Proper Recognition and Management of Exertional Heat Stroke in a High School Cross Country Runner: A Validation Clinical Case Report

Abstract

A 14-year-old female high school cross country runner (height = 154 cm, mass = 48.1 kg) with no history of exertional heat stroke (EHS) collapsed at the end of a race. An athletic trainer (AT) assessed the patient, who presented with difficulty breathing then other signs of EHS (i.e. confusion, agitation). The patient was taken to the medical area, draped with a towel, and a rectal temperature (Tre) of 106.9°F(41.6°C) was obtained. The emergency action plan was activated and emergency medical services (EMS) were called. The patient was submerged in a cold-water immersion tub until EMS arrived (~15 minutes; Tre = 100.1°F; cooling rate: 0.41°F·min−1[0.25°C·min−1]). At the hospital, the patient received intravenous fluids, and urine and blood tests were normal. The patient was not admitted and returned to running without sequelae. Following best practices, AT's in secondary schools can prevent death from EHS by properly recognizing EHS and providing rapid cooling before transport.