Table 4.
Heatstroke in-hospital management guidelines compliance scores (n = 98).
| Heatstroke Management Theme/Subtheme | Total Number of Eligible Cases | Number of Cases Consistent with Guidelines (n%) | Guideline Compliance Score |
|---|---|---|---|
| In-Hospital Considerations | 7.6 | ||
| ● Adhered to appropriate PPEs | 49 | 49 (100%) | 10 |
| ● Did not give antipyretics | 49 | 37 (75.5%) | 7.5 |
| ● Full pre-hospital report taken | 49 | 27 (55.1%) | 5.5 |
| Diagnosis confirmation with rectal thermometer | 49 | 37 (75.5%) | 7.5 |
| Case Management | |||
| A. Cooling | 7.6 | ||
| ● Cooling continued | 49 | 48 (98%) | 9.7 |
| ● Skin and rectal temperature continuously monitored | 49 | 48 (98%) | 9.7 |
| ● Skin temperature maintained > 30 °C | 49 | 17 (34.7%) | 3.4 |
| ● Cooling stopped when rectal temperature is 39 °C | 49 | 38 (77.6%) | 7.7 |
| B. Stabilize ABC | 9.5 | ||
| ● Airway stabilized | 49 | 48 (98%) | 9.7 |
| ● Breathing stabilized: administer oxygen to keep oxygen saturation (SaO2) > 94 | 49 | 46 (93.9%) | 9.3 |
| Special considerations | 4.3 | ||
| ● Rhabdomyolysis diagnosed | 49 | 9 (18.4%) | 1.8 |
| ● Volume expanded by giving more fluids | 49 | 20 (40.8%) | 4.0 |
| ● Intravenous furosemide, mannitol, and sodium bicarbonate were given | 49 | 3 (6.1%) | 0.6 |
| ● Potassium and calcium were monitored | 49 | 23 (46.9%) | 4.6 |
| ● If hyperkalaemia, the patient was treated | 14 | 4 (28.6%) | 3.0 |
| ● In case of seizure/shivering, benzodiazepines given | 21 | 17 (81%) | 8.0 |
| ● In case of multiple organ system dysfunction, supportive therapy given | 7 | 6 (85.7%) | 8.5 |
ABC: airway, breathing, and circulation (ABC); PPEs: Personal protective equipment.