Treatment of choice in heat stroke is:

BHU NO-2019

Medical & Surgical Nursing

Easy

Appeared in: BHU NO-2019

Explanation

Heat stroke is a life-threatening medical emergency caused by the failure of the body's heat-regulating mechanisms, leading to a core temperature above 40°C (104°F).
The primary treatment goal is to lower the core body temperature as rapidly as possible to prevent permanent neurological and multi-organ damage.
Ice cold water sponging is an effective external cooling method that promotes rapid heat loss through conduction and evaporation, directly addressing the failed thermoregulation.
The mortality and morbidity from heat stroke are directly related to the duration of the hyperthermia, making rapid cooling the most critical intervention.

Option A: Tepid water sponging does not provide the rapid rate of cooling required to treat the severe, life-threatening hyperthermia of heat stroke.
Option B: Intravenous tramadol is an opioid analgesic used for pain management and has no therapeutic effect on lowering body temperature.
Option D: Intravenous paracetamol is an antipyretic that is ineffective and contraindicated in heat stroke. It works by lowering the hypothalamic set point, which is normal in heat stroke. It can also exacerbate liver damage, a common complication.

Clinical Relevance

Nursing practice connection: Knowing Management of Heat Stroke helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing heat stroke as a medical emergency requiring immediate, aggressive intervention is a critical nursing skill. Delay in cooling can lead to death or permanent disability.
Nurses must continuously monitor the patient's core temperature during cooling to prevent iatrogenic hypothermia (overshooting the target temperature), which has its own set of complications.
Post-cooling, nurses must monitor for complications such as rhabdomyolysis (evidenced by dark urine and high CK levels), acute kidney injury, and disseminated intravascular coagulation (DIC).

How to Approach the Question

First, identify the clinical condition presented in the question: 'heat stroke'. Recognize this as a life-threatening emergency.
Recall the core pathophysiology of heat stroke: it is a failure of the body's cooling system, not a fever (which is a change in the brain's temperature set-point).
Based on the pathophysiology, determine the primary treatment goal: rapid, external cooling to prevent organ damage.
Evaluate each option against this goal. 'Ice cold water sponging' directly addresses the need for rapid cooling.
Eliminate options that are irrelevant (Tramadol for pain) or contraindicated (Paracetamol, which is ineffective and harmful in this context).
Confirm that 'Tepid water sponging' is less effective and too slow for this emergency, solidifying 'Ice cold water sponging' as the best choice.

Concept Tested & Keywords

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