In a heat-related emergency with decreased consciousness, after moving the patient to a cool environment and securing the airway, what should you assess next?

• A. Check the blood glucose level if the patient has altered mental status.
• B. Administer a rapid IV fluid bolus of normal saline.
• C. Administer acetaminophen to reduce fever.
• D. Insert an orogastric tube.

Answer: (A)

When someone with a heat-related illness has altered mental status, the next priority after securing the airway and starting cooling is to quickly identify reversible causes of AMS. Checking a rapid blood glucose level is essential because hypoglycemia can mimic or drive altered consciousness and is treatable right away. A glove-side glucometer reading guides immediate management: if glucose is low, administer glucose promptly; if normal or high, you continue with cooling, reassessment, and supportive care. The other options aren’t the immediate next step because they don’t address a potential reversible cause of the AMS (glucose disturbance) and aren’t appropriate to perform before validating the patient’s metabolic status.