A 36-year-old-male is brought in by ambulance to your regional emergency department with confusion and agitation. He had been competing in the annual iron man event and collapsed shortly after crossing the finish line. On examination you find him to be confused and agitated, his skin is hot and sweaty to the touch, and his observations are as follows:

  • Temp 40.8°C
  • HR 138
  • BP 91/58
  • RR 30
  • Sats 97%RA
  • GCS 12 (E4V3M5)

1. List four investigations and provide a brief justification for each. 4 marks

2. List three initial temperature control strategies. 3 marks

Despite your initial management, the patient becomes increasingly altered, his temperature rises to 42.5°C and he has a generalised tonic-clonic seizure.

3. List six immediate treatment priorities including doses and endpoints where appropriate. 6 marks

4. List five complications of heat stroke. 5 marks