In exertional heatstroke, what is the priority action?

• A. Administer fluids orally
• B. Transport immediately without cooling
• C. Cool first, then transport
• D. Do not treat

Answer: (C)

Rapid cooling to bring the body's core temperature down is the immediate priority in exertional heatstroke. When heatstroke occurs, the body's cooling mechanisms fail and the risk of brain and organ damage is high, so you act fast to lower core temperature. The most effective on-site method is rapid cold-water immersion; if that isn’t possible, use aggressive evaporative cooling (spray with water while fan-forcing air over the body) and apply ice packs to key areas like the neck, armpits, and groin. The goal is to reduce the core temperature quickly and safely, then continue with transport for definitive care.

Fluids given by mouth don’t rapidly reduce core temperature and may be unsafe if the athlete is altered or unconscious, so they’re not the priority. Transport should occur after cooling is started but should not delay cooling. Do not leave the athlete untreated; exertional heatstroke demands immediate cooling followed by medical evaluation and care.