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Heat-related injuries in athletes. Heat illnesses include a spectrum of conditions ranging from heat syncope, heat cramps, and heat exhaustion to the more severe heat strokes.

Heat syncope. Heat syncope's a form of orthostatic hypotension that is related to dehydration. It occurs due to inadequate cardiac output and hypotension.
It occurs with standing quickly after sitting or lying down for prolonged durations in the heat.
Symptoms include fainting, dizziness and lightheadedness.
Treatment includes oral rehydration with water, juice or sports drinks and placing the patient flat on the ground in a cool area with slight elevation of the legs to push the blood back to the vital organs, such as the brain.

These painful muscle cramps occur due to the decreased sodium concentration in the blood.
The patient's core temperature is usually not elevated.
Sodium may decrease when salts are lost in sweat or with excessive water intake that does not include electrolytes, leading to a situation called dilutional hyponatremia. Symptoms include painful muscle cramps occurring commonly in the abdominal muscles, arms, legs and thighs. Treatment includes rest, cooling and IV fluids or oral rehydration with fluids which are rich in electrolytes such as sports drinks and juices to replenish the sodium stores. Heat cramps could be prevented by consuming fluids rich in electrolytes before strenuous activities.

Heat exhaustion. Heat exhaustion is the most common heat illness. The body temperature is elevated, but still less than 40 degrees Celsius. Core body temperature is best measured rectally.
Signs and symptoms include profuse sweating, a core body temperature that is elevated, but still lower than 40 degrees Celsius, weakness and fatigue, cramping, headaches, nausea and vomiting,
fainting, hypotension, increased heart rate and fast, shallow breathing.
Treatment includes rest, IV fluids or oral rehydration and rapid cooling by whole-body immersion in an ice bath.

Heat stroke. Heat stroke is the most severe form of heat illness. It is a medical emergency that needs immediate attention and the patient should be transported to the hospital as soon as possible.
Heat strokes occur due to failure of the body's normal thermoregulatory mechanism. If treatment is not started promptly, end organ failure and ultimately death may occur.
Heat strokes have a high mortality rate and require quick reduction of the patient's temperature.
The three most characteristic features of this condition include lack of sweating and a core body temperature that is elevated beyond 40 degrees Celsius, as well as altered mental status.
Additional signs and symptoms include hot, dry skin; disorientation, confusion and hallucinations; as well as headache and slurred speech.
One must remember that this is a serious medical emergency that requires rapid core body temperature reduction. Airway, breathing and circulation should be monitored closely.
Basic and advanced cardiac life support protocols should be implemented promptly. Rapid temperature reduction is achieved by immersing the whole body in an ice bath. Additionally, IV fluids should be administered.
Quizzes

1. What is the most severe form of heat illness?
A. Heat syncope
B. Heat cramps
C. Heat exhaustion
D. Heat stroke
Answer: D. Heat stroke
Explanation: It is a medical emergency with a high mortality rate if not treated rapidly.

2. What is a key distinguishing feature of heat stroke?
A. Profuse sweating
B. Dizziness only
C. Mild fatigue
D. Altered mental status
Answer: D. Altered mental status
Explanation: Confusion and hallucinations are classic signs of heat stroke.

3. What body position is recommended in heat syncope?
A. Sitting upright
B. Leaning forward
C. Lying flat with legs elevated
D. Standing still
Answer: C. Lying flat with legs elevated
Explanation: This improves blood return to the brain.

4. Which symptom is typical of heat exhaustion but not heat stroke?
A. Hot, dry skin
B. Profuse sweating
C. Confusion
D. Hallucinations
Answer: B. Profuse sweating
Explanation: Heat exhaustion presents with heavy sweating, unlike heat stroke.

5. What is the core body temperature threshold for diagnosing heat stroke?
A. 38°C
B. 39°C
C. Above 40°C
D. 36°C
Answer: C. Above 40°C
Explanation: This marks the dangerous threshold in heat stroke.

6. Which of the following is a cause of dilutional hyponatremia?
A. Eating too much salt
B. Excess water without electrolytes
C. Low potassium
D. Vitamin deficiency
Answer: B. Excess water without electrolytes
Explanation: Drinking plain water in excess can dilute blood sodium.

7. What is the preferred method for accurate core temperature measurement?
A. Oral thermometer
B. Axillary thermometer
C. Forehead scanner
D. Rectal thermometer
Answer: D. Rectal thermometer
Explanation: This is the most accurate for core body temperature.