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Retired NBME Step 2 CK Free 120 Answers

step2ck_free120/Block 2/Question#70 (reveal difficulty score)
A previously healthy 15-year-old boy is ...
Administer intravenous fluids ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: trauma surg

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submitted by โˆ—azibird(279)
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UTD:

Stabilization - Circulation

A child with exertional heat stroke may require 60 mL/kg or more of normal saline.

Rapid cooling

For children receiving treatment for heat stroke in the hospital, we suggest evaporative cooling rather than cold-water immersion. Evaporative cooling is preferred for hospital treatment of heat stroke in children because it does not interfere with efforts to maintain monitoring and ongoing resuscitation in unstable patients. Cold-water immersion is associated with significant discomfort, shivering, agitation, and combativeness; and is not clearly more efficacious for rapid cooling in the pediatric population. When evaporative cooling is not available, cold immersion is suggested.

https://www.uptodate.com/contents/heat-stroke-in-children

TL;DR

  • Everyone needs fluids (and those should probably be administered ASAP)
  • Cold-water immersion is not preferred
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 +1  upvote downvote
submitted by โˆ—bwdc(697)
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Follow your ABCs. Tachycardia and hypotension mean severe volume loss necessitating aggressive intravenous fluid resuscitation.

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