Table 3 Generally accepted unspecific treatment options for hyperthermia

Discontinue any neuroleptic agent or precipitating drug

Maintain cardiorespiratory stability

Control airway as needed

Cool with ice, ice-water immersion, misting or fans or use intravenous cooling techniques in severe cases

Control rigidity, agitation or seizures with diazepam or lorazepam, titrated to effect

Stop cooling at 38°C (usually after 30 minutes)

Use rectal or urinary bladder thermocouple for monitoring temperature

Maintain euvolemic state using normal saline and maintain urinary output at 1 to 2 ml/kg/hour

Anticipate disseminated intravasal coagulation, rhabdomyolysis, renal and hepatic failure, and hyperkalemia

Diagnose and treat infections as encephalitis and meningitis when clinically suspected

Avoid antipyretics, phenothiazines, and butyrophenones

Consider dantrolene or muscle relaxants in refractory cases; intubation and ventilation are likely to be required