Emergency Medicine
Heat Stroke (Exertional & Classical)
Core temp >40°C with CNS dysfunction — rapid cooling within 30 min critical, supportive care, complications.
Source: ACSM 2015; Wilderness Medical Society 2019
Step 1 of ~4
info
Recognise Heat Stroke
Core temperature >40°C + CNS dysfunction (confusion, ataxia, seizure, coma). Distinguish: classical (elderly, comorbid, heatwave) vs exertional (young, athletic, military). ABCDE; rectal / bladder / oesophageal thermometer (NOT tympanic). High mortality if cooling delayed beyond 30 min.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Aviptadil with Phentolamine Mesilate · Vasoactive Intestinal Peptide (VIP) + Alpha-Adrenoceptor Antagonist (Intracavernosal Erectile Dysfunction)
- Dipyridamole (Secondary Stroke Prevention) · Antiplatelet — Phosphodiesterase Inhibitor / Adenosine Uptake Inhibitor
- Neostigmine · Anticholinesterase (Reversal Agent)
- Prilocaine · Local Anaesthetic (Amide)
- Mepivacaine with adrenaline · Amide LA + vasoconstrictor
- Neostigmine with glycopyrronium · Anticholinesterase + antimuscarinic
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
A deeper exam-focused version of this pathway is available on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only. Always apply local guidelines and clinical judgement.