What are the immediate steps for suspected exertional heat stroke on the sidelines?

• A. Call EMS, remove excess clothing, apply rapid cooling with ice or immersion, monitor core temperature.
• B. Wait for symptoms to improve before cooling.
• C. Give large amounts of water by mouth immediately.
• D. Call EMS, remove excess clothing, apply rapid cooling with ice or immersion, monitor core temperature, and avoid giving fluids by mouth if unconscious.

Answer: (D)

Immediate management focuses on rapid cooling and getting medical help quickly. Suspected exertional heat stroke on the sidelines calls for activating EMS right away, removing excess clothing to expose the skin, and applying rapid cooling with ice or cold water immersion to bring the core temperature down as fast as possible. Continuously monitor core temperature to track cooling progress and determine when transport is needed. Do not give anything by mouth if the person is unconscious, since there’s a risk of choking or aspiration; if they are conscious and able to swallow, fluids may be considered later, but cooling and transport are the priorities. Waiting for symptoms to improve or giving large amounts of water without addressing cooling can delay life-saving care and worsen outcomes.