A 79-Year-Old Man Is Found Poorly Responsive in His Apartment

A 79-year-old man is found poorly responsive in his apartment by a neighbor in the middle of July.  The apartment is not air conditioned and the last few days have been extremely hot.  The patient's neighbors state that he lives alone and appeared fully functional in their interactions with him.  No additional medical history is available.
On physical examination, he appears obtunded and responds slowly to commands.  His temperature is 42.2° C (108° F) , blood pressure is 90/60 mm Hg, pulse is 104/min, and respirations are 16/min.  The patient's pulse oximetry shows 96% on room air.  Mucous membranes are dry.  His neck is supple, and jugular veins are flat in the supine position.  Cardiopulmonary examination is within normal limits.  There are no skin rashes.  Deep tendon reflexes are 2+ and symmetrical.  There is no muscular rigidity.
An electrocardiogram demonstrates sinus rhythm with nonspecific ST-segment changes.  A chest film shows no significant abnormalities.  Laboratory workup is pending.
In addition to volume resuscitation, which of the following is the best initial therapy for this patient?

A) Alcohol sponge baths
B) Aspirin suppositories
C) Dantrolene
D) Evaporative cooling
E) Immersion in ice water

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free