A 68-year-old man is brought to the emergency department with altered mental status, hot dry skin, and a core body temperature of 104°F (40°C). Which of the following interventions should be prioritized?
Oxygen therapy
Antipyretic medication
Rapid cooling measures
IV fluid administration
Rapid cooling is the most critical intervention for heat stroke, which this patient is experiencing. While all the options listed are important, immediate cooling takes precedence to prevent further organ damage and potential death. Immersion in ice water or applying ice packs to major blood vessels (neck, axilla, groin) can rapidly lower core body temperature. IV fluid administration is important but secondary to cooling. Oxygen therapy may be necessary but is not the primary intervention. Antipyretics are not effective in treating heat stroke as the condition is not caused by a fever-inducing illness.
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