Medical Services

Exertional heat illness (EHI) encompasses a range of injuries occurring when physical activity in hot environments causes body heat gain to exceed heat loss. This spectrum includes heat cramps, heat syncope, heat exhaustion, rhabdomyolysis, and the life-threatening exertional heat stroke.

EHI incidence rises during warmer months, with highest rates in American football, running, cycling, and adventure races. Predisposing factors include inadequate heat acclimation, dehydration, sleep deprivation, prior heat illness, and inappropriate clothing.

Heat exhaustion presents with core temperature below 102.2°F (39°C), profuse sweating, nausea, vomiting, fatigue, thirst, dizziness, and nausea but no central nervous dysfunction. Treatment involves body cooling and oral rehydration.

Exertional heat stroke is a medical emergency with core temperature exceeding 102.2°F (40°C), CNS dysfunction (confusion, disorientation, coma), and potential multi-organ failure. Signs include tachycardia, hypotension, altered mental status, slurred speech, and seizures. Immediate whole-body cooling via cold water immersion is critical before evacuation, with rapid cooling within one hour typically resulting in full recovery.

Prevention requires gradual heat acclimatization, activity modification in high-risk environments, and monitoring weather temperatures—sports should postpone when exceeding 86°F. Post-stroke, athletes rest 7 days before gradual return over one month.