Heatstroke is a critical medical emergency characterized by a rapid increase in body temperature, often exceeding 40°C (104°F), and is associated with severe physiological disturbances. Prehospital treatment of heatstroke patients is crucial for improving outcomes and reducing morbidity and mortality rates. Effective management strategies include early recognition, rapid cooling, and supportive care, which can significantly influence patient survival rates.
Early recognition of heatstroke is essential, as it allows for timely intervention. Studies indicate that prompt identification and treatment can greatly reduce mortality rates, especially in vulnerable populations such as military personnel and athletes exposed to extreme environmental conditions (Wang et al., 2020; Patel et al., 2023). The implementation of risk assessment tools in prehospital settings can aid in identifying patients at risk for heat-related illnesses, thereby facilitating quicker response times and appropriate treatment measures (Takegawa et al., 2023).
The cornerstone of prehospital treatment for heatstroke is rapid whole-body cooling. This can be achieved through various methods, including immersion in cold water, the application of ice packs to major blood vessels, and the use of cooling blankets (Patel et al., 2023; Davis & Evans, 2024). Research emphasizes that the sooner cooling measures are initiated, the better the clinical outcomes, as prolonged hyperthermia can lead to multi-organ dysfunction and increased mortality (Wu et al., 2021). For instance, a narrative review highlighted the critical role of early cooling in mitigating complications associated with heatstroke, such as acute kidney injury and neurological damage (Patel et al., 2023; Wu et al., 2021).
In addition to cooling, supportive care is vital in the prehospital setting. This includes monitoring vital signs, maintaining airway patency, with decreased level of consciousness the use of medication facilitated endotracheal intubation, and providing intravenous fluids to address dehydration, shock, and electrolyte imbalances (Patel et al., 2023; Griffen & Walter, 2024). Effective communication with emergency medical services (EMS) is also crucial, as it ensures that advanced care is prepared upon the patient's arrival at the hospital (Patel et al., 2023). Training for EMS personnel on the recognition and management of heat-related illnesses is essential, as gaps in knowledge can lead to delays in treatment (Griffen & Walter, 2024).
The universal use of benzodiazepines is not the current recommendation but could be tailored to the shivering, agitated patient or the patient experiencing seizure. There is no role for antipyretics in the treatment of heatstroke patients and may be toxic to the liver. (Morris, 2025)
Furthermore, public health initiatives aimed at increasing awareness and knowledge about heatstroke prevention and first aid can enhance community preparedness. Studies have shown that many individuals lack adequate training in first aid for heat-related illnesses, which underscores the need for educational programs targeting both the general public and specific groups, such as school teachers and agricultural workers (Khalid et al., 2020; Brady et al., 2024). These initiatives can empower bystanders to act swiftly and effectively in the event of a heatstroke incident, potentially saving lives (Xu et al., 2024; Brady et al., 2024).
In conclusion, the prehospital treatment of critical heatstroke patients involves a multifaceted approach that prioritizes early recognition, rapid cooling, and supportive care. Training and public awareness are essential components that can enhance the effectiveness of these interventions, ultimately improving patient outcomes in heatstroke cases.
References:
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- Davis, P. and Evans, D. (2024). An evidence-based algorithm of management of heatstroke in the emergency department. Advanced Emergency Nursing Journal, 46(1), 3-11.
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