Heat Stroke: Recognition, Cooling, and Transport Decisions

What differentiates heat stroke from heat exhaustion? Once central nervous system dysfunction appears, every minute spent at an elevated core temperature increases the risk of permanent neurologic injury or death.Ross and Will talk with emergency physician and wilderness medicine specialist Dr. Greg Doctor about the full spectrum of heat-related illness – from heat cramps, rash, and edema to syncope, exhaustion, and life-threatening heat stroke. They discuss how to avoid anchoring on the heat when a patient loses consciousness and what the critical dividing line between heat exhaustion and heat stroke is.

They also examine exercise-associated hyponatremia, drug-related hyperthermia, fluid selection, and the patients who may remain at risk even after they initially appear to recover.In this episode, you’ll learn:

How to distinguish heat syncope, heat exhaustion, and heat stroke

Why central nervous system dysfunction and an elevated core temperature matter most

How to choose between cold-water immersion, continuous water and fanning, ice sheets, and ice-water slurry techniques

When transport should be delayed for on-scene cooling, and when cooling should continue

Resources:Wilderness Medical Society Clinical Practice Guidelines for the Prevention & Treatment of Heat Illness: 2024 UpdateUnlocking Syncope with Matt MendesThe Critical Care of the Sick Runner: A Comprehensive Guide with Dr. Whitney BarrettWant more? Sign up for our weekly newsletter, The Confidence Dispatch.Want individualized coaching and mentorship? Check out The Loud & Clear Fellowship.Just have a question and want some personalized help? Book a free coaching call with us.Interested in ABLS Now? Our listeners get 10% off through the end of August.

Guests:Dr. Greg Doctor, emergency physician and wilderness medicine specialist