Snapshot A 16-year-old football player is brought to the school nurse by his teammates with extreme fatigue and altered mental status in early August. He refuses to be evaluated by his sports coach. Temporal temperature is 103°F (39.4°C). With restraining support from the teammates, the nurse records a rectal temperature of 105°F (40.5°C). The nurse informs the coach and quickly removes the athlete's equipment and clothing to facilitate cooling. The nurse then calls the ambulance to transfer the patient to the local hospital. His pretransfer rectal temperature is 102°F. Introduction Hyperthermia login to view 1 more bullet Hyperthermia is NOT fever login to view 3 more bullets Heat-related illnesses can be multifactorial login to view 3 more bullets Presentation Heat exhaustion and heat stroke definitions overlap login to view 25 more bullets Evaluation and Management Primary and secondary survey with resuscitation login to view 2 more bullets Best diagnostic test: rectal temperature Best initial step: anything that cools patient rapidly login to view 3 more bullets Avoid antipyretics (e.g., aspirin, Tylenol) Transfer patient to medical facility for definitive care If etiology is exertional, American College Sports Medicine guidelines recommends no exercise for 7 days after event Complications If patient does not respond quickly to cooling treatment, consider other etiologies of hyperthermia login to view 4 more bullets