How to treat exertional heat stroke

Exertional heat stroke is arguably one of the most serious medical conditions that can affect athletes. Up to 15% of patients die. Others suffer permanent organ and neurological damage.

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By definition, exertional heat stroke encompasses a core body temperature greater than 40°C (104°F) and altered mental status. It is believed to be the culmination of overheating from either dangerous environmental conditions or increases in body temperature from exertion, or both.

In this video, I discuss how athletic trainers and doctors can recognize and treat athletes suffering this emergency.

A baseline measurement of the athlete’s core body temperature is critical. The athletic trainer should take a rectal temperature, as it is better at determining core body temperature than other methods of taking a person’s temperature.

If an athlete does suffer heat stroke, athletic trainers and doctors can still prevent the athlete from dying if they recognize it and start treatment immediately.

It’s critical that doctors and athletic trainers recognize any alterations in mental status or other central nervous system dysfunction and obtain a rectal temperature to properly assess core body temperature. Then the medical staff must treat the athlete on site instead of first transporting him to hospital. They should use cold water immersion – putting him in a cold bath – to get his temperature down below 104°F. Then the athlete can be transported to a hospital.

Please remember, while I appreciate your questions, I cannot and will not offer specific medical advice by email, online, on my show, or in the comments at the end of these posts. My responses are meant to provide general medical information and education. Please consult your physician or health care provider for your specific medical concerns.