Two issues with this patient: asthma and heat stroke. Initial management should be as follows:

--ABCs: Ensure a patent airway. If respiration is not adequate, assist and consider intubation. Also, make sure pulse and blood pressure are acceptable.

--Begin IV hydration as rapidly as possible.

--Remove the patient's clothing and cool the body with water (sponge or bathe) and air (a fan is best). Direct cooling efforts towards areas of high circulation (neck, axillae, and groin).

--Ice packs are controversial due to the consequences of shivering.

--Management of asthma depends on the serverity and degree of obtundation. Note: asthma might be a red herring here as all symptoms can be attributed to heat stroke.