Hyperthermia 

Assessment

Pediatric Pearls: Signs & Symptoms: Differential: 
□ Use approved reference document for medication dosing, electrical therapy, and equipment sizes.□ Weakness 
□ Nausea & vomiting 
□ Cramping 
□ Syncope 
□ Diaphoresis & anhidrosis 
□ Altered Mental Status 
□ Bizarre behavior 
□ Hypotension 
□ Tachycardia		□ CVA 
□ Dehydration 
□ Encephalopathy 
□ Meningitis / Sepsis 
□ Head Trauma 
□ Overdose / Toxin 
□ Hypoglycemia 
□ Excited delirium 
□ Alcohol withdrawal

Clinical Management Options

EMT-B
• Age-appropriate core body temperature assessment 
• Oxygen, target SpO2 92 – 96% 
• Move to shaded/cool environment, discontinue physical activity, PO fluids if tolerated 
• If AMS, then BGL assessment 
• If AMS and/or body temperature > 102.2 F, then active cooling measures per patient condition: 
• Ice packs to neck, axilla and groin, wet patient, and increased airflow 
Paramedic
• Vascular access 
• Consider infusing Isotonic Crystalloid fluids titrated to effect 
• If AMS, then may infuse cold Isotonic Crystalloid if available up to 30 mL/kg or titrated to effect 
• If shivering develops, Midazolam for sedation
Consult Online Medical Control as Needed

Pearls

  • Signs of improvement to help titrate to effect include improved heart rate, decrease body temperature, resolution of thirst, feeling the need to urinate and/or increased urination, improvement in mental status, improvement in skin conditions, etc. 
  • If increased temperature, utilize passive cooling by removing excessive clothing or covers. 
  • NSAIDS should not be used in the setting of environmental heat emergencies. 
  • Exertional heat stroke should be suspected in anyone with a history of recent exertion and bizarre behavior, seizure, or syncope. 
  • Any AMS should have blood glucose performed. Severe heat emergencies may lead to liver dysfunction and hypoglycemia. 
  • If AMS and cold isotonic crystalloid fluids are not available, then begin isotonic crystalloid boluses. 
  • Damage caused by heat stroke is determined by how high the temperature got and how long it remained elevated. 
  • Cold water immersion is the most effective means of cooling. 
  • Active cooling should be removed when body temperature reaches 102.2 F.