ACSM Expert Consensus Statement on Exertional Heat Illness: Recognition, Management, and Return to Activity

Area of Science:

• Sports Medicine
• Environmental Physiology
• Emergency Medicine

Background:

• Exertional heat stroke (EHS) presents a significant risk of organ damage and mortality.
• Effective management hinges on a coordinated chain of survival, encompassing rapid recognition, intervention, and inter-team communication.

Purpose of the Study:

• To provide healthcare professionals with clear definitions and management strategies for exertional heat illness (EHI), including exertional heat exhaustion, exertional heat injury, and EHS.
• To emphasize the critical importance of early identification, cessation of activity, and rapid whole-body cooling for EHS survival.

Main Methods:

• This consensus statement synthesizes current knowledge on EHS.
• It highlights the necessity for healthcare providers to understand EHS definitions, causes, and subtle differences from other heat illnesses.
• Focuses on the critical time-sensitive nature of EHS management, comparing it to other life-threatening conditions.

Main Results:

• Early identification of suspected EHS, immediate cessation of physical activity, and rapid total body cooling are paramount for survival.
• Outcomes are closely linked to the duration of severe hyperthermia.
• Prevention strategies involve recognizing and mitigating risk factors through leadership, policy, and accessible on-site healthcare.

Conclusions:

• A synchronized chain of survival is essential for optimal EHS management.
• Prompt recognition and cooling are critical interventions.
• Prevention through risk factor modification and policy is key to reducing EHS incidence.