Prehospital Management of Exertional Heat Stroke in Field of Play Athlete Medical Service : Keeping the Olympic and Paralympic Legacy Alive

Abstract

Prognosis from exertional heat stroke depends on the duration of exercise-induced hyperthermia above 40°C with impaired central nervous dysfunction. The prognosis is reported to worsen once the duration of symptomatic hyperthermia exceeds 30 minutes. Therefore, it is imperative to start the treatment of collapsed patient before hospital admission. However, it is extremely difficult to execute exertional heat stroke prehospital care in Japan due to its regulation on medical practice. Nevertheless, delivery of prehospital care for exertional heat stroke patients may be possible in mass sporting events where medical personnel are stationed at the venue. When there is a foreseeable risk of exertional heat stroke, one must consider developing a policy and procedure that allows for trained professionals to implement prehospital treatment.