Expect the Unexpected: CNS Dysfunction in Exertional Heat Stroke at a Warm-Weather Road Race
Abstract:
Exertional heat stroke (EHS) is a life-threatening emergency defined by an elevated core body temperature and alteration in central nervous system (CNS) dysfunction. CNS changes may range from collapse secondary to loss of “hind limb” function to malaise, confusion, aggressiveness, and even coma. There is great variation with the timing and severity of the CNS dysfunction. In our 20+ year experience at a warm-weather road race, we have treated almost 500 patients with EHS. This presentation will review notable cases with examples of the varied presentations of CNS dysfunction.
Learning Objectives:
- Defend the use of rectal thermometry and CNS dysfunction to diagnose exertional heatstroke (EHS).
- Defend the use of cold-water immersion as the gold standard for treatment of EHS.
- Defend the use of rectal thermometry over mental status as a determinant of when to stop cooling.
Level:
Advanced
Domain(s):
Domain 2: Assessment Evaluation and Diagnosis
Domain 3: Critical Incident Management
Domain 4: Therapeutic Intervention
Orthopedic Domain(s):
N/A
CEUs:
1.0 Category A
Keywords:
Rectal temperature, rectal thermometer, cold-water immersion
In order to earn your CEUs, you must watch the session video in its entirety and complete the assessment.
Course Expiration:
All sessions of the NATA 76th Symposia On-Demand must be completed by October 31, 2025 at 11:59 p.m. CDT.
For full details, refer to the expiration policy on our FAQ page.
John Jardine, MD
John Jardine, MD, is a board certified emergency medicine physician. Dr. Jardine’s start in medicine was in Emergency Medical Services (EMS) as an EMT and then Paramedic in New York State. After 12 years of practicing prehospital medicine, Dr. Jardine earned his medical degree at Downstate Medical School in Brooklyn, NY. He completed residency in emergency medicine at Rhode Island Hospital/Brown University serving as chief resident in his senior year.
Dr. Jardine's interest in sports medicine was piqued when he first volunteered at the Falmouth Road Race in the summer of 2000. Two years later, he was appointed co-medical director of the race and has been directing medical operations since. Through the history of the race, the medical team has developed protocols for the treatment of exertional heat illness, and Dr. Jardine has treated nearly 500 cases of exertional heat stroke. He also serves as Chief Medical Officer for the Korey Stringer Institute at UCONN, with the mission to provide research and education to optimize safety and prevent sudden death in athletes, warfighters, and laborers. He has co-authored more than 40 peer-reviewed articles on the subject and has become a recognized expert in the treatment of exertional heat stroke.