Exertional heat stroke

Exertional heat stroke is a circumstantial pathology that the emergency physician must be able to evoke in the event of any sudden neurological disorder occurring during prolonged exercise. Exposure to heat is a contributive factor but its absence should not lead to the diagnosis being ruled out. Real prehospital emergency, exertional heat stroke can lead to multi visceral failure and death if the patient does not benefit from early cooling in the field. The gold standard of treatment is immediate immersion in water as cold as possible. Properly carried out, this rapidly improves consciousness and prevents the onset of complications. The challenge is therefore logistical for sports organizers and prehospital medical teams, who must ensure that bathtubs, water and ice cubes are available in sufficient quantities. The use of makeshift means (tarpaulins or covers filled with water and ice cubes) remains an alternative in the absence of specific equipment. Other medical measures are usually less urgent, and should under no circumstances delay the cooling process. Evacuation to a hospital will only be undertaken with a cooled patient whose target core temperature is <= 38.5 degrees C, measured rectally. Referral is then conditioned by the patient's clinical condition and the kinetics of the patient's care. Expected climate change and in particular the democratization of running events, are prompting our departments to step up their training and organizational efforts to better prevent, detect and treat exertional heat stroke.