration of benzodiazepines is indicated in patients with agitation and shivering, to stop excessive production of heat. […] Recommendations on the administration of intravenous fluids for circulatory support differ among patient populations and depend on the presence of hypovolemia, preexisting medical conditions, and preexisting cardiovascular disease. […] Treatment of rhabdomyolysis involves infusion of large amounts of intravenous fluids (fluid requirements may be as high as 10 L), alkalinization of the urine, and infusion of mannitol.

• #1 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Clinicians should prioritize cooling methods that achieve the most rapid rate of cooling. This includes ice-water immersion (1-5 C) or cold-water immersion (9-12 C). […] Clinicians should choose cooling methods that reach the target temperature within 30 minutes from recognition of heat stroke symptoms. […] Clinicians should prioritize cooling modalities that achieve a cooling rate greater than or equal to 0.155 C/min. […] We recommend against the use of dantrolene in patients with heat stroke. Quality of evidence: Very low. […] The routine use of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDS), and salicylates for temperature reduction should be avoided. […] Prophylactic antibiotics or prophylactic antiseizure medications should only be used in the context of research.

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

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

  Patients should be admitted to an intensive care unit and observed for multiple organ dysfunction, disseminated intravascular coagulation, and rhabdomyolysis. […] Antipyretics have no value and can contribute to liver or kidney damage. […] Rapid recognition of heatstroke and effective, aggressive cooling are extremely important. […] Use cool water immersion or evaporative cooling to rapidly cool the patient. […] Patients will require intensive care monitoring with aggressive supportive care.

• #1 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

  Coagulation factors (such as fresh frozen plasma, prothrombin complex, fibrinogen, cryoprecipitate, etc.) should be replenished as soon as possible. For fresh frozen plasma, the first dose is 10-15 ml/kg, followed by the addition of 200-400 ml according to the coagulation indices being monitored. Restore PT and APTT to normal levels. […] Infection can be resisted in the early stage by the prophylactic use of antibiotics such as second generation cephalosporin antibiotics. If there is infection, collect relevant specimens for smears and culture in a timely manner, increase the level of antibiotics, and add anti-fungals as necessary.

• #1 Heatstroke in Cats: Signs, Treatment, and Prevention | PetMD

  https://www.petmd.com/cat/conditions/systemic/heatstroke-cats

  Cats with heatstroke are also more susceptible to sepsis (severe infection throughout the entire body), so antibiotics (such as ampicillin and Clavamox) are often used. […] Kidney failure from heatstroke is possible. If this is the case, fluid therapy is essential but must be carefully monitored. […] In either of these cases, the veterinarian may recommend referral to a veterinary hospital where a ventilator or kidney dialysis is available. […] In mild to moderate cases of heatstroke in cats, pets often make a full recovery by the time they are discharged from the hospital. […] Your veterinarian may want to see your cat back in five to 10 days. This is so that they can perform a recheck examination and lab tests to assess your cats organ function, and sooner if your cat experiences vomiting, diarrhea, or disorientation. […] You can ask your veterinarian about the expected long-term care for your cat, as some pets with severe heatstroke may require long-term treatment for kidney failure, heart disease, or neurological problems.

• #1 Heat Stroke: Symptoms, Treatment & Recovery

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

  Heat stroke is life-threatening and requires immediate medical treatment. The longer your body temperature remains high, the greater your risk of complications (like organ damage) or death. […] Heat stroke treatment involves quickly cooling down your body and monitoring for complications. This requires care in an emergency room. […] Call 911 immediately if you (or someone you’re with) has signs of heat stroke. But don’t wait for help to arrive to begin treating heat stroke. The sooner your body starts cooling down ideally within 30 minutes of the start of symptoms the better your chances of recovery. […] Heat stroke affects a person’s ability to stay aware and awake, so they’ll likely need bystanders to help. […] Here’s what you should do for someone with signs of heat stroke: Move the person out of the sun or heat to a cooler spot. Pour water over their skin and use anything available to fan them. Soak a towel in ice water and apply it to their skin. Cover as much of their skin’s surface area as possible. Replace with newly soaked towels every minute or so. Apply ice or cold packs to their armpits or neck.

• #1 Exertional heat stroke treatment with cold water immersion

  https://www.ems1.com/heat-related-illness/articles/feel-the-heat-managing-exertional-heat-stroke-4sOBidEFVXyajamp/

  NAEMSP and NATA recommend a cool first, transport second approach to exertional heat stroke treatment with cold water immersion therapy. […] Recognizing the need for early and aggressive treatment of EHS, the National Association of EMS Physicians published an important consensus statement in 2018 that outlines the identification and management of EHS in the pre-hospital setting which will be reviewed here. […] Rapid cooling is the key management step of EHS. Rapid cooling should begin when the patient is symptomatic. Based on expert consensus, if the rectal temperature is greater than 40.5C (104.9F), cold water immersion cooling should occur when available, as it most expeditiously accomplishes rapid cooling. […] Given the importance of rapid cooling in the setting of EHS, EMS protocols should consider prioritizing cold water immersion over transport if the equipment is available onsite. NAEMSP and NATA both recommend a cool first, transport second approach.

• #1 Heat Stroke Treatment Doctor | Dr. Curtis Grote MD

  https://www.fastaiduc.com/heat-stroke

  Heatstroke requires immediate medical attention to prevent permanent damage or even death. The primary treatment goal is to lower the body’s temperature to a safe level. At Fast Aid Urgent Care, our heatstroke management approach may involve cooling therapy techniques like evaporation cooling, cold water immersion, cooling blankets, or ice packs. We may also administer intravenous fluids to rehydrate the body, monitor vital signs and electrolyte levels, and provide symptomatic relief for associated symptoms such as headache, nausea, and vomiting. […] At Fast Aid Urgent Care, our dedicated and experienced team is fully equipped to handle medical emergencies such as heat stroke. Heat stroke is a severe condition that is considered a medical emergency, necessitating immediate professional medical attention. If you or someone you know is exhibiting symptoms such as a high body temperature, altered mental state, changes in sweating, nausea, vomiting, flushed skin, rapid breathing, or a racing heart rate, it is important to seek help immediately from our medical team.

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

  https://bestpractice.bmj.com/topics/en-gb/3000174

  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). […] 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. […] Patients are at risk of multi-system organ failure, so careful monitoring is essential even after return to normothermia. […] This topic covers the management of both heat stroke and heat exhaustion in adults.

• #1 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  Fluid replacement: In cases of dehydration, electrolyte imbalances, or fluid loss, intravenous (IV) fluids may be administered to restore hydration and electrolyte balance. […] Monitoring and supportive care: The individual may require close monitoring and supportive care in a hospital setting, especially if they have severe symptoms or complications of heat stroke. This may include monitoring of organ function, administration of medications to control symptoms, and supportive measures to maintain vital signs and prevent complications. […] […] […] What is the Prognosis for Heat Stroke? […] The prognosis for heat stroke can vary depending on several factors, including the severity of the condition, promptness of treatment, presence of underlying health conditions, and age of the affected individual. With prompt and appropriate treatment, many people recover fully from heat stroke with minimal long-term complications. However, in severe cases or if treatment is delayed, heat stroke can lead to serious complications and even death.

• #1 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  – Multiorgan failure: In severe cases, heat stroke can cause failure of multiple organ systems, including the kidneys, liver, lungs, and heart, leading to systemic organ failure and death. […] […] […] How to Prevent Heat Stroke? […] Preventing heat stroke involves taking proactive measures to stay cool and hydrated, especially during hot weather or when engaging in strenuous activities. Here are some tips to help prevent heat stroke: […] – Stay hydrated: Drink plenty of fluids, especially water, throughout the day, even if you’re not feeling thirsty. Avoid beverages that contain alcohol, caffeine, or excessive sugar, as these can contribute to dehydration. […] – Dress appropriately: Wear lightweight, loose-fitting clothing in light colors to reflect sunlight and heat. Protect your head and face with a wide-brimmed hat and use sunscreen to prevent sunburn, which can impair the body’s ability to regulate temperature.

• #1 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. If suppression of body temperature is delayed, the fatality rate will be elevated. […] 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. […] Specific treatment measures are nine early and one ban, that is, early cooling, early expansion, early blood purification, early sedation, early intubation, early correction of coagulation dysfunction, early resistance to infection, early enteral nutrition, early immunoregulation, and a ban on surgical operations during the period of coagulation dysfunction.

• #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. […] Evaluate the importance of rapid cooling as a treatment for heat stroke. […] 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. […] Adequate rehydration is essential without over-correcting the sodium if derangements exist. […] It is mandatory to continually measure core temperature with a rectal or esophageal probe, and cooling measures should be stopped once the temperature is 38 to 39 degrees Celsius. […] Ice bath immersion is the timeliest to reduce core body temperature, however, in older populations, it may not be realistic as cardiac monitoring may not be feasible and extreme agitation may hinder compliance.

• #2 Heat Stroke: Symptoms, Treatment & Recovery

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

  Heat stroke is life-threatening and requires immediate medical treatment. The longer your body temperature remains high, the greater your risk of complications (like organ damage) or death. […] Heat stroke treatment involves quickly cooling down your body and monitoring for complications. This requires care in an emergency room. […] Call 911 immediately if you (or someone you’re with) has signs of heat stroke. But don’t wait for help to arrive to begin treating heat stroke. The sooner your body starts cooling down ideally within 30 minutes of the start of symptoms the better your chances of recovery. […] Heat stroke affects a person’s ability to stay aware and awake, so they’ll likely need bystanders to help. […] Here’s what you should do for someone with signs of heat stroke: Move the person out of the sun or heat to a cooler spot. Pour water over their skin and use anything available to fan them. Soak a towel in ice water and apply it to their skin. Cover as much of their skin’s surface area as possible. Replace with newly soaked towels every minute or so. Apply ice or cold packs to their armpits or neck.

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

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

  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. If possible, instruct the owner to begin cooling his or her dog during travel to the hospital. One study revealed dogs actively cooled before arriving at the hospital had a lower mortality rate (19%) than dogs not cooled prior to arrival (49%). […] Intravenous fluids are considered a cornerstone of heatstroke treatment. […] A bolus of crystalloids is beneficial for hypovolemic and hemoconcentrated heatstroke patients. Crystalloids provide cardiovascular support by expanding intravascular volume, and increasing blood flow to the periphery, aiding with the cooling process.

• #2 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Predicted increases in heat-related weather phenomena will result in increasing heat exposures and heat injuries such as heat stroke. Prompt recognition, early intervention, and evidence-based management are necessary to optimize outcomes. These SCCM guidelines outline recommendations for the treatment of patients with heat stroke. […] Active cooling measures are recommended over passive cooling methods, with cold- or ice-water immersion achieving the fastest cooling rate. This method should be prioritized where available. In patients with heat stroke, there is no evidence to support pharmacological interventions that affect temperature control, so they should be avoided. […] We recommend active cooling methods over passive cooling in patients with heat stroke. Quality of evidence: Very low.

• #2 Heat Stroke: Symptoms, Treatment & Recovery

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

  Healthcare providers in the emergency room focus on cooling your body until it gets to a safe temperature. Common methods for cooling include: Cold water immersion. This is usually used for exertional heat stroke rather than classic heat stroke. A provider dunks your entire body (except your head) in cold water or ice water. Heat leaves your body and enters the surrounding water. Misting and fanning. This is often used for classic heat stroke but can be suitable for either type. A provider sprays as much of your skin as possible with water while large fans circulate the air around you. As the water evaporates from your skin, your body temperature lowers. […] Providers will closely monitor you for signs of complications and give you further treatment as needed. This might include: IV fluids (through a vein). Intubation. Medications to support organ function.

• #2 Heatstroke: Symptoms, treatment, and prevention

  https://www.medicalnewstoday.com/articles/266551

  The main aim of treating heatstroke is to lower the patients temperature and prevent further damage. […] There are several potential ways to achieve this, including: […] Immersion: Submerge the person in cold water or an ice bath. […] Evaporation cooling: Mist cold water onto the skin while fanning warm air onto the body. This causes evaporation, which cools the skin. […] Cooling blankets and ice packs: Wrap cooling blankets around the individual with heatstroke. Place ice packs in regions where large veins come close to the skins surface, such as the groin, armpit, neck, and back. This ensures that the temperature of the blood rapidly decreases. […] Heatstroke is a serious condition; a person should seek professional medical help immediately. […] While waiting for help, the individual should go somewhere less warm and attempt to reduce their temperature with damp sheets, a cold bath, or cooling drinks. A person must avoid alcohol.

• #2 Azthena logo with the word Azthena

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

  In the hospital fluids and electrolytes are administered as necessary while closely monitoring breathing, airway and maintenance of blood circulation. […] Ice packs are applied to the patient’s neck, armpits and groins to cool at around 0.1C/minute. Ice-bath immersion has been shown to be the most effective cooling method. […] Cooling is slowed or stopped once the temperature is 38.5C, to avoid overcooling. Iced gastric lavage and peritoneal lavage is attempted in severe cases. […] Medications like Benzodiazepines and muscle relaxants are given to control shivering and fits. […] A urinary catheter is placed to measure the exact urine output. […] Complications like respiratory distress, encephalopatrhy (brain disorder), rhabdomyolysis, kidney or liver damage is managed according to severity and symptoms.

• #2 Heat Stroke Treatment & Management: Medical Care

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

  Antipyretics (eg, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heat stroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heat stroke. […] Immediate administration of benzodiazepines is indicated in patients with agitation and shivering, to stop excessive production of heat. […] Recommendations on the administration of intravenous fluids for circulatory support differ among patient populations and depend on the presence of hypovolemia, preexisting medical conditions, and preexisting cardiovascular disease. […] Treatment of rhabdomyolysis involves infusion of large amounts of intravenous fluids (fluid requirements may be as high as 10 L), alkalinization of the urine, and infusion of mannitol.

• #2 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  Fluid replacement: In cases of dehydration, electrolyte imbalances, or fluid loss, intravenous (IV) fluids may be administered to restore hydration and electrolyte balance. […] Monitoring and supportive care: The individual may require close monitoring and supportive care in a hospital setting, especially if they have severe symptoms or complications of heat stroke. This may include monitoring of organ function, administration of medications to control symptoms, and supportive measures to maintain vital signs and prevent complications. […] […] […] What is the Prognosis for Heat Stroke? […] The prognosis for heat stroke can vary depending on several factors, including the severity of the condition, promptness of treatment, presence of underlying health conditions, and age of the affected individual. With prompt and appropriate treatment, many people recover fully from heat stroke with minimal long-term complications. However, in severe cases or if treatment is delayed, heat stroke can lead to serious complications and even death.

• #2 Heat stroke in children – UpToDate

  https://www.uptodate.com/contents/heat-stroke-in-children

  Children with heat stroke require aggressive treatment because the extent of end-organ damage and mortality is related to the duration of hyperthermia. […] For hospital treatment of children with heat stroke, we suggest evaporative cooling rather than rapid cooling with cold-water immersion. […] We suggest that patients with heat stroke receive IV benzodiazepines (eg, midazolam or lorazepam) to prevent or to treat shivering during cooling measures, especially if a cooling blanket or ice packs are being used. […] After stabilization and rapid cooling, the child with heat stroke remains at high risk for multiple organ failure, metabolic abnormalities, and disorders of coagulation. […] Antipyretic medications (eg, acetaminophen, ibuprofen) are ineffective for the treatment of hyperthermia in heat stroke victims and should not be used because they may exacerbate liver injury (acetaminophen) or cause kidney injury or gastrointestinal bleeding (ibuprofen).

• #2 Heat stroke – Wikipedia

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

  Heat stroke occurs because of high external temperatures and/or physical exertion. Treatment is by rapid physical cooling of the body and supportive care. Recommended methods include spraying the person with water and using a fan, putting the person in ice water, or giving cold intravenous fluids. Adding ice packs around a person is beneficial but does not by itself achieve the fastest possible cooling. Treatment of heat stroke involves rapid mechanical cooling along with standard resuscitation measures. The body temperature must be lowered quickly via conduction, convection, or evaporation. During cooling, the body temperature should be lowered to less than 39 degrees Celsius, ideally less than 38-38.5 degrees Celsius. In the field, the person should be moved to a cool area, such as indoors or to a shaded area. Clothing should be removed to promote heat loss through passive cooling. Conductive cooling methods such as ice-water immersion should also be used, if possible. Evaporative and convective cooling by a combination of cool water spray or cold compresses with constant air flow over the body, such as with a fan or air-conditioning unit, is also an effective alternative. In hospital mechanical cooling methods include ice water immersion, infusion of cold intravenous fluids, placing ice packs or wet gauze around the person, and fanning. Aggressive ice-water immersion remains the gold standard for exertional heat stroke and may also be used for classic heat stroke. This method may require the effort of several people and the person should be monitored carefully during the treatment process. A rapid and effective cooling usually reverses concomitant organ dysfunction. Dantrolene, a muscle relaxant used to treat other forms of hyperthermia, is not an effective treatment for heat stroke. Antipyretics such as aspirin and acetaminophen are also not recommended as a means to lower body temperature in the treatment of heat stroke and their use may lead to worsening liver damage. The person’s condition should be reassessed and stabilized by trained medical personnel. And the person’s heart rate and breathing should be monitored. IV fluid resuscitation is usually needed for circulatory failure and organ dysfunction and is also indicated if rhabdomyolysis is present. In severe cases hemodialysis and ventilator support may be needed.

• #2 Heat Stroke Treatment & Management: Medical Care

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

  Treatment of hepatic failure includes the following: Infusion of dextrose solutions to correct hypoglycemia, early recognition and treatment of DIC, with replacement of clotting factors, fresh frozen plasma, platelets, and blood, meticulous respiratory support. […] Pulmonary edema is a common complication of heat stroke and may be due to a number of factors, including fluid overload from aggressive rehydration, renal failure, congestive heart failure, and ARDS. […] AKI initially is treated with intravenous fluids, diuretics, and correction of associated acid-base and electrolyte abnormalities.

• #2 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

  Coagulation factors (such as fresh frozen plasma, prothrombin complex, fibrinogen, cryoprecipitate, etc.) should be replenished as soon as possible. For fresh frozen plasma, the first dose is 10-15 ml/kg, followed by the addition of 200-400 ml according to the coagulation indices being monitored. Restore PT and APTT to normal levels. […] Infection can be resisted in the early stage by the prophylactic use of antibiotics such as second generation cephalosporin antibiotics. If there is infection, collect relevant specimens for smears and culture in a timely manner, increase the level of antibiotics, and add anti-fungals as necessary.

• #2

  https://www.vin.com/apputil/content/defaultadv1.aspx?pId=22915&catId=124655&id=8896657&ind=419&objTypeID=17

  Management of Heat Stroke in the Dog World Small Animal Veterinary Association Congress Proceedings, 2018 […] Heatstroke is caused by the inability to dissipate accumulated heat. In dogs it is characterized by core temperatures above 105.8F (41C) with CNS dysfunction. […] Treatment Options […] Cooling – whole body cooling prior to admission is highly recommended. The literature provides different cooling methods (e.g., cold enema, gastric lavage, and ice baths); however, other successful and perhaps more practical methods use evaporative cooling via whole body irrigation with tap water and placement of a fan facing the animal. […] During cooling, the patients temperature should be monitored every 515 minutes to avoid hypothermia. Cooling should be terminated when body temperature has reached 39.5C (103F). […] Most canine heatstroke victims suffer from distributive shock, as described above. […] Therefore, judicious fluid therapy is warranted. An initial crystalloid dose of 1020 ml/kg should be administered and perfusion parameters (HR, MM, CRT, pulse quality, blood pressure, mentation, and urine output) continuously reassessed to help guide fluid additional fluid therapy. […] All dogs with heatstroke should be given oxygen therapy during triage. […] Mannitol therapy may be beneficial in animals with cerebral edema causing intracranial hypertension, although it can also worsen cerebral hemorrhage, if present. […] Antimicrobial treatment is not warranted in mild to moderate cases. In severe cases, broad spectrum antibiotics are indicated to treat sepsis due to presumed gastrointestinal bacterial translocation. […] Serial monitoring of the patients clinical and clinicopathological parameters is essential for early identification of complications and appropriate intervention. […] In conclusion, heatstroke in dogs is a life-threatening condition, resulting in serious secondary complications such as DIC, AKI, and ARDS, and a high mortality rate despite appropriate treatment. Early admission and treatment along with whole body cooling by the owners and caregivers are important for survival.

• #2 Heat Stroke: Symptoms, Causes and Treatment | Red Cross

  https://www.redcross.org/take-a-class/resources/learn-first-aid/heat-stroke?srsltid=AfmBOopS7b7l8B8xmfbjhweTE4joIZ5TsJn_43lh7E40Ujc22Jy89pEv

  General Care: Heat Stroke […] After calling 9-1-1, apply one of the following rapid cooling methods based on your resources: Immediately immerse them up to their neck in cold water if safe to do. Apply cold, wet cloths or towels to skin; then apply ice packs and fan them. Have the person take a cold shower. […] Continue methods for 20 minutes, until the person feels better or EMS arrives. […] Continue checking them as appropriate to determine if additional care is needed. […] Give care for shock, if necessary. […] Reassure person you will help and EMS has been called (if appropriate). […] Watch for changes in condition, including breathing and responsiveness, and give care as appropriate and trained.

• #2 Exertional heat stroke treatment with cold water immersion

  https://www.ems1.com/heat-related-illness/articles/feel-the-heat-managing-exertional-heat-stroke-4sOBidEFVXyajamp/

  NAEMSP and NATA recommend a cool first, transport second approach to exertional heat stroke treatment with cold water immersion therapy. […] Recognizing the need for early and aggressive treatment of EHS, the National Association of EMS Physicians published an important consensus statement in 2018 that outlines the identification and management of EHS in the pre-hospital setting which will be reviewed here. […] Rapid cooling is the key management step of EHS. Rapid cooling should begin when the patient is symptomatic. Based on expert consensus, if the rectal temperature is greater than 40.5C (104.9F), cold water immersion cooling should occur when available, as it most expeditiously accomplishes rapid cooling. […] Given the importance of rapid cooling in the setting of EHS, EMS protocols should consider prioritizing cold water immersion over transport if the equipment is available onsite. NAEMSP and NATA both recommend a cool first, transport second approach.

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

  https://bestpractice.bmj.com/topics/en-gb/3000174

  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). […] 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. […] Patients are at risk of multi-system organ failure, so careful monitoring is essential even after return to normothermia. […] This topic covers the management of both heat stroke and heat exhaustion in adults.

• #2

• #2 Heat Stroke Treatment & Management: Medical Care

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

  Some studies have shown that promptly reducing the exposure time to excessive heat can dramatically improve long-term outcomes and decrease irreversible injury. If treatment is initiated within this so-called golden hour and is aggressive enough to rapidly reduce the core body temperature, complications (including multisystem organ failure) may be averted and the patient may have a much better prognosis. […] Removal of restrictive clothing and spraying water on the body, covering the patient with ice watersoaked sheets, or placing ice packs in the axillae and groin may reduce the patient’s temperature significantly. Patients who are unable to protect their airway should be intubated. Patients who are awake and responsive should receive supplemental oxygen. […] The goal of treatment is to reduce the temperature by at least 0.2C/min to approximately 39C. A flexible indwelling thermistor rectally or an esophageal probe can be placed to monitor core body temperature during treatment; alternatively, a more modern method is to use a temperature-sensing Foley catheter. Because thermal instability may persist for a few days after the onset of heat stroke, the temperature must be monitored continuously until it is stable.

• #2 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  – Stay cool: Seek shade or air-conditioned environments during the hottest parts of the day, especially during peak sun exposure between 10 a.m. and 4 p.m. Use fans or air conditioning to cool indoor spaces, and take cool showers or baths to lower your body temperature. […] – Take breaks: If you’re engaging in outdoor activities or strenuous exercise, take frequent breaks in the shade or cool areas to rest, hydrate, and cool down. Avoid overexertion, especially during the hottest parts of the day. […] – Know the warning signs: Be aware of the signs and symptoms of heat-related illnesses, including heat exhaustion and heat stroke. Seek medical attention immediately if you or someone else exhibits symptoms such as dizziness, nausea, rapid heartbeat, confusion, or hot, dry skin. […] – Acclimate to the heat: Gradually increase your exposure to hot weather and physical activity to allow your body to acclimate to the heat over time. This can help improve your tolerance to hot conditions and reduce the risk of heat-related illnesses.

• #2 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

  Rapid cooling is the most important treatment measure. The case fatality rate is closely related to hyperthermia and its duration. If cooling is delayed, the fatality rate increases significantly. As soon as a patient is removed from the hot environment, immediately begin cooling and continue to monitor core temperature. Cooling targets are to quickly cool the core temperature to 39 C or below within 10-40 min and to 38.5 C or below within 2 h. […] Quickly move the patient from a hot and humid environment to a shady and breezy place, make the patient lie down, and remove all clothing; use a cold water spray or wet towels to wipe the entire body; use fanning to accelerate evaporation and convection cooling; continue to monitor body temperature. […] A patient who has one of the following conditions may be considered for continuous bedside continuous renal replacement therapy (CRRT). Patients with two or more of the following conditions should undergo hemofiltration treatment immediately: typical physical cooling methods are ineffective and body temperature continues to be higher than 40 C for more than 2 h; serum potassium 6.5 mmol/L; CK 5,000 U/L or the rate of increase exceeds 1 fold/12 h; oliguria, anuria, or difficulty in controlling volume overload; Cr daily incremental increase value 44.2 mol/L; difficulty in correcting the electrolyte and acid-base imbalance; instability in hemodynamics; severe infection, sepsis; a combination of multiple organ damage or the appearance of multiple organ dysfunction syndrome (MODS).

• #3 Heat Stroke Treatment & Management: Medical Care

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

  Some studies have shown that promptly reducing the exposure time to excessive heat can dramatically improve long-term outcomes and decrease irreversible injury. If treatment is initiated within this so-called golden hour and is aggressive enough to rapidly reduce the core body temperature, complications (including multisystem organ failure) may be averted and the patient may have a much better prognosis. […] Removal of restrictive clothing and spraying water on the body, covering the patient with ice watersoaked sheets, or placing ice packs in the axillae and groin may reduce the patient’s temperature significantly. Patients who are unable to protect their airway should be intubated. Patients who are awake and responsive should receive supplemental oxygen. […] The goal of treatment is to reduce the temperature by at least 0.2C/min to approximately 39C. A flexible indwelling thermistor rectally or an esophageal probe can be placed to monitor core body temperature during treatment; alternatively, a more modern method is to use a temperature-sensing Foley catheter. Because thermal instability may persist for a few days after the onset of heat stroke, the temperature must be monitored continuously until it is stable.

• #3 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Clinicians should prioritize cooling methods that achieve the most rapid rate of cooling. This includes ice-water immersion (1-5 C) or cold-water immersion (9-12 C). […] Clinicians should choose cooling methods that reach the target temperature within 30 minutes from recognition of heat stroke symptoms. […] Clinicians should prioritize cooling modalities that achieve a cooling rate greater than or equal to 0.155 C/min. […] We recommend against the use of dantrolene in patients with heat stroke. Quality of evidence: Very low. […] The routine use of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDS), and salicylates for temperature reduction should be avoided. […] Prophylactic antibiotics or prophylactic antiseizure medications should only be used in the context of research.

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

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

  Treatment includes rapid external cooling, IV fluid resuscitation, and support as needed for organ dysfunction. […] The importance of rapid recognition and effective, aggressive cooling cannot be overemphasized. […] Cold water immersion results in the lowest morbidity and mortality rates and is the treatment of choice when available. […] Evaporative cooling is also very effective and works best if the patient has adequate peripheral circulation (requiring adequate cardiac output). […] Cooling measures should be stopped once temperature reaches approximately 39 C to avoid overcooling and causing iatrogenic hypothermia. […] Necessary resuscitation should proceed while cooling is done. […] IV hydration with 0.9% saline solution should be started with 1 to 2 L of cooled 0.9% saline to help decrease core temperature.

• #3 Heat stroke – Wikipedia

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

  Heat stroke occurs because of high external temperatures and/or physical exertion. Treatment is by rapid physical cooling of the body and supportive care. Recommended methods include spraying the person with water and using a fan, putting the person in ice water, or giving cold intravenous fluids. Adding ice packs around a person is beneficial but does not by itself achieve the fastest possible cooling. Treatment of heat stroke involves rapid mechanical cooling along with standard resuscitation measures. The body temperature must be lowered quickly via conduction, convection, or evaporation. During cooling, the body temperature should be lowered to less than 39 degrees Celsius, ideally less than 38-38.5 degrees Celsius. In the field, the person should be moved to a cool area, such as indoors or to a shaded area. Clothing should be removed to promote heat loss through passive cooling. Conductive cooling methods such as ice-water immersion should also be used, if possible. Evaporative and convective cooling by a combination of cool water spray or cold compresses with constant air flow over the body, such as with a fan or air-conditioning unit, is also an effective alternative. In hospital mechanical cooling methods include ice water immersion, infusion of cold intravenous fluids, placing ice packs or wet gauze around the person, and fanning. Aggressive ice-water immersion remains the gold standard for exertional heat stroke and may also be used for classic heat stroke. This method may require the effort of several people and the person should be monitored carefully during the treatment process. A rapid and effective cooling usually reverses concomitant organ dysfunction. Dantrolene, a muscle relaxant used to treat other forms of hyperthermia, is not an effective treatment for heat stroke. Antipyretics such as aspirin and acetaminophen are also not recommended as a means to lower body temperature in the treatment of heat stroke and their use may lead to worsening liver damage. The person’s condition should be reassessed and stabilized by trained medical personnel. And the person’s heart rate and breathing should be monitored. IV fluid resuscitation is usually needed for circulatory failure and organ dysfunction and is also indicated if rhabdomyolysis is present. In severe cases hemodialysis and ventilator support may be needed.

• #3 Heat stroke (hyperthermia) Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/heat-stroke-hyperthermia.html

  The first step in treating heat stroke is to reduce body temperature by cooling the body from the outside. This can be done by removing tight or unnecessary clothing, spraying the person with water, blowing cool air on the person, or wrapping the person loosely in wet sheets. Alternatively, ice packs can be placed at the neck, groin and armpits to accelerate cooling. […] Severe cases may require cardiopulmonary bypass, in which the person’s blood is diverted from the heart and lungs into a collection machine, cooled, and then returned to the body. […] In some cases, anti-seizure or muscle-relaxing medications may be given to control convulsions and shivering. Aspirin and acetaminophen (Tylenol) do not help lower body temperature when a person has heat stroke, and these medications should be avoided if heat stroke is suspected.

• #3 Heat Stroke Medication: Benzodiazepines, Alkalinizing agents, Diuretics (osmotic), Adrenergic agonist agents

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

  In patients with heat stroke, benzodiazepines play a major role in providing sedation, controlling convulsions, and controlling shivering. Barbiturates (eg, phenobarbital) may be used to control convulsions if benzodiazepines are not effective. […] Hypotension is treated first with cooling and intravenous crystalloid fluids; vasopressors may be needed for hypotension refractory to fluid repletion. Treatment of rhabdomyolysis involves infusing large amounts of intravenous fluids (as much as 10 L may be required), alkalinization of urine, and mannitol infusion. […] Benzodiazepines are safe and effective in controlling agitation, convulsions, and shivering. […] Sodium bicarbonate is useful in alkalization of the urine to prevent acute myoglobinuric renal failure. It may be administered as a bolus injection or as an infusion. The ideal solution to which sodium bicarbonate is added should be hypotonic.

• #3 Heat Stroke Treatment & Management: Medical Care

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

  Antipyretics (eg, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heat stroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heat stroke. […] Immediate administration of benzodiazepines is indicated in patients with agitation and shivering, to stop excessive production of heat. […] Recommendations on the administration of intravenous fluids for circulatory support differ among patient populations and depend on the presence of hypovolemia, preexisting medical conditions, and preexisting cardiovascular disease. […] Treatment of rhabdomyolysis involves infusion of large amounts of intravenous fluids (fluid requirements may be as high as 10 L), alkalinization of the urine, and infusion of mannitol.

• #3 Heat Stroke Treatment & Management: Medical Care

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

  Treatment of hepatic failure includes the following: Infusion of dextrose solutions to correct hypoglycemia, early recognition and treatment of DIC, with replacement of clotting factors, fresh frozen plasma, platelets, and blood, meticulous respiratory support. […] Pulmonary edema is a common complication of heat stroke and may be due to a number of factors, including fluid overload from aggressive rehydration, renal failure, congestive heart failure, and ARDS. […] AKI initially is treated with intravenous fluids, diuretics, and correction of associated acid-base and electrolyte abnormalities.

• #3 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

  Coagulation factors (such as fresh frozen plasma, prothrombin complex, fibrinogen, cryoprecipitate, etc.) should be replenished as soon as possible. For fresh frozen plasma, the first dose is 10-15 ml/kg, followed by the addition of 200-400 ml according to the coagulation indices being monitored. Restore PT and APTT to normal levels. […] Infection can be resisted in the early stage by the prophylactic use of antibiotics such as second generation cephalosporin antibiotics. If there is infection, collect relevant specimens for smears and culture in a timely manner, increase the level of antibiotics, and add anti-fungals as necessary.

• #3 Heatstroke: First aid

  https://www.mayoclinic.org/first-aid/first-aid-heatstroke/basics/art-20056655

  For heatstroke, cool the person through whatever means available. For example: […] Put the person in a cool tub of water or a cool shower. […] Spray the person with a garden hose. […] Sponge the person with cool water. […] Fan the person while misting with cool water. […] Place ice packs or cool, wet towels on the neck, armpits and groin. […] Cover the person with cool, damp sheets. […] If the person is conscious, offer chilled water, a sports drink containing electrolytes or another nonalcoholic beverage without caffeine. […] Begin CPR if the person loses consciousness and shows no signs of circulation, such as breathing, coughing or movement.

• #3 Exertional heat stroke treatment with cold water immersion

  https://www.ems1.com/heat-related-illness/articles/feel-the-heat-managing-exertional-heat-stroke-4sOBidEFVXyajamp/

  EHS can be effectively managed in the prehospital environment when recognized in a timely fashion. A high index of suspicion is needed anytime an athlete experiences CNS disturbance after doing physical activity: responders can be falsely reassured when the climate does not appear too warm, CNS disturbance is only mild or if the patients skin is not hot to the touch. […] A multidisciplinary approach should be taken to incorporate on-site medical personnel, such as athletic trainers, in developing protocols to ensure the coordinated management of EHS. Finally, EMS agencies should take steps to ensure the availability of equipment such as rectal thermometers and cold-water immersion supplies at local athletic centers, sporting events and military training venues.

• #3 Heat Stroke: Symptoms, Treatment & Recovery

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

  Healthcare providers in the emergency room focus on cooling your body until it gets to a safe temperature. Common methods for cooling include: Cold water immersion. This is usually used for exertional heat stroke rather than classic heat stroke. A provider dunks your entire body (except your head) in cold water or ice water. Heat leaves your body and enters the surrounding water. Misting and fanning. This is often used for classic heat stroke but can be suitable for either type. A provider sprays as much of your skin as possible with water while large fans circulate the air around you. As the water evaporates from your skin, your body temperature lowers. […] Providers will closely monitor you for signs of complications and give you further treatment as needed. This might include: IV fluids (through a vein). Intubation. Medications to support organ function.

• #3 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  Fluid replacement: In cases of dehydration, electrolyte imbalances, or fluid loss, intravenous (IV) fluids may be administered to restore hydration and electrolyte balance. […] Monitoring and supportive care: The individual may require close monitoring and supportive care in a hospital setting, especially if they have severe symptoms or complications of heat stroke. This may include monitoring of organ function, administration of medications to control symptoms, and supportive measures to maintain vital signs and prevent complications. […] […] […] What is the Prognosis for Heat Stroke? […] The prognosis for heat stroke can vary depending on several factors, including the severity of the condition, promptness of treatment, presence of underlying health conditions, and age of the affected individual. With prompt and appropriate treatment, many people recover fully from heat stroke with minimal long-term complications. However, in severe cases or if treatment is delayed, heat stroke can lead to serious complications and even death.

• #3 Heat Exhaustion and Heat Stroke – Symptoms | familydoctor.org

  https://familydoctor.org/condition/heat-exhaustion-heatstroke/

  Heat exhaustion and heatstroke treatment If you or someone else has heat exhaustion, treat symptoms in the following ways. Get out of the heat quickly and into a cool place, or at least shade. Lie down and elevate your legs to get blood flowing to your heart. Take off any tight or extra clothing. Apply cool towels to your skin or take a cool bath. This will help regulate and lower your internal body temperature. Drink fluids, such as water or a sports drink. Do not guzzle them, but take sips. Do not drink fluids with caffeine or alcohol. Call 911 if: Symptoms don’t improve or they still have a fever of 102°F after 30 minutes of initial treatment. The person goes into shock, faints, or has seizures. The person is not breathing. You also should begin CPR right away to try and revive them. […] Living with heat exhaustion and heat stroke After you’ve had heat exhaustion or heatstroke, you will be sensitive to heat. This can last for about a week. It’s important to rest and let your body recover. Avoid hot weather and exercise. Ask your doctor when it’s safe to return to your normal activities.

• #3 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  – Multiorgan failure: In severe cases, heat stroke can cause failure of multiple organ systems, including the kidneys, liver, lungs, and heart, leading to systemic organ failure and death. […] […] […] How to Prevent Heat Stroke? […] Preventing heat stroke involves taking proactive measures to stay cool and hydrated, especially during hot weather or when engaging in strenuous activities. Here are some tips to help prevent heat stroke: […] – Stay hydrated: Drink plenty of fluids, especially water, throughout the day, even if you’re not feeling thirsty. Avoid beverages that contain alcohol, caffeine, or excessive sugar, as these can contribute to dehydration. […] – Dress appropriately: Wear lightweight, loose-fitting clothing in light colors to reflect sunlight and heat. Protect your head and face with a wide-brimmed hat and use sunscreen to prevent sunburn, which can impair the body’s ability to regulate temperature.

• #3 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

  Rapid cooling is the most important treatment measure. The case fatality rate is closely related to hyperthermia and its duration. If cooling is delayed, the fatality rate increases significantly. As soon as a patient is removed from the hot environment, immediately begin cooling and continue to monitor core temperature. Cooling targets are to quickly cool the core temperature to 39 C or below within 10-40 min and to 38.5 C or below within 2 h. […] Quickly move the patient from a hot and humid environment to a shady and breezy place, make the patient lie down, and remove all clothing; use a cold water spray or wet towels to wipe the entire body; use fanning to accelerate evaporation and convection cooling; continue to monitor body temperature. […] A patient who has one of the following conditions may be considered for continuous bedside continuous renal replacement therapy (CRRT). Patients with two or more of the following conditions should undergo hemofiltration treatment immediately: typical physical cooling methods are ineffective and body temperature continues to be higher than 40 C for more than 2 h; serum potassium 6.5 mmol/L; CK 5,000 U/L or the rate of increase exceeds 1 fold/12 h; oliguria, anuria, or difficulty in controlling volume overload; Cr daily incremental increase value 44.2 mol/L; difficulty in correcting the electrolyte and acid-base imbalance; instability in hemodynamics; severe infection, sepsis; a combination of multiple organ damage or the appearance of multiple organ dysfunction syndrome (MODS).

• #4 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Clinicians should prioritize cooling methods that achieve the most rapid rate of cooling. This includes ice-water immersion (1-5 C) or cold-water immersion (9-12 C). […] Clinicians should choose cooling methods that reach the target temperature within 30 minutes from recognition of heat stroke symptoms. […] Clinicians should prioritize cooling modalities that achieve a cooling rate greater than or equal to 0.155 C/min. […] We recommend against the use of dantrolene in patients with heat stroke. Quality of evidence: Very low. […] The routine use of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDS), and salicylates for temperature reduction should be avoided. […] Prophylactic antibiotics or prophylactic antiseizure medications should only be used in the context of research.

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

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

  Treatment includes rapid external cooling, IV fluid resuscitation, and support as needed for organ dysfunction. […] The importance of rapid recognition and effective, aggressive cooling cannot be overemphasized. […] Cold water immersion results in the lowest morbidity and mortality rates and is the treatment of choice when available. […] Evaporative cooling is also very effective and works best if the patient has adequate peripheral circulation (requiring adequate cardiac output). […] Cooling measures should be stopped once temperature reaches approximately 39 C to avoid overcooling and causing iatrogenic hypothermia. […] Necessary resuscitation should proceed while cooling is done. […] IV hydration with 0.9% saline solution should be started with 1 to 2 L of cooled 0.9% saline to help decrease core temperature.

• #4 Heat Stroke: Symptoms, Treatment & Recovery

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

  Healthcare providers in the emergency room focus on cooling your body until it gets to a safe temperature. Common methods for cooling include: Cold water immersion. This is usually used for exertional heat stroke rather than classic heat stroke. A provider dunks your entire body (except your head) in cold water or ice water. Heat leaves your body and enters the surrounding water. Misting and fanning. This is often used for classic heat stroke but can be suitable for either type. A provider sprays as much of your skin as possible with water while large fans circulate the air around you. As the water evaporates from your skin, your body temperature lowers. […] Providers will closely monitor you for signs of complications and give you further treatment as needed. This might include: IV fluids (through a vein). Intubation. Medications to support organ function.

• #4 Heat Stroke Medication: Benzodiazepines, Alkalinizing agents, Diuretics (osmotic), Adrenergic agonist agents

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

  Mannitol is the drug of choice for forced diuresis in patients with rhabdomyolysis because of a number of beneficial effects on the kidneys, including an antioxidant effect. […] Dobutamine is a synthetic compound structurally similar to catecholamines. It is the drug of choice for circulatory support in heat stroke.

• #4 Heat stroke in children – UpToDate

  https://www.uptodate.com/contents/heat-stroke-in-children

  Children with heat stroke require aggressive treatment because the extent of end-organ damage and mortality is related to the duration of hyperthermia. […] For hospital treatment of children with heat stroke, we suggest evaporative cooling rather than rapid cooling with cold-water immersion. […] We suggest that patients with heat stroke receive IV benzodiazepines (eg, midazolam or lorazepam) to prevent or to treat shivering during cooling measures, especially if a cooling blanket or ice packs are being used. […] After stabilization and rapid cooling, the child with heat stroke remains at high risk for multiple organ failure, metabolic abnormalities, and disorders of coagulation. […] Antipyretic medications (eg, acetaminophen, ibuprofen) are ineffective for the treatment of hyperthermia in heat stroke victims and should not be used because they may exacerbate liver injury (acetaminophen) or cause kidney injury or gastrointestinal bleeding (ibuprofen).

• #4 Heat Stroke Medication: Benzodiazepines, Alkalinizing agents, Diuretics (osmotic), Adrenergic agonist agents

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

  In patients with heat stroke, benzodiazepines play a major role in providing sedation, controlling convulsions, and controlling shivering. Barbiturates (eg, phenobarbital) may be used to control convulsions if benzodiazepines are not effective. […] Hypotension is treated first with cooling and intravenous crystalloid fluids; vasopressors may be needed for hypotension refractory to fluid repletion. Treatment of rhabdomyolysis involves infusing large amounts of intravenous fluids (as much as 10 L may be required), alkalinization of urine, and mannitol infusion. […] Benzodiazepines are safe and effective in controlling agitation, convulsions, and shivering. […] Sodium bicarbonate is useful in alkalization of the urine to prevent acute myoglobinuric renal failure. It may be administered as a bolus injection or as an infusion. The ideal solution to which sodium bicarbonate is added should be hypotonic.

• #4 Heat Stroke Treatment & Management: Medical Care

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

  Treatment of hepatic failure includes the following: Infusion of dextrose solutions to correct hypoglycemia, early recognition and treatment of DIC, with replacement of clotting factors, fresh frozen plasma, platelets, and blood, meticulous respiratory support. […] Pulmonary edema is a common complication of heat stroke and may be due to a number of factors, including fluid overload from aggressive rehydration, renal failure, congestive heart failure, and ARDS. […] AKI initially is treated with intravenous fluids, diuretics, and correction of associated acid-base and electrolyte abnormalities.

• #4

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=tw3250spec

  Heatstroke is a medical emergency. Even with immediate treatment, it can be life-threatening or result in serious, long-term complications. After calling 911 or other emergency medical services, follow these first aid steps. […] Cool the body. Move the person into a cool place, out of direct sunlight. Remove the person’s unnecessary clothing, and place the person on their side to expose as much skin surface to the air as possible. Cool the person’s entire body in a cold water or ice bath or by sponging or spraying cold water, and fan the person to help lower the person’s body temperature. Apply ice packs over as much of the body as you can. […] Check the person’s rectal temperature. Try to reduce it to 39C (102F) or lower as soon as possible. The longer the body is at a high temperature, the more serious the illness and the more likely it is that complications will develop.

• #4 Heat Stroke: Causes, Symptoms, Treatment, and Prevention

  https://expresserharkerheights.com/blog/heat-stroke-causes-symptoms-treatment-and-prevention/

  The first step in treating a person who you think has suffered a heatstroke is calling a 24-hour emergency room near you. They will give you first aid tips for heat stroke that you can follow before you get to the ER near you. […] First aid steps to follow before getting to an ER for heatstroke include the following: Take the person away from the heat to a shade or indoors, Take off excess clothing, Cool the person by; spraying him or her with a garden hose, dipping him in a cold-water tub, sponging using cool water, or placing cold compressors on the patients groin and neck armpits or head, If possible, give the person cool drinks without alcohol or coffee, Monitor the persons body temperature by using a rectum thermometer and work to reduce it. […] At the 24-hour emergency room for heat stroke, the doctor performs a diagnosis of the patient to check the extent of the damage done by the heatstroke and other possible causes of the high temperature. The doctor carries out a spinal tap, blood tests, and a CT scan. Blood and urine tests are done to monitor the functionality of the patients kidneys. The doctor will then prescribe suitable medication to the victim. Depending on the severity of the heat stroke, the patient may remain in the hospital for more than a day for effective treatment.

• #4

• #4 Heat Exhaustion Signs and Treatment

  https://www.webmd.com/fitness-exercise/heat-exhaustion

  Heat exhaustion usually goes away with rest and fluids. You should feel better within an hour. […] Still, you’ll probably be more sensitive to high temperatures during the following week. So, it’s best to avoid hot weather and heavy exercise until your doctor tells you that it’s safe to resume your normal activities.

• #4 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  – Multiorgan failure: In severe cases, heat stroke can cause failure of multiple organ systems, including the kidneys, liver, lungs, and heart, leading to systemic organ failure and death. […] […] […] How to Prevent Heat Stroke? […] Preventing heat stroke involves taking proactive measures to stay cool and hydrated, especially during hot weather or when engaging in strenuous activities. Here are some tips to help prevent heat stroke: […] – Stay hydrated: Drink plenty of fluids, especially water, throughout the day, even if you’re not feeling thirsty. Avoid beverages that contain alcohol, caffeine, or excessive sugar, as these can contribute to dehydration. […] – Dress appropriately: Wear lightweight, loose-fitting clothing in light colors to reflect sunlight and heat. Protect your head and face with a wide-brimmed hat and use sunscreen to prevent sunburn, which can impair the body’s ability to regulate temperature.

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

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

  Treatment includes rapid external cooling, IV fluid resuscitation, and support as needed for organ dysfunction. […] The importance of rapid recognition and effective, aggressive cooling cannot be overemphasized. […] Cold water immersion results in the lowest morbidity and mortality rates and is the treatment of choice when available. […] Evaporative cooling is also very effective and works best if the patient has adequate peripheral circulation (requiring adequate cardiac output). […] Cooling measures should be stopped once temperature reaches approximately 39 C to avoid overcooling and causing iatrogenic hypothermia. […] Necessary resuscitation should proceed while cooling is done. […] IV hydration with 0.9% saline solution should be started with 1 to 2 L of cooled 0.9% saline to help decrease core temperature.

• #5 Heatstroke Versus Heat Exhaustion: What’s the Difference?

  https://www.everydayhealth.com/stroke/heat-stroke-versus-heat-exhaustion-whats-the-difference/

  People can usually treat heat exhaustion with cold water, cool air, and rest. Heatstroke is an emergency medical condition that requires immediate care. […] Heatstroke, on the other hand, is a life-threatening condition that requires emergency treatment. Without medical intervention, the condition can quickly cause brain, heart, kidney, and muscle damage or failure, and it can be fatal. […] When caring for someone you suspect has heatstroke, the first thing you should do is call an ambulance. While you wait for medical professionals to arrive, try to lower the person’s body temperature in the following ways: Move the person to a shaded or air-conditioned area to cool down. If possible, place them in a cool bath or shower or cool them with water from a garden hose. […] According to a meta-analysis of 63 studies on heatstroke treatment methods, submerging a person in cold water about 34 to 63 degrees F is the most effective method to lower core body temperature. […] Importantly, Mayo Clinic advises against giving a person with heatstroke anything to drink. Many people with heatstroke have an altered mental state, which could make it unsafe for them to drink fluids.

• #5 Heat Stroke Treatment & Management: Medical Care

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

  Antipyretics (eg, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heat stroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heat stroke. […] Immediate administration of benzodiazepines is indicated in patients with agitation and shivering, to stop excessive production of heat. […] Recommendations on the administration of intravenous fluids for circulatory support differ among patient populations and depend on the presence of hypovolemia, preexisting medical conditions, and preexisting cardiovascular disease. […] Treatment of rhabdomyolysis involves infusion of large amounts of intravenous fluids (fluid requirements may be as high as 10 L), alkalinization of the urine, and infusion of mannitol.

• #5 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Clinicians should prioritize cooling methods that achieve the most rapid rate of cooling. This includes ice-water immersion (1-5 C) or cold-water immersion (9-12 C). […] Clinicians should choose cooling methods that reach the target temperature within 30 minutes from recognition of heat stroke symptoms. […] Clinicians should prioritize cooling modalities that achieve a cooling rate greater than or equal to 0.155 C/min. […] We recommend against the use of dantrolene in patients with heat stroke. Quality of evidence: Very low. […] The routine use of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDS), and salicylates for temperature reduction should be avoided. […] Prophylactic antibiotics or prophylactic antiseizure medications should only be used in the context of research.

• #5 Heat Stroke Medication: Benzodiazepines, Alkalinizing agents, Diuretics (osmotic), Adrenergic agonist agents

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

  Mannitol is the drug of choice for forced diuresis in patients with rhabdomyolysis because of a number of beneficial effects on the kidneys, including an antioxidant effect. […] Dobutamine is a synthetic compound structurally similar to catecholamines. It is the drug of choice for circulatory support in heat stroke.

• #5 Heat stroke – Wikipedia

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

  Heat stroke occurs because of high external temperatures and/or physical exertion. Treatment is by rapid physical cooling of the body and supportive care. Recommended methods include spraying the person with water and using a fan, putting the person in ice water, or giving cold intravenous fluids. Adding ice packs around a person is beneficial but does not by itself achieve the fastest possible cooling. Treatment of heat stroke involves rapid mechanical cooling along with standard resuscitation measures. The body temperature must be lowered quickly via conduction, convection, or evaporation. During cooling, the body temperature should be lowered to less than 39 degrees Celsius, ideally less than 38-38.5 degrees Celsius. In the field, the person should be moved to a cool area, such as indoors or to a shaded area. Clothing should be removed to promote heat loss through passive cooling. Conductive cooling methods such as ice-water immersion should also be used, if possible. Evaporative and convective cooling by a combination of cool water spray or cold compresses with constant air flow over the body, such as with a fan or air-conditioning unit, is also an effective alternative. In hospital mechanical cooling methods include ice water immersion, infusion of cold intravenous fluids, placing ice packs or wet gauze around the person, and fanning. Aggressive ice-water immersion remains the gold standard for exertional heat stroke and may also be used for classic heat stroke. This method may require the effort of several people and the person should be monitored carefully during the treatment process. A rapid and effective cooling usually reverses concomitant organ dysfunction. Dantrolene, a muscle relaxant used to treat other forms of hyperthermia, is not an effective treatment for heat stroke. Antipyretics such as aspirin and acetaminophen are also not recommended as a means to lower body temperature in the treatment of heat stroke and their use may lead to worsening liver damage. The person’s condition should be reassessed and stabilized by trained medical personnel. And the person’s heart rate and breathing should be monitored. IV fluid resuscitation is usually needed for circulatory failure and organ dysfunction and is also indicated if rhabdomyolysis is present. In severe cases hemodialysis and ventilator support may be needed.

• #5 Heat Stroke: Symptoms, Causes and Treatment | Red Cross

  https://www.redcross.org/take-a-class/resources/learn-first-aid/heat-stroke?srsltid=AfmBOopS7b7l8B8xmfbjhweTE4joIZ5TsJn_43lh7E40Ujc22Jy89pEv

  General Care: Heat Stroke […] After calling 9-1-1, apply one of the following rapid cooling methods based on your resources: Immediately immerse them up to their neck in cold water if safe to do. Apply cold, wet cloths or towels to skin; then apply ice packs and fan them. Have the person take a cold shower. […] Continue methods for 20 minutes, until the person feels better or EMS arrives. […] Continue checking them as appropriate to determine if additional care is needed. […] Give care for shock, if necessary. […] Reassure person you will help and EMS has been called (if appropriate). […] Watch for changes in condition, including breathing and responsiveness, and give care as appropriate and trained.

• #5 Heat Stroke: Causes, Symptoms, Treatment, and Prevention

  https://expresserharkerheights.com/blog/heat-stroke-causes-symptoms-treatment-and-prevention/

  The first step in treating a person who you think has suffered a heatstroke is calling a 24-hour emergency room near you. They will give you first aid tips for heat stroke that you can follow before you get to the ER near you. […] First aid steps to follow before getting to an ER for heatstroke include the following: Take the person away from the heat to a shade or indoors, Take off excess clothing, Cool the person by; spraying him or her with a garden hose, dipping him in a cold-water tub, sponging using cool water, or placing cold compressors on the patients groin and neck armpits or head, If possible, give the person cool drinks without alcohol or coffee, Monitor the persons body temperature by using a rectum thermometer and work to reduce it. […] At the 24-hour emergency room for heat stroke, the doctor performs a diagnosis of the patient to check the extent of the damage done by the heatstroke and other possible causes of the high temperature. The doctor carries out a spinal tap, blood tests, and a CT scan. Blood and urine tests are done to monitor the functionality of the patients kidneys. The doctor will then prescribe suitable medication to the victim. Depending on the severity of the heat stroke, the patient may remain in the hospital for more than a day for effective treatment.

• #5

• #5 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  – Stay cool: Seek shade or air-conditioned environments during the hottest parts of the day, especially during peak sun exposure between 10 a.m. and 4 p.m. Use fans or air conditioning to cool indoor spaces, and take cool showers or baths to lower your body temperature. […] – Take breaks: If you’re engaging in outdoor activities or strenuous exercise, take frequent breaks in the shade or cool areas to rest, hydrate, and cool down. Avoid overexertion, especially during the hottest parts of the day. […] – Know the warning signs: Be aware of the signs and symptoms of heat-related illnesses, including heat exhaustion and heat stroke. Seek medical attention immediately if you or someone else exhibits symptoms such as dizziness, nausea, rapid heartbeat, confusion, or hot, dry skin. […] – Acclimate to the heat: Gradually increase your exposure to hot weather and physical activity to allow your body to acclimate to the heat over time. This can help improve your tolerance to hot conditions and reduce the risk of heat-related illnesses.

• #5 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. […] Treatment involves monitoring the patient in a cool, shady environment and ensuring adequate hydration. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Physicians also must monitor electrolyte abnormalities, be alert to signs of renal or hepatic failure, and replace fluids in patients with heatstroke. […] 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 initial treatment of patients with heat exhaustion involves stabilization in a cool area. […] Evaporative cooling may be initiated by wetting the skin.

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

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

  Due to the high risk of bacterial translocation secondary to GI damage, consider broad-spectrum antibiotics, while keeping the possibility of antibiotic resistance in mind. […] Mannitol—an osmotic diuretic that expands intravascular volume, decreases blood viscosity and intracranial pressure, and improves cerebral microcirculation—can be administered if the patient has neurologic signs. […] Ventricular arrhythmias are common in patients presenting with heatstroke because cardiac cells are susceptible to thermal injury and ischemia. Damage to the myocardium causes defects in conduction leading to ventricular arrhythmias, which can be treated with lidocaine.

• #6 Heatstroke: First aid

  https://www.mayoclinic.org/first-aid/first-aid-heatstroke/basics/art-20056655

  For heatstroke, cool the person through whatever means available. For example: […] Put the person in a cool tub of water or a cool shower. […] Spray the person with a garden hose. […] Sponge the person with cool water. […] Fan the person while misting with cool water. […] Place ice packs or cool, wet towels on the neck, armpits and groin. […] Cover the person with cool, damp sheets. […] If the person is conscious, offer chilled water, a sports drink containing electrolytes or another nonalcoholic beverage without caffeine. […] Begin CPR if the person loses consciousness and shows no signs of circulation, such as breathing, coughing or movement.

• #6 Heat Stroke Treatment & Management: Medical Care

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

  Heat stroke is a medical emergency and continues to be one of the leading causes of preventable death in sports. Rapid reduction of the core body temperature is the cornerstone of treatment because the duration of hyperthermia is the primary determinant of outcome. Patients diagnosed with exertional heat stroke (EHS) or nonexertional heat stroke (NEHS) should be admitted to the hospital for at least 48 hours to monitor for complications. […] Once heat stroke is suspected, cooling must begin immediately and must be continued during the patient’s resuscitation. The American College of Sports Medicine recommends that cooling be initiated at the scene, before transporting the patient to an emergency department for further evaluation and treatment. […] Controversy still exists over what therapeutic modality is most effective in the treatment of heat stroke. However, the basic premise of rapidly lowering the core temperature to about 39C (to avoid overshooting and rebound hyperthermia) remains the primary goal. Rehydration therapy alone is insufficient for heat stroke patients and should be combined with active cooling.

• #6 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  – Stay cool: Seek shade or air-conditioned environments during the hottest parts of the day, especially during peak sun exposure between 10 a.m. and 4 p.m. Use fans or air conditioning to cool indoor spaces, and take cool showers or baths to lower your body temperature. […] – Take breaks: If you’re engaging in outdoor activities or strenuous exercise, take frequent breaks in the shade or cool areas to rest, hydrate, and cool down. Avoid overexertion, especially during the hottest parts of the day. […] – Know the warning signs: Be aware of the signs and symptoms of heat-related illnesses, including heat exhaustion and heat stroke. Seek medical attention immediately if you or someone else exhibits symptoms such as dizziness, nausea, rapid heartbeat, confusion, or hot, dry skin. […] – Acclimate to the heat: Gradually increase your exposure to hot weather and physical activity to allow your body to acclimate to the heat over time. This can help improve your tolerance to hot conditions and reduce the risk of heat-related illnesses.

• #6 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

  Coagulation factors (such as fresh frozen plasma, prothrombin complex, fibrinogen, cryoprecipitate, etc.) should be replenished as soon as possible. For fresh frozen plasma, the first dose is 10-15 ml/kg, followed by the addition of 200-400 ml according to the coagulation indices being monitored. Restore PT and APTT to normal levels. […] Infection can be resisted in the early stage by the prophylactic use of antibiotics such as second generation cephalosporin antibiotics. If there is infection, collect relevant specimens for smears and culture in a timely manner, increase the level of antibiotics, and add anti-fungals as necessary.

• #7 Heat-related illness signs, symptoms and treatment | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/healthy+living/protecting+your+health/environmental+health/healthy+in+the+heat/heat-related+illness+signs+symptoms+and+treatment

  If the person is conscious: move them to a cool area and keep them still, give them small sips of fluid, bring their temperature down using any method available, loosen their clothes, sprinkle them with cool water, or wrap them in a damp sheet, place cool, damp cloths in their armpits, on the back of their neck and on their forehead to cool them down as quickly as possible, use a fan to help cool them down if one is available, do not give them aspirin or paracetamol. […] If the person is unconscious: move the person to somewhere cool and keep them still if possible, lay them on their side (recovery position) and check they can breathe properly, perform CPR if needed, do not give aspirin or paracetamol to a person affected by heat, stay with them until the ambulance arrives.

• #7 Heat stroke in children – UpToDate

  https://www.uptodate.com/contents/heat-stroke-in-children

  All children with heat stroke should be admitted to a pediatric critical care unit setting in order to maintain appropriate monitoring and to treat ongoing and delayed end-organ dysfunction. […] The prognosis in children with heat stroke is poorly characterized. Extrapolation from studies in adults suggests that morbidity or mortality are directly related to duration and degree of hyperthermia.

• #7 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  – Stay cool: Seek shade or air-conditioned environments during the hottest parts of the day, especially during peak sun exposure between 10 a.m. and 4 p.m. Use fans or air conditioning to cool indoor spaces, and take cool showers or baths to lower your body temperature. […] – Take breaks: If you’re engaging in outdoor activities or strenuous exercise, take frequent breaks in the shade or cool areas to rest, hydrate, and cool down. Avoid overexertion, especially during the hottest parts of the day. […] – Know the warning signs: Be aware of the signs and symptoms of heat-related illnesses, including heat exhaustion and heat stroke. Seek medical attention immediately if you or someone else exhibits symptoms such as dizziness, nausea, rapid heartbeat, confusion, or hot, dry skin. […] – Acclimate to the heat: Gradually increase your exposure to hot weather and physical activity to allow your body to acclimate to the heat over time. This can help improve your tolerance to hot conditions and reduce the risk of heat-related illnesses.

• #7 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. […] Treatment involves monitoring the patient in a cool, shady environment and ensuring adequate hydration. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Physicians also must monitor electrolyte abnormalities, be alert to signs of renal or hepatic failure, and replace fluids in patients with heatstroke. […] 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 initial treatment of patients with heat exhaustion involves stabilization in a cool area. […] Evaporative cooling may be initiated by wetting the skin.

• #8 Heatstroke: First aid

  https://www.mayoclinic.org/first-aid/first-aid-heatstroke/basics/art-20056655

  For heatstroke, cool the person through whatever means available. For example: […] Put the person in a cool tub of water or a cool shower. […] Spray the person with a garden hose. […] Sponge the person with cool water. […] Fan the person while misting with cool water. […] Place ice packs or cool, wet towels on the neck, armpits and groin. […] Cover the person with cool, damp sheets. […] If the person is conscious, offer chilled water, a sports drink containing electrolytes or another nonalcoholic beverage without caffeine. […] Begin CPR if the person loses consciousness and shows no signs of circulation, such as breathing, coughing or movement.

• #8 Heatstroke: Symptoms, Causes, Types, Prevention, and Complications | Max Hospital

  https://www.maxhealthcare.in/blogs/heat-stroke-symptoms-causes-and-types

  – Stay cool: Seek shade or air-conditioned environments during the hottest parts of the day, especially during peak sun exposure between 10 a.m. and 4 p.m. Use fans or air conditioning to cool indoor spaces, and take cool showers or baths to lower your body temperature. […] – Take breaks: If you’re engaging in outdoor activities or strenuous exercise, take frequent breaks in the shade or cool areas to rest, hydrate, and cool down. Avoid overexertion, especially during the hottest parts of the day. […] – Know the warning signs: Be aware of the signs and symptoms of heat-related illnesses, including heat exhaustion and heat stroke. Seek medical attention immediately if you or someone else exhibits symptoms such as dizziness, nausea, rapid heartbeat, confusion, or hot, dry skin. […] – Acclimate to the heat: Gradually increase your exposure to hot weather and physical activity to allow your body to acclimate to the heat over time. This can help improve your tolerance to hot conditions and reduce the risk of heat-related illnesses.

• #8 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

  Coagulation factors (such as fresh frozen plasma, prothrombin complex, fibrinogen, cryoprecipitate, etc.) should be replenished as soon as possible. For fresh frozen plasma, the first dose is 10-15 ml/kg, followed by the addition of 200-400 ml according to the coagulation indices being monitored. Restore PT and APTT to normal levels. […] Infection can be resisted in the early stage by the prophylactic use of antibiotics such as second generation cephalosporin antibiotics. If there is infection, collect relevant specimens for smears and culture in a timely manner, increase the level of antibiotics, and add anti-fungals as necessary.

• #9 Heatstroke: First aid

  https://www.mayoclinic.org/first-aid/first-aid-heatstroke/basics/art-20056655

  For heatstroke, cool the person through whatever means available. For example: […] Put the person in a cool tub of water or a cool shower. […] Spray the person with a garden hose. […] Sponge the person with cool water. […] Fan the person while misting with cool water. […] Place ice packs or cool, wet towels on the neck, armpits and groin. […] Cover the person with cool, damp sheets. […] If the person is conscious, offer chilled water, a sports drink containing electrolytes or another nonalcoholic beverage without caffeine. […] Begin CPR if the person loses consciousness and shows no signs of circulation, such as breathing, coughing or movement.

• #9 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. If suppression of body temperature is delayed, the fatality rate will be elevated. […] 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. […] Specific treatment measures are nine early and one ban, that is, early cooling, early expansion, early blood purification, early sedation, early intubation, early correction of coagulation dysfunction, early resistance to infection, early enteral nutrition, early immunoregulation, and a ban on surgical operations during the period of coagulation dysfunction.

• #10 Heatstroke: First aid

  https://www.mayoclinic.org/first-aid/first-aid-heatstroke/basics/art-20056655

  For heatstroke, cool the person through whatever means available. For example: […] Put the person in a cool tub of water or a cool shower. […] Spray the person with a garden hose. […] Sponge the person with cool water. […] Fan the person while misting with cool water. […] Place ice packs or cool, wet towels on the neck, armpits and groin. […] Cover the person with cool, damp sheets. […] If the person is conscious, offer chilled water, a sports drink containing electrolytes or another nonalcoholic beverage without caffeine. […] Begin CPR if the person loses consciousness and shows no signs of circulation, such as breathing, coughing or movement.

• #10 Heatstroke: Causes, consequences and clinical guidelines – The National Medical Journal of India

  https://nmji.in/heatstroke-causes-consequences-and-clinical-guidelines/

  Heatstroke is a life-threatening emergency that should be managed aggressively. […] The most important step is rapid therapeutic cooling at 1 C every 10 minutes till a core temperature of 38 C (100.4 F) is reached. […] Different approaches to therapeutic cooling may be adopted in combination. […] The goal is to bring down the temperature to 38-39 C within the first hour and cooling measures should not be stopped till this is achieved. […] There is no role of antipyretic agents such as paracetamol or aspirin or other drugs such as dantrolene in bringing down the body temperature in heatstroke. […] The presence and seriousness of persistent complications is indicative of the severity of the heatstroke and a negative outcome in terms of mortality or irreversible brain damage. […] If consciousness is regained within a few hours of hospitalization, prognosis is good. […] The key to prevent deaths due to heatstroke is dissemination of advance information to the public on preparedness and prevention and, if it still occurs, arrange for early diagnosis, rapid cooling and management of complications.

• #11

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=tw3250spec

  Watch for signs of rapidly progressing heatstroke. These include seizure, unconsciousness for longer than a few seconds, and moderate to severe difficulty breathing. […] Start CPR if needed. If the person is unconscious or does not respond to your voice or touch, be ready to start CPR. […] Give the person fluids for hydration. If the person is awake and alert enough to swallow, give them plenty of cool water to drink. You may have to help. Make sure the person is sitting up enough so that they don’t choke. Most people with heatstroke have an altered level of consciousness and cannot safely be given fluids to drink. […] Do not give aspirin or acetaminophen to reduce a high body temperature that can occur with heatstroke. These medicines may cause problems because of the body’s response to heatstroke.

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