In exertional heatstroke, core temp >105°F with CNS dysfunction and hot, flushed skin with minimal sweating; cooling first, then transport.

In exertional heatstroke, core temp >105°F with CNS dysfunction and hot, flushed skin with minimal sweating; cooling first, then transport.

• A. Heat Rash
• B. Exertional Heatstroke
• C. Heat Cramps
• D. Heat Syncope

Answer: (B)

Exertional heatstroke is identified by a core temperature above 105°F (40.5°C) with central nervous system dysfunction (confusion, agitation, seizures, collapse) and hot, flushed skin with little or no sweating. This combination shows that the body's cooling mechanisms have failed, making it a medical emergency. The priority is rapid cooling to lower the core temperature as quickly as possible—cold-water immersion is the preferred method when available, or other rapid cooling techniques if immersion isn’t possible—then arrange transport to a medical facility while continuing cooling. Other heat illnesses don’t match this presentation. Heat cramps involve painful muscle spasms with normal mental status and sweating. Heat syncope is fainting from low blood pressure after exertion, often with adequate sweating and milder symptoms. Heat rash is a localized skin irritation from sweating. The described signs point to exertional heatstroke and the need for cooling-first management.

Exertional heatstroke is identified by a core temperature above 105°F (40.5°C) with central nervous system dysfunction (confusion, agitation, seizures, collapse) and hot, flushed skin with little or no sweating. This combination shows that the body's cooling mechanisms have failed, making it a medical emergency. The priority is rapid cooling to lower the core temperature as quickly as possible—cold-water immersion is the preferred method when available, or other rapid cooling techniques if immersion isn’t possible—then arrange transport to a medical facility while continuing cooling.

Other heat illnesses don’t match this presentation. Heat cramps involve painful muscle spasms with normal mental status and sweating. Heat syncope is fainting from low blood pressure after exertion, often with adequate sweating and milder symptoms. Heat rash is a localized skin irritation from sweating. The described signs point to exertional heatstroke and the need for cooling-first management.