[Treatment of heat stroke]

Immediate cooling and support of organ-system function are the two main therapeutic objectives in patients with heat stroke. When cooling is rapidly initiated and both the body temperature and cognitive function return to the normal range within an hour of onset of symptoms, most patients recover fully. Immersion in an ice-water bath is the most effective cooling method, and evaporative cooling is a rapid and effective alternative. To prevent the development of rhabdomyolysis-induced acute renal failure, aggressive IV rehydration should be continued for first 24 to 72 hours with the goal of maintaining a minimum urine output of 2 mL/kg/h. Treatment of heat cramps also consists of fluid and salt replacement (PO or IV) and rest in a cool environment. In severe cases, IV magnesium sulphate may be effective to relieve muscle cramping.