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Exertional Heat Stroke

  • William M. AdamsEmail author
  • Rebecca L. Stearns
  • Douglas J. Casa
Chapter
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Abstract

Exertional heat stroke (EHS), defined as an internal body temperature > 40 °C with associated neuropsychiatric impairment, is a medical emergency, requiring prompt recognition, management, and care to ensure survival. Caused by a number of intrinsic (e.g., acclimatization status, cardiovascular fitness, hydration) and extrinsic (e.g., environmental conditions, clothing requirements, work-to-rest ratios) risk factors, these risk factors can create a “perfect storm” to overwhelm an individual’s thermoregulatory capacity during exercise or physical activity. In the event EHS is suspected, prompt recognition and assessment of the patient’s internal body temperature and cognitive function is vital in order to guide the proper treatment plan. When EHS is confirmed, aggressive, whole-body cooling is required to cool the patient under the critical threshold for cell damage (40.83 °C) within 30 minutes of collapse to optimize the chances of survival without long-term sequelae. Following the EHS incident, considerations must be taken in order to augment the recovery process prior to returning back to full activity/duty/work. This chapter will provide an evidence-based review of the etiology, pathophysiology, and management and care of EHS for clinicians and scientists to utilize in order to optimize the care provided to athletes, soldiers, and laborers at risk for EHS.

Keywords

Hyperthermia Cold water immersion Rectal temperature Cool first, transport second Risk factors 
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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • William M. Adams
    • 1
    Email author
  • Rebecca L. Stearns
    • 2
  • Douglas J. Casa
    • 2
  1. 1.Department of KinesiologyUniversity of North Carolina at GreensboroGreensboroUSA
  2. 2.Korey Stringer Institute, Department of Kinesiology, University of ConnecticutStorrsUSA

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