Exertional heat stroke — OSCE

Station brief (8–10 minutes)

A 15-year-old cross-country runner is carried into the emergency department after collapsing five kilometres into a race on a 39-degree summer afternoon. His rectal temperature is 41.5 degrees Celsius. He is confused and combative. His skin is hot and sweating profusely, his pulse is 140 beats per minute, his blood pressure is 104/60, and his capillary glucose is 6.2 mmol per litre. Cold-water immersion is available in the department. You are the registrar leading the resuscitation, with a skilled nurse and a junior doctor present. Recognise the diagnosis, lead the immediate cooling, state the drugs you would not give and why, and arrange the disposition. Name the source for each threshold and dose. ^{[1] [3]}