Correct!
1. Cool the patient as quickly as possible
The patient was found unresponsive on a trail in Arizona which can be quite hot. He has a core body temperature of 105.8º F which meets the definition of heatstroke. The initial treatment of heatstroke is to cool the patient as quickly as possible (1). Rapid reduction of the core body temperature is the cornerstone of treatment because the duration of hyperthermia is the primary determinant of outcome.
The optimal method of rapidly cooling patients has been a matter of debate for some time. Ice-water immersion or an equivalent method has the advantage of rapidly reducing core body temperature which can reduce core body temperature to less than 39°C in approximately 20-40 minutes. Evaporative heat loss, although perhaps less effective than immersion techniques, poses fewer practical difficulties. Evaporative body heat loss may be accomplished by removing all of the patient's clothes and intermittently spraying the patient's body with warm water while a powerful fan blows across the body, allowing the heat to evaporate. A number of other cooling techniques have been suggested, but none has proven superior to or equal to cold-water immersion or evaporative techniques. These include peritoneal, thoracic, rectal, and gastric lavage with ice water; cold intravenous fluids; cold humidified oxygen; cooling blankets; and wet towels. Antipyretics (e.g., acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heatstroke
Patients with heatstroke invariably are volume depleted, but cooling alone may improve hypotension and cardiac function by allowing blood to redistribute centrally. Aggressive fluid resuscitation generally is not recommended.
Which of the following laboratory values should be obtained? (Click on the correct answer to proceed to the third of five panels)