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Heat Stroke

- Discussion:
   - heat exhaustion:
         - dizzniness, fatigue, nause vomiting and mild temp elevation
   - heat stroke - core temp greater than 104 with mental status changes
         - brain loses ability to regulate heat (cooling system fails)
         - organ failure
         - strikes suddenly with little warning
         - brain death begins at 106 deg.
         - death may take 3-4 days;
         - peripheral temps may give falsely low readings;
   - sports prescreening issues
         - sickle cell trait
         - use of performance enhancing agents
                 - references:
                       - The neurosurgeon in sport: awareness of the risks of heatstroke and dietary supplements.
                       - Creatine Supplements
         - obesity
         - heat related illness
         - cardiac disease
   - prevention:
         - athletes needs 2 weeks to acclimate to the heat with progressive work outs.
         - regular breaks in the shade with fluid replacement
         - helmets will rapidly increase core temp
         - daily wts (before and after practice) to ensure that players have rehydraded
         - more than 3% wt loss from the prior day in unacceptable and requires rehydration (and no practice for that day);

   - treatment:
         - rehydration;
         - cold water immersion (ice water baths)
               - ref: On-Site Treatment of Exertional Heat Stroke
         - IV hydration / EMS / admission
         - liver enzymes
         - months before player may return to sports

CDC - Extreme Heat

Ice Treatment Called Crucial In Heat Stroke 

Management of Heatstroke and Heat Exhaustion

Validity of devices that assess body temperature during outdoor exercise in the heat. 

Are heat stroke and physical exhaustion underestimated causes of acute hepatic failure?

In Summer’s Heat, Watch What You Drink

The Claim: Diabetes Makes You Sensitive to Heat

After Heatstroke, When Is It Safe to Exercise?