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What differentiates heat stroke from heat exhaustion? Once central nervous system dysfunction appears, every minute spent at an elevated core temperature increases the risk of permanent neurologic injury or death.
Ross and Will talk with emergency physician and wilderness medicine specialist Dr. Greg Doctor about the full spectrum of heat-related illness – from heat cramps, rash, and edema to syncope, exhaustion, and life-threatening heat stroke.
They discuss how to avoid anchoring on the heat when a patient loses consciousness and what the critical dividing line between heat exhaustion and heat stroke is.
They also examine exercise-associated hyponatremia, drug-related hyperthermia, fluid selection, and the patients who may remain at risk even after they initially appear to recover.
In this episode, you’ll learn:
- How to distinguish heat syncope, heat exhaustion, and heat stroke
- Why central nervous system dysfunction and an elevated core temperature matter most
- How to choose between cold-water immersion, continuous water and fanning, ice sheets, and ice-water slurry techniques
- When transport should be delayed for on-scene cooling, and when cooling should continue
Resources:
Wilderness Medical Society Clinical Practice Guidelines for the Prevention & Treatment of Heat Illness: 2024 Update
Unlocking Syncope with Matt Mendes
The Critical Care of the Sick Runner: A Comprehensive Guide with Dr. Whitney Barrett
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Guests:
Dr. Greg Doctor, emergency physician and wilderness medicine specialist
