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American College of Sports Medicine Roundtable on Exertional Heat Stroke - Return to Duty/Return to Play: Conference Proceedings

O'Connor, Francis G.; Casa, Douglas J.; Bergeron, Michael F.; Carter, Robert III; Deuster, Patricia; Heled, Yuval; Kark, John; Leon, Lisa; MCDermott, Brendon; O'Brien, Karen; Roberts, William O.; Sawka, Michael

doi: 10.1249/JSR.0b013e3181f1d183
Special Communication

On October 22-23, 2008, an ACSM Roundtable was convened at the Uniformed Services University (Bethesda, MD) to discuss return-to-play or return-to-duty for people who have experienced exertional heat illness (EHI) and to develop consensus-based recommendations. The conference assembled experts from the civilian sports medicine community and the Department of Defense to discuss relevant EHI issues, such as potential long-term consequences, the concept of thermotolerance, and the role of thermal tolerance testing in return-to-play decisions. Although the group was unable to move forward with new consensus recommendations, they clearly documented critical clinical concerns and scientific questions, including the following: 1) no uniform core definitions of EHI; 2) limited validated criteria to assess recovery from exertional heat stroke (EHS); and 3) inadequate ability to predict who may be predisposed to a subsequent heat injury after EHS. Areas of potential future research are identified.

1Military and Emergency Medicine, Consortium for Health and Military Performance, Uniformed Services University, Bethesda, MD; 2Korey Stringer Institute, Neag School of Education, University of Connecticut, Storrs, CT; 3Sanford School of Medicine of the University of South Dakota, Sioux Falls, SD; 4U.S. Army Research Institute of Environmental Medicine Thermal and Mountain Medicine Division, Natick, MA; 5Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, Israel; 6Department of Hematology, Thomas Jefferson University, Philadelphia, PA; 7Department of Health and Human Performance, University of Tennessee at Chatanooga, Chattanooga, TN; 8Command Surgeon, U.S. Army Training and Doctrine Command; 9Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN

Address for correspondence: Francis G. O'Connor, M.D., M.P.H., FACSM, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814 (E-mail:

Copyright © 2010 by the American College of Sports Medicine.