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Exertional Heat Stroke: New Concepts Regarding Cause and Care

Casa, Douglas J. PhD, ATC, FACSM, FNATA1,2; Armstrong, Lawrence E. PhD, FACSM1,2; Kenny, Glen P. PhD2,3; O’Connor, Francis G. MD, MPH, FACSM2,4; Huggins, Robert A. MEd, ATC1,2

Current Sports Medicine Reports: May/June 2012 - Volume 11 - Issue 3 - p 115–123
doi: 10.1249/JSR.0b013e31825615cc
Sideline and Event Management: Section Articles

When athletes, warfighters, and laborers perform intense exercise in the heat, the risk of exertional heat stroke (EHS) is ever present. The recent data regarding the fatalities due to EHS within the confines of organized American sport are not promising: during the past 35 years, the highest number of deaths in a 5-year period occurred from 2005 to 2009. This reminds us that, regardless of the advancements of knowledge in the area of EHS prevention, recognition, and treatment, knowledge has not been translated into practice. This article addresses important issues related to EHS cause and care. We focus on the predisposing factors, errors in care, physiology of cold water immersion, and return-to-play or duty considerations.

1Department of Kinesiology, University of Connecticut, Storrs, CT; 2Korey Stringer Institute, Neag School of Education, University of Connecticut, Storrs, CT; 3School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; and 4Military and Emergency Medicine, Uniformed Services University, Bethesda, MD

Address for correspondence: Douglas J. Casa, PhD, ATC, FACSM, FNATA, Korey Stringer Institute, Department of Kinesiology, University of Connecticut, 2095 Hillside Road, U-1110, Storrs, CT 06269-1110 E-mail:

© 2012 American College of Sports Medicine