Management of Exertional Heat Stroke in Athletics: Interdisciplinary Medical Care

Abstract

Management of exertional heat stroke (EHS) requires seamless coordination between medical (e.g., team physician, primary care physician, emergency physician, athletic trainer, physiotherapist) and nonmedical (e.g., athlete, coaches, administrative officials, parents) stakeholders of athlete’s health and safety. These individuals are expected to work together to optimize EHS prevention, pre-hospital care, transport, in-hospital care, and return to physical activity. At each level of EHS management, both medical and nonmedical stakeholders must understand and implement current best practices from leading sports medicine associations. In athletic settings, it is often the qualified on-site medical personnel’s job (e.g., athletic trainer, physiotherapist) to serve as the gatekeeper of relevant information and ensure medical and nonmedical stakeholders understand the need and responsibility to execute current best practices. In the last decade, various guidelines and statewide policies on EHS management have been introduced by medical and athletic organizations. Among those that mandated the use of evidence-based best practices, longitudinal and cross-sectional data are now starting to observe favorable reductions in heat-related injuries. These data demonstrate the effectiveness of systemic policy implementation and further support the need to involve all stakeholders of athlete’s health and safety to take part in the management of EHS.