Heat stroke

What it is

Heat stroke stands at the end of a spectrum of heat illness that runs from heat cramps through heat exhaustion.

How it is diagnosed

A high temperature is not heat stroke on its own, and the list to work against is: drug induced heat illness, neuroleptic malignant syndrome, serotonin syndrome, delirium tremens, typhus, typhoid fever, hypothalamic hemorrhage and thyroid storms.

The heat syndromes are set out as one spectrum, and the temperature is what places a patient on it:

• Heat cramps: LL pain
• Heat exhaustion: electrolyte ab, T <40.5
• Heat stroke: T >40.5, AMS

The measurement decides the management, so it has to be a core measurement, not axillary. An oesophageal temperature probe, or a urine catheter with a temperature probe, is what the cooling is read from.