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Exertional Heat Illness: Emerging Concepts and Advances in Prehospital Care

Published online by Cambridge University Press:  10 April 2015

Riana R. Pryor ,
Ronald N. Roth ,
Joe Suyama  and
David Hostler
Riana R. Pryor
Affiliation:
University of Connecticut, Department of Kinesiology, Storrs, Connecticut USA
Ronald N. Roth
Affiliation:
University of Pittsburgh, Department of Emergency Medicine, Pittsburgh, Pennsylvania USA
Joe Suyama
Affiliation:
University of Pittsburgh, Department of Emergency Medicine, Pittsburgh, Pennsylvania USA
David Hostler*
Affiliation:
SUNY University at Buffalo, Department of Exercise and Nutrition Sciences, Buffalo, New York USA
*
Correspondence: Dave Hostler, PhD Exercise and Nutrition Sciences SUNY University at Buffalo 212 Kimball Tower Buffalo, New York 14226 USA E-mail: dhostler@buffalo.edu
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Abstract

Exertional heat illness is a classification of disease with clinical presentations that are not always diagnosed easily. Exertional heat stroke is a significant cause of death in competitive sports, and the increasing popularity of marathons races and ultra-endurance competitions will make treating many heat illnesses more common for Emergency Medical Services (EMS) providers. Although evidence is available primarily from case series and healthy volunteer studies, the consensus for treating exertional heat illness, coupled with altered mental status, is whole body rapid cooling. Cold or ice water immersion remains the most effective treatment to achieve this goal. External thermometry is unreliable in the context of heat stress and direct internal temperature measurement by rectal or esophageal probes must be used when diagnosing heat illness and during cooling. With rapid recognition and implementation of effective cooling, most patients suffering from exertional heat stroke will recover quickly and can be discharged home with instructions to rest and to avoid heat stress and exercise for a minimum of 48 hours; although, further research pertaining to return to activity is warranted.

Pryor RR, Roth RN, Suyama J, Hostler D. Exertional Heat Illness: Emerging Concepts and Advances in Prehospital Care. Prehosp Disaster Med. 2015;30(3):19.

Keywords

Emergency Medical Serviceshyperthermiamass event

Information

Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 3 , June 2015 , pp. 297 - 305
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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