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Heat stroke — MCCQE Part 1 MCQ

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ModerateHyperthermiaHeat strokeMCCQE Part 1

22-year-old runner presents with collapse during a summer race. Core temperature is 41°C and he is confused. Which of the following is the most appropriate next step?

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Correct answer: A — Start immediate rapid cooling and supportive resuscitation

Start immediate rapid cooling and supportive resuscitation is best because hyperthermia with CNS dysfunction is heat stroke. Wait for confirmatory testing before any stabilisation is suboptimal because resuscitation and time-critical treatment should not wait when instability is present; Discharge once symptoms temporarily improve is suboptimal because temporary improvement can precede deterioration; Give an adjunctive medication as the sole first-line treatment is suboptimal because adjuncts do not replace definitive stabilisation; Delay escalation until cardiac arrest or respiratory failure occurs is suboptimal because early escalation is central to emergency care. Cooling is the definitive time-critical treatment.

Reference: Canadian emergency medicine guidance