Exertional Heat Stroke Knowledge and Management among Emergency Medical Service Providers

Abstract

This study evaluated emergency medical services (EMS) providers’ knowledge of exertional heat stroke (EHS) and assessed current EMS capabilities for recognizing and managing EHS. EMS providers currently practicing in the United States were recruited to complete a 25-item questionnaire. There were 216 questionnaire responses (183 complete) representing 28 states. On average, respondents were 42.0 ± 13.0 years old, male (n = 163, 75.5%), and white (n = 176, 81.5%). Most respondents were Paramedics (n = 110, 50.9%) and had ≥16 years of experience (n = 109/214, 50.9%) working in EMS. Fifty-five percent (n = 99/180) of respondents had previously treated a patient with EHS. The average number of correct answers on the knowledge assessment was 2.6 ± 1.2 out of 7 (~37% correct). Temporal (n = 79), tympanic (n = 76), and oral (n = 68) thermometers were the most prevalent methods of temperature assessment available. Chemical cold packs (n = 164) and air conditioning (n = 134) were the most prevalent cooling methods available. Respondents demonstrated poor knowledge regarding EHS despite years of experience, and over half stating they had previously treated EHS in the field. Few EMS providers reported having access to an appropriate method of assessing or cooling a patient with EHS. Updated, evidence-based training needs to be provided and stakeholders should ensure their EMS providers have access to appropriate equipment.

Prehospital emergency medicine for children receiving palliative home care in Germany—a cross-sectional, exploratory study of EMS providers

“…A strength of the questionnaires was a comprehensive sample size of >1,000 participants ( 27 – 30 ), with a high response rate of >80%, representing all levels of EMT and EMP education and providing broad insight into the experiences of EMS providers. The higher age of EMPs may be due to the longer duration of medical studies (6 years) compared with EMT training (520 h to 3 years).…”

Hourly Associations between Heat Index and Heat-Related Emergency Medical Service (EMS) Calls in Austin-Travis County, Texas

“…In addition, exposure to high temperatures for extended periods of time is a causal factor for a variety of heat-related illnesses, including heat cramps, heat stress, heat syncope, heat exhaustion, dehydration, heat stroke, and death [19,[21][22][23]. Previous research conducted on exertional heat stroke also has highlighted its severeness; it causes central nervous system (CNS) dysfunction (e.g., altered level of consciousness, disorientation, confusion, hysteria, irritability, aggressiveness, and seizure) [24][25][26][27]. Given that, incidents were also subdivided into the following categories based on the International Classification of Diseases, 11th revision (ICD 11): cardiovascular (n = 12,093), respiratory (n = 7587), neurological (n = 4619), and non-severe (n = 20,019) cases [28].…”

Treating exertional heat stroke: Limited understanding of the female response to cold water immersion

“…Notably, this cooling rate was achieved in 10 °C water; thus, an even greater rate and shorter immersion time may have been observed in colder water. Despite its role in EHS diagnosis and treatment, the use and availability of rectal temperature assessment tools in the field is limited, even for health professionals like athletic trainers and emergency medicine providers (Mazerolle et al, 2010;Hirschhorn et al, 2021). Accordingly, it is critical that this time-duration guideline, which is most pertinent in real-world scenarios, is confirmed to be safe and effective for women.…”

“…While rapid cooling is favourable in treating EHS, the potential risk of hypothermia exists if core temperature is not closely monitored via an in-dwelling rectal thermometer. Unfortunately, such temperature monitoring equipment is seldom used or accessible in the field despite its importance in EHS diagnosis and treatment (Mazerolle et al, 2010;Hirschhorn et al, 2021). Thus it begs the question, are the current EHS guidelines optimised to protect women?…”