How is exertional heat stroke recognized and treated promptly?

• A. Gradual fatigue with sweating.
• B. Headache and nausea; take analgesics.
• C. Dizziness only.
• D. Sudden collapse with hot, often dry or moist skin, confusion or unconsciousness; immediate cooling with water immersion or ice packs and EMS.

Answer: (D)

Exertional heat stroke is a medical emergency and must be treated with swift cooling. Recognizing it hinges on a sudden collapse during or after strenuous exercise, extremely high body temperature, and altered mental status such as confusion or unconsciousness. The skin is typically very hot to the touch and can be dry or moist.

The correct approach is to act immediately: call EMS right away and begin rapid cooling without delay. Remove excess clothing or gear and get the person into a cooler environment if possible. If available, immerse the person in cool water or apply a continuous stream of cool water while fanning to boost evaporation. If immersion isn’t possible, place ice packs or cold packs in the neck, armpits, and groin and continue cooling the skin while awaiting medical help. Do not give fluids by mouth if the person is unconscious or unresponsive. The goal is to lower the core temperature quickly to reduce risk of organ damage, and rapid cooling dramatically improves outcomes.

This contrasts with options describing fatigue with sweating, headaches with analgesics, or dizziness alone, which reflect less severe heat-related conditions (like heat fatigue or heat exhaustion) and do not involve the dangerous mental status changes or the need for immediate aggressive cooling that define heat stroke.