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Exertional Heat Illness Spencer Tomberg Sports Medicine/Emergency Medicine Fellow University of Utah

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Exertional Heat Illness

Spencer TombergSports Medicine/Emergency Medicine Fellow

University of Utah

89.6

97.7100

12290.50

VS

RTP

Return to Play Protocol

No exercise for at least 7 days after discharge from medical care. Must be symptom free.

Follow-up in 1-week for repeat labs/imaging based on the affected organs.

Once cleared: exercise begins in a cool environment. Over 2-weeks exercise duration and heat exposure are increased. Build up heat tolerance and start acclimatization.

Re-eval athletes who are still symptomatic after 4-weeks of gradual return to activity. Exercise heat tolerance testing.

Athletes who progress well can transition to full training.

Full return to sport after 2-4 weeks of full training with no adverse events.

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ACSM Heat and Humidity Guidelines for Races. http://www.rrm.com/Newsarchives/archive11/11heat.htm

Anderson, J. Tomberg, S. Eastley, K. Exercise Associated Hyponatremia. Critical Decisions in Emergency Medicine. August 2017.Vol. 31, Number 8.

Asplund , CA1, O’Connor, FG. Challenging Return to Play Decisions: Heat Stroke, Exertional Rhabdomyolysis, and Exertional Collapse Associated With Sickle Cell Trait. Sports Health. 2016 Mar-Apr;8(2):117-25.

Auerbach, P. Wilderness Medicine: 6th Edition. Pathophysiology of Heat-Related Illnesses: CHAPTER 10. p 215-231.

Casa, D.J., Huggins, R.A. Exertional Heat Stroke: New Concepts Regarding Cause and Care. Current Sports Medicine Reports: May/June 2012 - Volume 11 - Issue 3 - p 115–123

Leberle, R, Trabold, B, et al. Association of high volumes of hydroxyethyl starch with acute kidney injury in elderly trauma patients.Injury. 2015 Jan;46(1):105-9.

Mutter, TC, Ruth, C, Dart, A. Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function. Cochrane Database Syst Rev. 2013 Jul 23;(7)

O’Connor, F.G., et al. American College of Sports Medicine Roundtable on Exertional Heat Stroke: Return to Duty/Returnto Play: Conference Proceedings.Current Sports Medicine Reports. Volume 9 c Number 5 c September/October 2010. P. 314-321.

Sylvester, J.E., et.al. Exertional Heat Stroke and American Football:What the Team Physician Needs to Know. The American Journal of Orthopedics. September/October 2016. No. 345. p341-348.