Predisposing Risk Factors on Susceptibility to Exertional Heat Illness: Clinical Decision-Making Considerations

Abstract

For any heat illness prevention program to be effective, greater attention and continued observation is needed for athletes at high risk for EHI. For many athletic teams or programs, because of the sheer numbers and associated catastrophic injury potential, health care professionals must implement a system by which high-risk individuals are monitored during activity with the highest level of vigilance for prevention of EHI.

On-Site Treatment of Exertional Heat Stroke

“…1 Included in this are genetic predisposition, 17 hydration status, sleep status, and medications. 8 Future studies or registries should include these factors to further our understanding of risk factors involved in the development of exertional heat stroke.…”

Emergency Response of Indian Hajj Medical Missionto Heat Illness Among Indian Pilgrims in Tent-Clinics atMina and Arafat During Hajj, 2016

“…Pilgrims, caretakers, administrators, and healthcare personnel should be kept in sync with health protection against heat illness through Heat Alert Response Systems based on Wet Bulb Globe Temperature-based assessment so as to prevent social attenuation in lean periods. 12,36 Technological advancements such as healthcare robots and drones can facilitate rapid relief, the provision of medical supplies, and can minimize human resource deployment in future Hajj pilgrimages. 38 The IPPC warns about the increasing frequency and/or intensity of heat waves leading to heat-related premature mortality of the urban poor and primarily the elderly in cities What Is Already Known?…”

“…Education on religious concessions to Hajj rituals so as to minimize heat exposure and enhance health protection, hydration, and behavioral modification can be disseminated in mosques. 36,37 Information on first response training on moving patients to shade, administering cold baths/ sponging, providing cold non-alcoholic fluids, elevating feet, and evacuating patients to a medical facility needs to be disseminated to pilgrims in mass gatherings. Pilgrims, caretakers, administrators, and healthcare personnel should be kept in sync with health protection against heat illness through Heat Alert Response Systems based on Wet Bulb Globe Temperature-based assessment so as to prevent social attenuation in lean periods.…”

Exertional Heat Stroke in Athletes

“…Those are athletes who have some medical or physiological condition that can provoke heat intolerance [18,19]. A comprehensive list of predisposing factors for EHS is shown in Table 1.…”

“…These factors exert their negative effects mainly through disruption of body's thermoregulation by either impairing heat dissipation process or increasing endogenous heat production [17]. Lack of heat acclimation, poor fitness level, obesity, dehydration and current or recent illness are considered to be the most significant predisposing factors for EHS [18,20]. Sleep loss and generalized fatigue are acknowledged as predisposing factors, and have been implicated in several EHS cases [21].…”