What are the Wilderness Medical Society guidelines on the prehospital (field) care of patients with heat stroke?

Updated: Aug 02, 2019
  • Author: Robert S Helman, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Field treatment

Consider rectal temperature, when available, as the most accurate measurement of core hyperthermia compared with axillary, oral, or aural thermometry.

Do not delay initiating empiric cooling in a hyperthermic individual with an altered sensorium; cooling should not be delayed by a measurement value that may be below the diagnostic threshold of 40°C (104°F).

Use passive cooling measures to minimize thermal strain and maximize heat loss.

Minimize dehydration and use intravenous fluids for rehydration.

Cold-water immersion is the optimal cooling method for heat stroke.

Consider evaporative or convective cooling as adjunct methods if cold water immersion is unavailable.

Do not use antipyretics.

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