Today we have a topical special on heat stroke, following the record-breaking temperatures across Europe recently peaking at 44 degrees Celsius! Heat stroke is one of the truly terrifying environmental emergencies, with a mortality rate approaching a staggering 33% (when associated with hypotension). Not only does it have an extremely high mortality rate – but also leaves many patients with significant functional impairment with around 1 in 3 having moderate to severe functional impairment at discharge. In a wilderness environment it can be challenging to treat and is a truly time critical emergency where ‘time is organ function’. Eoin and Ffyon discuss the Wilderness Medicine Society's guidelines and their own experiences of managing heatstroke in wilderness environments.

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