Monitor temperature regularly by measuring rectal temperature.[1]Lipman GS, Gaudio FG, Eifling KP, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of heat illness: 2019 update. Wilderness Environ Med. 2019 Dec;30(4s):S33-46.
https://www.wemjournal.org/article/S1080-6032(18)30199-6/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/31221601?tool=bestpractice.com
In practice, use an oesophageal probe in intubated patients.
In practice, order serial bloods and monitor laboratory tests at least once daily (particularly potassium levels, renal function, arterial blood gases, clotting profile, and creatine kinase; see the Diagnosis section). If the patient is critically unwell or there is evidence of organ failure, consider repeating bloods more frequently.
Be vigilant for complications that may develop at a later stage (even after return to normothermia) including rhabdomyolysis, acute kidney injury, disseminated intravascular coagulation, and acute liver failure.[1]Lipman GS, Gaudio FG, Eifling KP, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of heat illness: 2019 update. Wilderness Environ Med. 2019 Dec;30(4s):S33-46.
https://www.wemjournal.org/article/S1080-6032(18)30199-6/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/31221601?tool=bestpractice.com
[2]Gauer R, Meyers BK. Heat-related illnesses. Am Fam Physician. 2019 Apr 15;99(8):482-9.
https://www.aafp.org/afp/2019/0415/p482.html
http://www.ncbi.nlm.nih.gov/pubmed/30990296?tool=bestpractice.com
See the Complications section.
Practical tip
Be cautious of falsely elevated rectal temperature measurements in the recovery phase resulting from the insulating effect of body mass.[1]Lipman GS, Gaudio FG, Eifling KP, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of heat illness: 2019 update. Wilderness Environ Med. 2019 Dec;30(4s):S33-46.
https://www.wemjournal.org/article/S1080-6032(18)30199-6/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/31221601?tool=bestpractice.com