You are transporting a 35-year-old male patient who was found unconscious in his backyard after working outside on an extremely hot day. His core body temperature is 104°F (40°C), and he exhibits hot, dry skin, tachycardia, and confused mental status. What is the most appropriate initial management for this patient?
Encourage the patient to drink cold water to stay hydrated
Administer intravenous fluids and monitor vital signs
Apply cool, damp sheets and increase air flow over the patient
Place the patient in a cold water bath to rapidly decrease core temperature
The correct intervention in a case of heatstroke involves rapidly reducing the patient's core body temperature to prevent further organ damage. Evaporative cooling (placing cool, damp sheets over the patient and using fans to increase the rate of evaporation) is an effective method in this setting. Ensuring adequate hydration and monitoring vital signs are also important but are secondary to the immediate need to lower body temperature. Submersion in cold water may not be feasible in a transport setting.
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