Except for the mildest cases, patients diagnosed with exertional heatstroke or nonexertional heatstroke should be admitted to the hospital for at least 48 hours to monitor for complications.
Numerous cooling techniques have been suggested, but none has proven superior to or equal to cold-water immersion or evaporative techniques. These include peritoneal, thoracic, rectal, and gastric lavage with ice water; cold intravenous fluids; cold humidified oxygen; cooling blankets; and wet towels.
Antipyretics (eg, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heatstroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heatstroke.
Neuroleptics (eg, chlorpromazine), which were the mainstays of therapy in the past, are best avoided because of their deleterious adverse effects, including lowering of the seizure threshold, interference with thermoregulation, anticholinergic properties, hypotension, hepatotoxicity, and other adverse effects.
Benzodiazepines—and, if necessary, barbiturates—are the recommended agents for treatment of patients who are having convulsions. Barbiturates may be used despite their theoretical impedance of sweat production.
For more on the treatment of heatstroke, read here.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Richard H. Sinert. Fast Five Quiz: Test Your Knowledge of Common Summer Injuries - Medscape - Jun 26, 2017.