Recognizing and treating heat-related illnesses

Techniques and approaches for emergency medical services and pharmacists

https://doi.org/10.53730/ijhs.v4nS1.15166

Authors

  • Abdulkarim Hamed Alsulami KSA, National Guard Health Affairs
  • Ibrahim Ahmad Dagha KSA, National Guard Health Affairs
  • Saif Helal Almutairi KSA, National Guard Health Affairs
  • Abdulrahman Abdullah Nazal Alanzi KSA, National Guard Health Affairs
  • Najlaa Saeed Alghamdi KSA, National Guard Health Affairs
  • Bandar Mansour Alanzi KSA, National Guard Health Affairs
  • Abdulrahman Ramadhan Alenezi KSA, National Guard Health Affairs
  • Fares Saqir Aldhafeeri KSA, National Guard Health Affairs
  • Sanad Samah Alharbi KSA, National Guard Health Affairs
  • Bader Naif Alotaibi KSA, National Guard Health Affairs
  • Meshal Falah Alenezi KSA, National Guard Health Affairs
  • Mohammed Rashed Aldhahri KSA, National Guard Health Affairs
  • Ahmed Saer Alshmari KSA, National Guard Health Affairs
  • Mohammed Ayyat Alanazi KSA, National Guard Health Affairs
  • Muath Saad Alsultan KSA, National Guard Health Affairs

Keywords:

Heat-related illnesses, endurance sports, exertional heat stress, emergency medical services, temperature regulation, athlete safety

Abstract

Background: The increasing frequency of endurance sports events and the associated risk of heat-related illnesses underscore the importance of effective recognition and treatment techniques for emergency medical services (EMS). High-profile incidents involving heat stress, such as those observed in Olympic and Ironman competitions, highlight the need for comprehensive strategies to manage exertional heat illnesses. Aim: This article aims to review current techniques and approaches for recognizing and treating heat-related illnesses via pharmacists, focusing on the implications for EMS during endurance sports events. Methods: A review of historical and recent cases of heat-related illnesses in endurance sports was conducted. This includes analyzing the physiological mechanisms of heat stress, examining the pathophysiology of heat-related injuries, and evaluating current medical guidelines and intervention strategies. Data were gathered from sports medicine literature, international sporting regulations, and recent research studies. Results: The review reveals that effective management of heat-related illnesses requires early recognition of symptoms, understanding the pathophysiology of heat stress, and implementing preventive measures. Key interventions include monitoring environmental conditions using wet globe bulb temperature (WGBT) indices, enforcing temperature limits in event planning, and improving athlete acclimatization and hydration strategies. The effectiveness of these measures varies depending on individual athlete responses and environmental conditions.

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References

Crowe J. Crowe’s nest: spirit of competition continues to drive her. Los Angeles Times 16 Jul 2007.

Cornwall W. Why do so many triathletes collapse just before the finish line? Triathlete 29 Sep 2016.

Howe AS, Boden BP. Heat-related illness in athletes. Med Sci Sports Exerc. 2007;39(3):556–72.

Guyton AC, Hall JE. Textbook of medical physiology. 11th ed. Philadelphia: Elsevier Saunders; 2006. p. 890–2.

Wilmore JH, Costill DL. Physiology of sport and exercise, vol. 1999. 2nd ed. Champaign, IL: Human Kinetics; 1999. p. 110–46.

Armstrong LE, Casa DJ, Millard-Stafford M, Moran DS, Pyne SW, Roberts WO. American College of Sports Medicine position stand. Exertional heat illness during training and competition. Med Sci Sports Exerc. 2007;39(3):556–72. DOI: https://doi.org/10.1249/MSS.0b013e31802fa199

Taylor NA. Human heat adaptation. Compr Physiol. 2014;4:325–65. https://doi.org/10.1002/cphy.c130022. DOI: https://doi.org/10.1002/cphy.c130022

Bergeron MF, Engebretsen L. Protecting elite athletes in extreme and challenging environments: advancing the dialogue. Br J Sports Med. 2012;46:769. https://doi.org/10.1136/bjsports-2012-091457. DOI: https://doi.org/10.1136/bjsports-2012-091457

Racinais S, Alonso JM, Coutts AJ, et al. Consensus recommendations on training and competing in the heat. Br J Sports Med. 2015;49:1164–73. DOI: https://doi.org/10.1136/bjsports-2015-094915

FINA Medical rules 2008.

Triathlon. ITU medical documents. Guidelines for exertional heat illness prevention. 30 Jan 2014.

Budd G. Wet-bulb globe temperature (WBGT)—its history and its limitations. J Sci Med Sport. 2008;11:20–32. DOI: https://doi.org/10.1016/j.jsams.2007.07.003

Smith JE. Cooling methods used in the treatment of exertional heat illness. Br J Sports Med. 2005;39:503–7. https://doi.org/10.1136/bjsm.2004.013466. DOI: https://doi.org/10.1136/bjsm.2004.013466

Bahr R, Reeser JC. New guidelines are needed to manage heat stress in elite sports: the Federation Internationale de Volleyball (FIVB) Heat Stress Monitoring Programme. Br J Sports Med. 2012;46:805–9. https://doi.org/10.1136/bjsports-2012-091102. DOI: https://doi.org/10.1136/bjsports-2012-091102

Mountjoy M, Alonso JM, Bergeron MF, et al. Hyperthermic related challenges in aquatics, athletics, football, tennis and triathlon. Br J Sports Med. 2012;46:800–4. https://doi.org/10.1136/bjsports-2012-091272. DOI: https://doi.org/10.1136/bjsports-2012-091272

Bergeron MF, Bahr R, Bärtsch P, et al. International Olympic Committee consensus statement on thermoregulatory and altitude challenges for high-level athletes. Br J Sports Med. 2012;46:770–9. https://doi.org/10.1136/bjsports-2012-091296. DOI: https://doi.org/10.1136/bjsports-2012-091296

Khan, A. A. (2019). Heat related illnesses: Review of an ongoing challenge. Saudi medical journal, 40(12), 1195. Brotherhood JR. Heat stress and strain in exercise and sport. J Sci Med Sport. 2008;11:6–19. DOI: https://doi.org/10.15537/smj.2019.12.24727

Tansey EA, Johnson CD. Recent advances in thermoregulation. Adv Physiol Educ. 2015 Sep;39(3):139–48. https://doi.org/10.1152/advan.00126.2014. DOI: https://doi.org/10.1152/advan.00126.2014

Nichols AW. Heat-related illness in sports and exercise. Curr Rev Musculoskelet Med. 2014;7(4):355–65. https://doi.org/10.1007/s12178-014-9240-0. DOI: https://doi.org/10.1007/s12178-014-9240-0

Argaud L, Ferry T, Le QH, Marfisi A, Ciorba D, Achache P, Ducluzeau R, Robert D. Short- and long-term outcomes of heatstroke following the 2003 heat wave in Lyon, France. Arch Intern Med. 2007;167:2177–83. DOI: https://doi.org/10.1001/archinte.167.20.ioi70147

Dematte JE, O'Mara K, Buescher J, Whitney CG, Forsythe S, McNamee T, Adiga RB, Ndukwu IM. Near-fatal heat stroke during the 1995 heat wave in Chicago. Ann Intern Med. 1998;129:173–81. DOI: https://doi.org/10.7326/0003-4819-129-3-199808010-00001

Huisse MG, Pease S, Hurtado-Nedelec M, Arnaud B, Malaquin C. Wolff et al Leukocyte activation: the link between inflammation & coagulation during heatstroke. A study of patients during the 2003 heat wave in Paris. Crit Care Med. 2008;36:2288–95. DOI: https://doi.org/10.1097/CCM.0b013e318180dd43

Tong HS, Tang YQ, Chen Y, Qiu JM, Wen Q, Su L. Early elevated HMGB1 level predicting the outcome in exertional heatstroke. J Trauma. 2011;71:808–14. DOI: https://doi.org/10.1097/TA.0b013e318220b957

Hubbard RW, Matthew CB, Durkot MJ, Francesconi RP. Novel approaches to the pathophysiology of heatstroke: the energy-depletion model. Ann Emerg Med. 1987;16:1066–75. DOI: https://doi.org/10.1016/S0196-0644(87)80760-6

Hubbard RW, Armstrong LE. The heat illness: biochemical, ultrastructural, & fluid-electrolyte considerations. In: Pandolf KB, Sawka MN, Gonzalez RR, editors. Human performance physiology & environment medicine at terrestrial extremes. Indianapolis, IN: Benchmark Press; 1988. p. 305–59.

Kim J, Lee J, Kim S, Ryu HY, Cha KS, Sung DJ. Exercise-induced rhabdomyolysis mechanisms and prevention: a literature review. J Sport Health Sci. 2016;5:324–33. DOI: https://doi.org/10.1016/j.jshs.2015.01.012

Bosenberg AT, Brock-Utne JG, Wells MT, Blake GT, Gaffin SL. Strenuous exercise causes systemic endotoxemia. J Appl Physiol. 1988;65:106–8. DOI: https://doi.org/10.1152/jappl.1988.65.1.106

Leon LR, Bouchama A. Heat stroke. Compr Physiol. 2015;5:611–47. https://doi.org/10.1002/cphy.c140017. DOI: https://doi.org/10.1002/cphy.c140017

Schwellnus MP. Cause of exercise associated muscle cramps (EAMC)-altered neuromuscular control, dehydration or electrolyte depletion? Br J Sports Med. 2009;43:401–8. DOI: https://doi.org/10.1136/bjsm.2008.050401

Bergeron MF. Exertional heat cramps: recovery and return to play. J Sport Rehabil. 2007;16(3):190–6. DOI: https://doi.org/10.1123/jsr.16.3.190

Stacey MJ, Parsons IT, Woods DR, Taylor PN, Ross D, Brett SJ. Susceptibility to exertional heat illness and hospitalisation risk in UK military personnel. BMJ Open Sport Exerc Med. 2015;1:000055. https://doi.org/10.1136/bmjsem-2015-000055. DOI: https://doi.org/10.1136/bmjsem-2015-000055

Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002;346:1978–88. DOI: https://doi.org/10.1056/NEJMra011089

Carter RIII, Cheuvront SN, Williams JO, et al. Epidemiology of hospitalizations and deaths from heat illness in soldiers. Med Sci Sports Exerc. 2005;37:1338–44. https://doi.org/10.1249/01.mss.0000174895.19639.ed. DOI: https://doi.org/10.1249/01.mss.0000174895.19639.ed

Stacey MJ, Brett S, Woods D, et al. Case ascertainment of heat illness in the British Army: evidence of under-reporting from analysis of Medical and Command notifications, 2009–2013. J R Army Med Corps. 2015; https://doi.org/10.1136/jramc-2014-000384.doi:10.1136/jramc-2014-000384. DOI: https://doi.org/10.1136/jramc-2014-000384

Abriat A, Brosset C, Brégigeon M, et al. Report of 182 cases of exertional heatstroke in the French Armed Forces. Mil Med. 2014;179:309–14. https://doi.org/10.7205/MILMED-D-13-0031. DOI: https://doi.org/10.7205/MILMED-D-13-00315

Dallam GM, Jonas S, Miller TK. Medical considerations in triathlon competition: recommendations for triathlon organisers, competitors and coaches. Sports Med. 2005;35:143–61. DOI: https://doi.org/10.2165/00007256-200535020-00004

Gosling CM, Gabbe BJ, McGivern J, et al. The incidence of heat casualties in sprint triathlon: the tale of two Melbourne race events. J Sci Med Sport. 2008;11:52–7. DOI: https://doi.org/10.1016/j.jsams.2007.08.010

Published

15-01-2020

How to Cite

Alsulami, A. H., Dagha, I. A., Almutairi, S. H., Alanzi, A. A. N., Alghamdi, N. S., Alanzi, B. M., Alenezi, A. R., Aldhafeeri, F. S., Alharbi, S. S., Alotaibi, B. N., Alenezi, M. F., Aldhahri, M. R., Alshmari, A. S., Alanazi, M. A., & Alsultan, M. S. (2020). Recognizing and treating heat-related illnesses: Techniques and approaches for emergency medical services and pharmacists. International Journal of Health Sciences, 4(S1), 229–242. https://doi.org/10.53730/ijhs.v4nS1.15166

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