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Exertional heat stroke — DIPIMC MCQ

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HardEnvironmental MedicineExertional heat strokeDIPIMCDipIMC

A runner collapses after a marathon. Their core temperature is 41.2°C, they are confused and ataxic, and an immersion tub is available at the roadside. Airway and circulation are currently maintained. What is the priority treatment?

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Correct answer: B — Begin cold-water immersion while monitoring and planning transfer

The best answer is “Begin cold-water immersion while monitoring and planning transfer”. Exertional heat stroke is defined by hyperthermia with central nervous system dysfunction and requires immediate active cooling; available cold-water immersion should not be delayed for tests, antipyretics or transport. Airway, circulation and core-temperature monitoring continue concurrently. Antipyretics do not reverse the environmental and exertional heat load, and passive measures are inadequate for this time-critical syndrome.

Reference: RCUK 2025 Special Circumstances Guidelines: https://www.resus.org.uk/professional-library/2025-resuscitation-guidelines/special-circumstances-guidelines