Theme: Hyperthermia, Heatstroke, Serotonin syndrome, Neuroleptic malignant syndrome.
An 82-year-old man is admitted to hospital on a hot summer evening following concern from his carers. He was found in an armchair confused, drowsy and unable to stand unaided. He was last seen in the morning. On initial assessment he was tachypnoeic, tachycardic with hypotension. There was an absence of skin wettedness. His GCS was 10 and rectal temperature was found to be 39.3oC following non-invasive cooling methods pre-hospital.
Past medical history includes diabetes mellitus, hypertension, ischaemic heart disease and a depressive disorder. Regular medications include amlodipine, betahistine, bisoprolol, fluoxetine, furosemide, macrogol 3350 and quetiapine.
