Environmental *

Objectives (EM)

1. Suspect the diagnosis of heat stroke in a patient with altered mental status and fever in a situation of heat stress, and act immediately to reduce the temperature.
2. When managing a patient with severe hyperthermia (i.e., at risk for heat stroke), cool the patient promptly and aggressively using multiple effective modalities, before having confirmed any etiological diagnosis, while considering the need to look for etiologies other than environmental heat stress (e.g., neuroleptic malignant syndrome, OD, endocrine, infections).
3. When managing a hypothermic patient, use effective modalities for rewarming, monitor the temperature using an accurate probe, and continue appropriate resuscitation measures until core temperature has recovered.
4. Recognise that pain and other unexplained symptoms after diving could be dysbarism in origin, and refer the patients for hyperbaric therapy when appropriate.
5. In patients presenting following an electrical injury, consider and look for internal injuries (including myocardial) and associated trauma that are not apparent from external signs, and monitor appropriately until the risk of complication is mitigated.