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What is exertional heat stroke (EHS)?

  • Life-threatening medical emergency
  • Body’s temperature is too high
  • Left untreated, exertional heat stroke results in death due to organ damage across all body systems (liver, kidney, brain, etc.)
  • Until medical help arrives, the key is to immediately lower elevated body temperature
  • EHS is different from classic heat stroke, which usually effects children and the elderly during prolonged hot weather.

What is exertional heat stroke (EHS)?

  • Life-threatening medical emergency
  • Body’s temperature is too high
  • Left untreated, exertional heat stroke results in death due to organ damage across all body systems (liver, kidney, brain, etc.)
  • Until medical help arrives, the key is to immediately lower elevated body temperature
  • EHS is different from classic heat stroke, which usually effects children and the elderly during prolonged hot weather.

Symptoms

Rectal temperature over 105 degrees (oral, axillary, tympanic, and temporal measurements are inaccurate and cannot be trusted).

And any or all of the following:

  • Erratic pulse (strong and rapid or weak and rapid)
  • Lack of coordination
  • Collapse
  • Low blood pressure
  • Vomiting
  • Headache
  • Loss of consciousness and/or seizure
  • Shock
  • Irritability, confusion, disorientation
  • Sweaty skin that may be red/flushed or pale

Risk factors

Risk factors

Treatment

Rapid and aggressive whole-body cooling is the key to survival of EHS. The goal is to lower core body temperature to less than 102.5 degrees Fahrenheit within 30 minutes of collapse.

  • Remove all equipment and excess clothing.
  • Cool the athlete as quickly as possible within 30 minutes via whole body ice water immersion (place them in a tub or other container with ice and water). Stir water and add ice throughout cooling process.
  • If immersion is not possible take athlete to a shaded, cool area and use rotating cold, wet towels to cover as much of the body surface as possible. A cold shower is also an alternative if full body immersion is not available.
  • Maintain airway, breathing and circulation.
  • After cooling has been initiated, activate emergency medical system by calling 911
  • Monitor vital signs such as rectal temperature, heart rate, respiratory rate, and blood pressure.
  • Cease cooling when rectal temperature reaches 101-102˚F. Body temperature will decrease 1 degree for every 5 minutes athletes are in a cold tub. If rectal temperature is not available, DO NOT USE AN ALTERNATE METHOD (oral, tympanic, axillary, forehead sticker, etc.). These devices are not accurate and should never be used to assess an athlete exercising in the heat.

Content by Susan Yeargin Ph.D ATC

Learn Even More!

Link to NFL Article
Link to NFL Article
Link to NFL Article
Link to NFL Article