Heat Stroke is defined by end organ damage. The following is a list of end organ damage and the immediate interventions:

a. Renal Failure: Promote urine flow by administering adequate IV fluids. Mannitol and furosemide have sometimes been recommended to restore adequate renal blood flow, but only after the patient has been adequately rehydrated.

b. Rhabdomyolysis: Hydration, alkalinization of urine if myoglobinuria is suspected or present. Also, hyperkalemic arrythmias can be potentiated by hypocalcemia seen in association with rhabdomyolysis. The ECG is more sensitive than measureme nts of serum potassium in assessing the degree of risk.

c. DIC: More common in exertional heatstroke. Usually resolves spontaneously, although FFP or platelets might be required.

d. Seizures: Management discussed in Answer 4. Cerebral microhemmorrhages can result in permanent neurological deficits in some patients with very severe heatstroke.