American family physician
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Heat stroke victims lack thermoregulatory control. Treatment includes immediate cooling, circulatory support and monitoring for secondary complications. Neuroleptic malignant syndrome is a complication of neuroleptic drug therapy; skeletal muscle hypertonicity helps distinguish this entity from heat stroke. Malignant hyperthermia should be considered in any patient who is under physiologic or anesthetic stress and develops hyperthermia plus skeletal muscle rigidity, tachypnea, hypoxia, tachycardia and hyperkalemia.
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The family physician should be skilled in the treatment of victims of immersion accidents. Specific management at the scene and in the emergency room is critical to survival and a good neurologic outcome. Hospital admission with careful evaluation and observation is usually indicated. Patients and community groups must be reminded of precautions that will prevent many injuries and deaths.