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Exertional heat stroke (EHS) is defined by CNS dysfunction plus hyperthermia. Evidence supports “cool first, transport second.” Cold-water immersion (CWI) targeting rapid cooling (≥0.15–0.20°C/min) reduces morbidity/mortality; discontinue immersion when core temp falls to ~38.9–39.0°C to avoid overcooling. Option A delays definitive cooling and risks deterioration. Option C underutilizes the most effective modality; ice towels alone are inferior to CWI. NSAIDs (D) are inappropriate; they can worsen renal risk and do not treat hyperthermia. Ensure rectal temperature (gold standard) monitoring, continuous airway/breathing assessment, and remove excess clothing/equipment. Assign roles: one leader, one timer/recorder, immersion team, and EMS liaison. Post-event, review heat policy: acclimatization stages, WBGT-based modifications, hydration/education, and exertional sickling precautions. Maintain ready CWI setups (tub, tarp/“taco,” ice, water, thermometer) at all high-risk events.