A fifty five year old man presented to our hospital with altered sensorium, tachypnoea, tachycardia and normal BP. There was history of lower limb weakness just half an hour before losing conciousness. His body temperature was 106 degree farenhiet, ECG was normal. There was no focal neurological defecit. He was diagnosed as heat stroke. Active cooling was started with ice water bath, IV fluids, cold saline gastric lavage. In the next fifteen minutes he started having massive haemoptysis. In the next ten minutes suddenly patient had a severe hypotension followed by cardio respitory arrest.Cinilcal pearls:
Heat stroke may have a subtle presentation and when recognised it may be too late to salvage the patient. So in a tropical country like India when the outside temperature is very often more than 45 degrees centigrade in summer months, one needs to be very careful with proper hydration and avoid out door job as much as possible during this period.
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