This patient was assessed in the resus area of the emergency department.
Simple non-invasive cooling measures were initiated immediately given an ongoing abnormally high core body temperature and concern his temperature was significantly higher before initial pre-hospital cooling. Given he was taking fluoxetine and quetiapine, alternative diagnoses such as serotonin syndrome and neuroleptic malignant syndrome were considered. With the clinical picture of high ambient summer temperatures, the patient being of advanced age and the patient taking numerous medications that increase the risk of heatstroke, a diagnosis of classical heatstroke was made.
The patient was admitted to critical care due to the reduced GCS and evidence of acute kidney injury. He was rapidly cooled using a body wrap system and he received supportive care for the evolving acute kidney injury and a moderate coagulopathy. After 6 days on the critical care unit, he was discharged to a ward environment.
