Question of the Month – September 2025
Your family joins your son’s best friend’s family on a camping trip and to do some river rafting. On the day of the river rafting, it is over 100 degrees with a heat index of 112. When your group pulls out of the river for lunch, they do so at a river bar and restaurant popular with rafters. Your child approaches you and states that his friend is really acting strange, not making sense. You go to investigate and find him with his parents. He does not seem to recognize them. He is hot to touch. No cough, no congestion. His face is erythematous.
After taking a brief history from the parents, you find that he has not been sick other than significant allergies starting last week, for which he is taking diphenhydramine. He takes methylphenidate for ADHD and recently started on sertraline.
Which of the following is the next best management step?
A. Call 911 and transport for full septic work-up
B. Move the patient to the shade and encourage cool oral fluids
C. Ice packs to the groin and axilla to induce cooling
D. Immediate ice bath on site