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Prehosp Disaster Med. 2015 Jun;30(3):297-305. doi: 10.1017/S1049023X15004628. Epub 2015 Apr 10.

Exertional heat illness: emerging concepts and advances in prehospital care.

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1University of Connecticut,Department of Kinesiology,Storrs,Connecticut USA.
2University of Pittsburgh,Department of Emergency Medicine,Pittsburgh,Pennsylvania USA.
3SUNY University at Buffalo,Department of Exercise and Nutrition Sciences,Buffalo,New York USA.


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.


ACSM American College of Sports Medicine; EMS Emergency Medical Services; Emergency Medical Services; NATA National Athletic Trainers’ Association; WGBT Wet Globe Bulb Temperature; hyperthermia; mass event

[Indexed for MEDLINE]

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