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Variance In Diagnosing Heat Illness Without The Kleiner Exertional Heat Illness Scale: 797 Board #19 9:00 AM -10:30 AM

Buczkowske, David J.; Kleiner, Douglas M. FACSM; Dooley, Dia B.

Medicine & Science in Sports & Exercise: May 2005 - Volume 37 - Issue 5 - p S147
C-21: Free Communication/Poster – Athlete Medical Evaluation and Care: THURSDAY, JUNE 2, 2005 9:00 AM - 12:00 PM: ROOM: Ryman C2

University of Florida, Jacksonville, FL

(Sponsor:Douglas M Kleiner, FACSM)

The Kleiner Exertional Heat Illness Scale (KEHIS) was developed to standardize the way various medical professionals classify heat illness. Its design enables clinicians from all backgrounds and specialties to apply standard criteria to signs and symptoms to more accurately determine severity.

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The purpose of this study was to illustrate how diverse clinical judgment can be if no universal scale is applied.

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40 physicians/residents/medical students (MD), nurses/nursing students (RN), and paramedics/paramedic students (EMT) were each given 10 written scenarios with various signs and symptoms from the 5 categories utilized by the KEHIS (muscle cramps, skin appearance, core temperature, mental status, and history of heat illness). The data from the 400 scenarios are initially reported as group data. Subjects were asked to estimate the severity of the heat illness, both numerically (0–25) and by category (mild, moderate or severe) based on the scenario presented. These data were then compared to values determined by the KEHIS score card. Descriptive data are presented as means (± SD), ranges, and percent of agreement.

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Mean KEHIS scores reported for the 400 scenarios were:MD = 15.4 (± 6.9)(range 1–25), RN = 14.9 (± 7.3)(range 1–25), EMT = 14.5 (± 6.9)(range 1–25), and KEHIS = 12.4 (± 5.5)(range 4–20). When evaluated by category, MD agreed with KEHIS 51%, RN agreed with KEHIS 58%, and EMT agreed with KEHIS 54%.

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These data demonstrate the inaccuracy and large amount of variability that is found in clinical diagnosis without the assistance of a universal scale. Additional research and further validation of the KEHIS is recommended.

©2005The American College of Sports Medicine