Introduction
:
Exertional heat stroke (EHS) is a major concern in military
trainees performing intense physical exercise, with substantial morbidity rates.
Prehospital diagnosis of EHS is essentially clinical. Thus, soldiers, command
personnel, and medical staff are taught to recognize this injury and immediately
begin aggressive treatment to prevent further deterioration.
Patients and Meth
-
ods
:
During 2007, 5 otherwise healthy Israeli Defense Forces (IDF) soldiers were
diagnosed with EHS while performing strenuous exercise. They were treated
vigorously according to the IDF EHS-treatment protocol and were referred to
the emergency department.
Results
:
On arrival at the emergency department,
physical examination including rectal temperature was unremarkable in all
soldiers. Blood and urine workup showed near-normal values. No other medical
conditions that could have explained the clinical presentation were found. All
soldiers were discharged shortly afterward, with no further consequences. A heat-
tolerance test was performed several weeks after the event and was interpreted as
normal. All soldiers returned to active service.
Conclusion
:
Because the initial
clinical findings were very suggestive of EHS and because no other condition
could have explained the prehospital transient hyperthermia, we suggest that
these soldiers were correctly diagnosed with EHS, and we propose that rapid
vigorous cooling prevented further deterioration and complications. We suggest
calling this condition aborted heat stroke.