Exertional Heat Stroke

2019 ◽  
pp. 59-79
Author(s):  
William M. Adams ◽  
Rebecca L. Stearns ◽  
Douglas J. Casa
2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Bertram K. Woitok ◽  
Shawki Bahmad ◽  
Gregor Lindner

Background.Exertional heat stroke is a life-threatening condition often complicated by multiorgan failure. We hereby present a case of a 25-year-old male presenting with syncope after a 10  km run in 28°C outside temperature who developed acute liver failure. Case Presentation. Initial temperature was found to be 41.1°C, and cooling measures were rapidly applied. He suffered from acute renal failure and rhabdomyolysis and proceeded to acute liver failure (ASAT 6100 U/l and ALAT 6561 U/l) due to hypoxic hepatitis on day 3. He did not meet criteria for emergency liver transplantation and recovered on supportive care. Conclusions. Acute liver failure due to heat stroke is a life-threatening condition with often delayed onset, which nevertheless resolves on supportive care in the majority of cases; thus, a delayed referral to transplant seems to be reasonable.


Author(s):  
Rebecca Hirschhorn ◽  
Oluwagbemiga DadeMatthews ◽  
JoEllen Sefton

This study evaluated emergency medical services (EMS) providers’ knowledge of exertional heat stroke (EHS) and assessed current EMS capabilities for recognizing and managing EHS. EMS providers currently practicing in the United States were recruited to complete a 25-item questionnaire. There were 216 questionnaire responses (183 complete) representing 28 states. On average, respondents were 42.0 ± 13.0 years old, male (n = 163, 75.5%), and white (n = 176, 81.5%). Most respondents were Paramedics (n = 110, 50.9%) and had ≥16 years of experience (n = 109/214, 50.9%) working in EMS. Fifty-five percent (n = 99/180) of respondents had previously treated a patient with EHS. The average number of correct answers on the knowledge assessment was 2.6 ± 1.2 out of 7 (~37% correct). Temporal (n = 79), tympanic (n = 76), and oral (n = 68) thermometers were the most prevalent methods of temperature assessment available. Chemical cold packs (n = 164) and air conditioning (n = 134) were the most prevalent cooling methods available. Respondents demonstrated poor knowledge regarding EHS despite years of experience, and over half stating they had previously treated EHS in the field. Few EMS providers reported having access to an appropriate method of assessing or cooling a patient with EHS. Updated, evidence-based training needs to be provided and stakeholders should ensure their EMS providers have access to appropriate equipment.


2021 ◽  
pp. bjsports-2020-103854
Author(s):  
Yuri Hosokawa ◽  
Sebastien Racinais ◽  
Takao Akama ◽  
David Zideman ◽  
Richard Budgett ◽  
...  

ObjectivesThis document aimed to summarise the key components of exertional heat stroke (EHS) prehospital management.MethodsMembers of the International Olympic Committee Adverse Weather Impact Expert Working Group for the Olympic Games Tokyo 2020 summarised the current best practice regarding the EHS prehospital management.ResultsSports competitions that are scheduled under high environmental heat stress or those that include events with high metabolic demands should implement and adopt policy and procedures for EHS prehospital management. The basic principles of EHS prehospital care are: early recognition, early diagnosis, rapid, on-site cooling and advanced clinical care. In order to achieve these principles, medical organisers must establish an area called the heat deck within or adjacent to the main medical tent that is optimised for EHS diagnosis, treatment and monitoring. Once admitted to the heat deck, the rectal temperature of the athlete with suspected EHS is assessed to confirm an elevated core body temperature. After EHS is diagnosed, the athlete must be cooled on-site until the rectal temperature is below 39°C. While cooling the athlete, medical providers are recommended to conduct a blood analysis to rule out exercise-associated hyponatraemia or hypoglycaemia, provided that this can be safely performed without interrupting cooling. The athlete is transported to advanced care for a full medical evaluation only after the treatment has been provided on-site.ConclusionsA coordination of care among all medical stakeholders at the sports venue, during transport, and at the hospital is warranted to ensure effective management is provided to the EHS athlete.


2008 ◽  
Vol 25 (5) ◽  
pp. 283-284 ◽  
Author(s):  
R Whiticar ◽  
D Laba ◽  
S Smith

1988 ◽  
Vol 11 (2) ◽  
pp. 184-187 ◽  
Author(s):  
M.E. Pattison ◽  
J.L. Logan ◽  
S.M. Lee ◽  
D.A. Ogden

2013 ◽  
Vol 42 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Zachary Y. Kerr ◽  
Stephen W. Marshall ◽  
R. Dawn Comstock ◽  
Douglas J. Casa

2007 ◽  
Vol 16 (3) ◽  
pp. 163-181 ◽  
Author(s):  
Brendon P. McDermott ◽  
Douglas J. Casa ◽  
Susan W. Yeargin ◽  
Matthew S. Ganio ◽  
Lawrence E. Armstrong ◽  
...  

Objective:To describe the current scientific evidence of recovery and return to activity following exertional heat stroke (EHS).Data Sources:Information was collected using MEDLINE and SPORTDiscus databases in English using combinations of key words, exertional heat stroke, recovery, rehabilitation, residual symptoms, heat tolerance, return to activity, and heat illness.Study Selection:Relevant peer-reviewed, military, and published text materials were reviewed.Data Extraction:Inclusion criteria were based on the article’s coverage of return to activity, residual symptoms, or testing for long-term treatment. Fifty-two out of the original 554 sources met these criteria and were included in data synthesis.Data Synthesis:The recovery time following EHS is dependent on numerous factors, and recovery length is individually based and largely dependent on the initial care provided.Conclusion:Future research should focus on developing a structured return-to-activity strategy following EHS.


2010 ◽  
Vol 9 (5) ◽  
pp. 314-321 ◽  
Author(s):  
Francis G. O'Connor ◽  
Douglas J. Casa ◽  
Michael F. Bergeron ◽  
Robert Carter ◽  
Patricia Deuster ◽  
...  

2010 ◽  
Vol 73 (4) ◽  
pp. 212-215 ◽  
Author(s):  
Ching-Wei Lee ◽  
Chin-Lin Perng ◽  
Yi-Shin Huang ◽  
Jiing-Chyuan Luo ◽  
Chi-Lai Hung ◽  
...  

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