Which cooling strategy is prioritized in exertional heat stroke management?

Which cooling strategy is prioritized in exertional heat stroke management?

• A. Cool first and transport second
• B. Transport first and cool later
• C. Oral hydration only without cooling
• D. Evaporative cooling without immersion

Answer: (A)

Rapid cooling on-site is the top priority in exertional heat stroke because the danger comes from a dangerously high core temperature affecting brain function and other organs. The best and fastest way to achieve this is cold-water immersion, which cools the body quickly (roughly 0.15–0.20°C per minute) and helps bring the core temperature down toward 39°C or lower as soon as possible. Start cooling immediately at the scene and keep the process going; transport should occur once cooling is underway or once a safer temperature is reached, so that ongoing cooling can continue during transfer if needed. Relying on oral hydration alone cannot lower core temperature quickly enough to treat exertional heat stroke, and evaporative cooling without immersion is slower and less reliable than immersion. If immersion isn’t available, use the strongest feasible cooling method, but the priority remains to initiate cooling right away rather than delay for transport.

Rapid cooling on-site is the top priority in exertional heat stroke because the danger comes from a dangerously high core temperature affecting brain function and other organs. The best and fastest way to achieve this is cold-water immersion, which cools the body quickly (roughly 0.15–0.20°C per minute) and helps bring the core temperature down toward 39°C or lower as soon as possible. Start cooling immediately at the scene and keep the process going; transport should occur once cooling is underway or once a safer temperature is reached, so that ongoing cooling can continue during transfer if needed.

Relying on oral hydration alone cannot lower core temperature quickly enough to treat exertional heat stroke, and evaporative cooling without immersion is slower and less reliable than immersion. If immersion isn’t available, use the strongest feasible cooling method, but the priority remains to initiate cooling right away rather than delay for transport.