Consensus Statement- PreHospital Care of Exertional Heat Stroke By: Luke N. Belval, Douglas J. Casa, William M. Adams, George T. Chiampas, Jolie C. Holschen, Yuri Hosokawa, John Jardine, Shawn F. Kane, Michele Labotz, Renée S. Lemieux, Kyle B. McClaine, Nathaniel S. Nye, Francis G. O'Connor, Bryan Prine, Neha P. Raukar, Michael S. Smith & Rebecca L. Stearns Belval LN, Casa DJ, Adams WM, Chiampas GT, Davis R, Holschen J, Hosokawa Y, Jardine JF, Kane SF, Labotz M, Lemieux R, McClaine K, Nye NS, O’Connor FG, Prine B, Raukar N, Smith MS, Stearns RL. Consensus Statement- PreHospital Care of Exertional Heat Stroke. Prehospital Emergency Care. 2018;22(3):392-397. https://doi.org/10.1080/10903127.2017.1392666 This is an Accepted Manuscript of an article published by Taylor & Francis in Prehospital Emergency Care on 16 January 2018, available online: http://www.tandfonline.com/10.1080/10903127.2017.1392666. ***© 2018 National Association of EMS Physicians. Reprinted with permission. No further reproduction is authorized without written permission from Taylor & Francis. This version of the document is not the version of record. *** Abstract: Exertional heat stroke (EHS) is one of the most common causes of sudden death in athletes. It also represents a unique medical challenge to the prehospital healthcare provider due to the time sensitive nature of treatment. In cases of EHS, when cooling is delayed, there is a significant increase in organ damage, morbidity, and mortality after 30 minutes, faster than the average EMS transport and ED evaluation window. The purpose of this document is to present a paradigm for prehospital healthcare systems to minimize the risk of morbidity and mortality for EHS patients. With proper planning, EHS can be managed successfully by the prehospital healthcare provider. Keywords: heat stroke | heat stress disorders | hyperthermia | sports | exercise Article: INTRODUCTION Exertional heat stroke (EHS) is an emergent hyperthermic condition that occurs in individuals performing physical activity, typically in warm environments (1, 2), but can also occur with exertion or impaired heat dissipation in cool environments (3). This is contrasted by classic heat stroke, which occurs more commonly in those lacking normal thermoregulation, such as the elderly and infants during heat waves. EHS is characterized by severe hyperthermia (>40.5°C) and end organ dysfunction, which typically manifests as central nervous system (CNS) dysfunction (4). Optimal outcomes from EHS requires rapid reversal of hyperthermia through whole body cooling (5, 6). Evidence has shown that immediate and aggressive cooling after brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by The University of North Carolina at Greensboro