EM Cases · Heat illness and heat stroke
Classic heat stroke in the heat wave — the elderly found down
An ACEM Fellowship OSCE clinical-management (resus) station on classic (non-exertional) heatstroke in an older patient: recognition, immediate cooling, drugs to avoid, and the circulatory failure of heatstroke.
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Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
An 82-year-old woman is brought from a sealed top-floor flat during a city heat wave, found unconscious by a neighbour. Core temperature 41.2 degrees, GCS 7 (E1 V2 M4), skin hot and dry, HR 128 irregular, BP 88/54.
Stem
All persons, presentations and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
References8ShowHide
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- [13]DeGroot DW, Ruby B, Koo A, O'Connor FG Far from Home: Heat-Illness Prevention and Treatment in Austere Environments. Wilderness Environ Med, 2025.PMID 40262113
- [11]McDermott BP, et al. Acute whole-body cooling for exercise-induced hyperthermia: a systematic review. J Athl Train, 2009.PMID 19180223
- [14]Bouchama A, Abuyassin B, Lehe C, et al. Classic and exertional heatstroke. Nature reviews. Disease primers, 2022.PMID 35115565
- [15]Gauer R, Meyers BK Heat-Related Illnesses. American family physician, 2019.PMID 30990296
- [16]Garcia CK, Renteria LI, Leite-Santos G, et al. Exertional heat stroke: pathophysiology and risk factors. BMJ medicine, 2022.PMID 36936589