SAQ 903 – Environmental – exertional heat stroke after cycling race

A 42-year-old man presents after a long-distance bicycle race. He has been acting strangely and has fainted twice. He drank plenty of water during the event and did not fall.

Observation	Value
Rectal temperature	39.5 deg C
HR	122/min regular
BP	100/45 mmHg
GCS	14

List five potential causes for his symptoms and signs.

(Marked out of 5.0)

/ 5

List five important investigations and give the rationale for each.

(Marked out of 10.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Investigation</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Rationale</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">1</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">2</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">3</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">4</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">5</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

/ 10

His rectal temperature rises to 41 deg C. Outline four initial management actions.

(Marked out of 4.0)

/ 4

Despite resuscitation his temperature rises to 42 deg C and he has a generalised seizure. Outline six treatment priorities, including doses or endpoints where appropriate.

(Marked out of 6.0)

/ 6

Total Score: 0 / 25

Percentage: 0%