Heat Stroke

Heat Stroke

Signs and symptoms

  • Altered mental status is a hallmark
  • Usually temp > 104 F
  • Labs almost always include hepatic dysfunction, can also include rhabdomyolysis or coagulopathies
  • Two types of heat stroke:
    • Classic (non-exertional): elderly patient with comorbidities, may have anhidrosis, high mortality
    • Exertional: young athlete, severe dehydration, more systemic abnormalities

 ManagementStart evaporative cooling and target 102 F to prevent overcorrecting

  • Ice packs to groin and axilla, can consider GI cold water lavage
  • Consider intubation due to aspiration risk
  • Start benzodiazepines to prevent shivering
  • No indication for anti-pyretics

And don’t forget to always keep a broad differential as discussed by Dr. Cafaro!


  • Bouchama, Abderrezak & P Knochel, James. (2002). Heat Stroke. The New England journal of medicine. 346. 1978-88. 10.1056/NEJMra011089. 
  • Flavio G. Gaudio, Colin K. Grissom. (2016). Cooling Methods in Heat Stroke. The Journal of Emergency Medicine. Volume 50, Issue 4, 607-616. https://doi.org/10.1016/j.jemermed.2015.09.014.