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Heat stroke — DIPIMC MCQ

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HardEnvironmental MedicineHeat strokeDIPIMCDipIMC

At a summer marathon, a runner collapses, confused and aggressive, with hot dry skin, a core temperature of 41 degrees Celsius and a heart rate of 140. What is the most important immediate intervention?

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Correct answer: A — Begin rapid active cooling alongside resuscitation

Exertional heat stroke with central nervous system dysfunction and a core temperature above 40 degrees Celsius is a medical emergency, and rapid active cooling (for example cold-water immersion or applying iced water) is the priority alongside airway, breathing and circulation support and transfer. Antipyretics do not work in heat stroke because the problem is environmental heat load rather than a raised set-point. Oral fluids and rest alone are inadequate, and delaying cooling worsens outcome. Pearl: cool aggressively towards a safe temperature, since the duration of severe hyperthermia drives organ injury.

Reference: JRCALC Clinical Guidelines; Resuscitation Council UK Guidelines 2025 (First Aid)