Climate change, heat and child health — formative SAQs

SAQ 1 (10 marks)

A 16-year-old collapses during a humid preseason training session. He is confused. Staff ask whether to drive him straight to hospital without cooling because “he is still sweating.” ^{[6] [7]}

1. Define heat stroke and explain why sweating does not exclude the diagnosis. (3) ^[6]
2. Outline your immediate field management priorities, including preferred cooling. (4) ^[7]
3. List three investigations you will arrange once cooling is under way and one pitfall to avoid. (3) ^[6]

Model answer

Heat stroke: hyperthermia with CNS dysfunction after heat exposure or exertion. Exertional forms often retain sweating; dry skin is not required. ^[6]

Immediate priorities: remove from heat and strip gear; cool first with cold-water immersion when available; protect airway; oxygen as needed; check glucose; IV access and isotonic fluids for hypovolaemia; treat seizures; continuous monitoring; transport with ongoing cooling if still critically hot. ^[7]

Labs once cooling started: glucose (bedside), electrolytes, renal function, CK, LFTs, coagulation, blood gas/ECG as indicated. Pitfall: delaying cooling for CT or lab confirmation. ^{[6] [7]}