Initial cooling measures can be initiated based on touch assessment of temperature but core temperature should be measured as soon as possible.

Remove the patients clothing (whilst preserving dignity), keep the patient in a cool environment and use fans to increase evaporative cooling.

Urgent cooling is required if the temperature exceeds 39 C this can be accomplished by intravenous infusion of cold fluids and immersion in ice baths.

Care must be taken not to cause iatrogenic hypothermia.

As ABD shares several features with Neuroleptic Malignant Syndrome and Malignant Hyperthermia, use of dantrolene may be considered.9,19 We advise following Toxbase advice.

Antipyretics such as paracetamol are not helpful as they help to lower the thermoregulatory set point in fever which is normal in the hyperthermia associated with ABD.20