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Exertional heat stroke — MRCEM SBA MCQ

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HardEnvironmental MedicineExertional heat strokeMRCEM SBA

A 24-year-old runner collapses near the finish of a hot race. Rectal temperature is 41.2°C and he is confused and ataxic. What is the most appropriate immediate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Start rapid cooling by cold-water immersion

The best answer is “Start rapid cooling by cold-water immersion”. Confusion or ataxia with core temperature above 40°C during exertion is exertional heat stroke. Rapid whole-body cooling, preferably cold-water immersion, should start immediately while airway, circulation and emergency transfer are managed. Antipyretics do not correct exertional hyperthermia, and blood tests or oral fluids must not delay cooling.

Reference: British Journal of Sports Medicine: Exertional heat illness consensus guidance: https://bjsm.bmj.com/content/49/18/1164