From the Guidelines
Heat stroke requires immediate medical attention, and the primary treatment involves rapidly cooling the body to reduce core temperature, with cold- or ice-water immersion being the preferred method, as it achieves the fastest cooling rate, according to the most recent guidelines from the Society of Critical Care Medicine 1. The treatment of heat stroke is focused on reducing the body temperature as quickly as possible and supporting the cardiovascular system. The most effective method of cooling is cold- or ice-water immersion, which should be prioritized when available. This method is recommended over passive cooling methods, such as applying cool water or ice packs to the neck, armpits, and groin.
- Key aspects of treatment include:
- Rapid cooling to reduce core temperature
- Cold- or ice-water immersion as the preferred cooling method
- Intravenous fluids to restore hydration and electrolyte balance
- Monitoring of vital signs, including heart rate, blood pressure, and respiratory rate
- Hospitalization for observation and supportive care, as heat stroke can cause organ damage The Society of Critical Care Medicine guidelines emphasize the importance of prompt recognition, early intervention, and evidence-based management to optimize outcomes in heat stroke patients 1.
- It is also important to note that pharmacological interventions that affect temperature control are not recommended, as there is no evidence to support their use in heat stroke patients 1. Overall, the goal of treatment is to reduce the body temperature as quickly as possible and support the cardiovascular system to prevent irreversible organ damage and death, with the most recent and highest quality evidence supporting the use of cold- or ice-water immersion as the primary cooling method 1.
From the Research
Heat Stroke Symptoms and Treatment
- Heat stroke is a life-threatening condition characterized by elevated body temperature and central nervous system dysfunction, including symptoms such as combativeness, delirium, seizures, and coma 2.
- The treatment for heat stroke involves early recognition and aggressive cooling, as well as management of life-threatening systemic complications 3, 4.
- Rapid recognition and expedited external or internal cooling methods, coupled with multidisciplinary management, are associated with improved outcomes 4.
- Delays in care are associated with adverse outcomes, highlighting the importance of prompt treatment 4.
Approaches to Cooling and Management
- External cooling devices can be used to treat heat stroke, as seen in the case of two Danish patients who were admitted to the intensive care unit and treated with an external cooling device 3.
- Field cooling and end of active cooling are important aspects of exertional heat stroke management, with approaches including shared clinical decision making for return to activity recommendations 5.
- Supportive care, including management of multiorgan failure and other systemic complications, is also crucial in the treatment of heat stroke 4, 6.
Importance of Early Recognition and Rapid Treatment
- Early recognition and rapid treatment of heat stroke are essential to reduce morbidity and mortality, with prompt cooling and management of systemic complications being critical to improving outcomes 3, 4, 6.
- The American College of Sports Medicine (ACSM) emphasizes the importance of a synchronized chain of survival, promoting rapid recognition and management, as well as communication between care teams, in the treatment of exertional heat illness 6.