SAQ 853 – Environmental – exertional heat stroke

A 25-year-old athlete is brought to your ED by a volunteer St John ambulance crew after collapsing during a marathon. He has only received basic first aid.

His vital signs and initial blood results are shown below.

Measure	Value
GCS	11 (E3 V4 M4)
Temp	41.5 deg C
HR	140 bpm
BP	85/40 mmHg
SpO2	98% on room air
Hb	185 g/L (115-165)
WCC	25 x 10^9/L (3.5-11)
Platelets	40 x 10^9/L (150-450)
Na	146 mmol/L (135-145)
K	5.7 mmol/L (3.5-5)
Urea	22 mmol/L (2-7)
Creatinine	410 micromol/L (60-110)
CK	27,000 IU/L (60-220)

List the three most likely differential diagnoses for this presentation.

(Marked out of 3.0)

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Outline three initial treatments you would commence, with target end-points.

(Marked out of 3.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Initial treatment</th> <th>Target end-point</th> </tr> </thead> <tbody> <tr> <td>1</td> <td></td> </tr> <tr> <td>2</td> <td></td> </tr> <tr> <td>3</td> <td></td> </tr> </tbody> </table> <p>

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List the three most important blood-test abnormalities and explain their significance.

(Marked out of 3.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Abnormality</th> <th>Significance</th> </tr> </thead> <tbody> <tr> <td>1</td> <td></td> </tr> <tr> <td>2</td> <td></td> </tr> <tr> <td>3</td> <td></td> </tr> </tbody> </table> <p>

/ 3

Following these investigation results, state the next three most important treatment steps.

(Marked out of 3.0)

/ 3

Total Score: 0 / 12

Percentage: 0%