Version June 2024
| Misconception | Explanation |
| Athletes stop sweating when they develop exertional heat stroke (EHS) | Since EHS occurs during intense exercise in the heat, athletes are almost always sweating profusely when they collapse. This widely held but completely inaccurate belief about EHS can delay diagnosis and is dangerous. |
| Athletes must be severely dehydrated to develop EHS | While dehydration may predispose athletes to exertional heat illness and can exacerbate EHS, it is not a necessary precondition. EHS can occur in as little as 20 minutes after the beginning of exercise, before severe fluid loss has occurred. Exercise intensity and environmental conditions (ie, heat and humidity) are the primary factors associated with EHS. |
| Body temperature can be accurately determined using external means | No external temperature assessment devices currently available have been proven accurate in athletes exercising in intense heat with a significant degree of hyperthermia. External temperature devices, including oral, tympanic, temporal, forehead sticker, and axillary devices, should never be used to diagnose EHS. The only device that is practical and accurate under these conditions is the rectal thermistor. |
| Lucid mental status in a patient with severe heat illness means everything is okay | Many patients with impending EHS appear lucid initially, only to progress to more severe disease. This initial period of normal mental function can mislead the clinician and obscure or delay the diagnosis. The lucid interval often coincides with minor central nervous system (CNS) dysfunction that is difficult to recognize. |
| Shivering delays cooling | Shivering does occur when a normothermic individual is placed in a cold water bath. However, this is seldom the case with hyperthermic individuals and rapid cooling occurs even in the few patients who manifest a shivering response. |
| The onset of exertional heat stroke (EHS) is unpredictable | Several predisposing factors for EHS are well documented. They include: environmental conditions (high temperature and/or high humidity), high intensity exercise, lack of acclimatization, poor physical fitness, equipment preventing heat loss, large mass to surface area ratio (eg, obesity), sleep deprivation, dehydration, and fever. |
| Cold water immersion puts the patient at risk of drowning | With proper precautions, there is almost no risk of drowning. Precautions include: supervising the patient at all times, obtaining adequate help from teammates and colleagues, and placing a sheet under the patient's armpits and across their chest to hold them upright and prevent their head from falling under water. |
| Cold water immersion is unsanitary | While unsanitary conditions may be present due to vomiting or diarrhea, an unsanitary tub is an acceptable tradeoff when providing a life-saving intervention. A dirty tub is easily cleaned. |
| Hypothermic afterdrop (continued cooling following immersion) can occur | Hypothermic afterdrop may be a concern if the athlete is cooled too long. However, if a proper measurement device (ie, rectal thermistor or rectal thermometer) is used, core body temperature can be closely monitored during treatment to prevent such an afterdrop. |
| Peripheral vasoconstriction (PVC) delays cooling | Although PVC may occur during cold water immersion, it has little impact compared to the large conductive and convective thermal transfer that rapidly cools the body. While initially PVC may increase core body temperature slightly even in an EHS patient, a rapid decrease in body temperature immediately follows. |
| Ice water immersion is uncomfortable for the patient | The physical comfort of the patient and staff is a secondary concern in the face of a life-threatening illness like EHS. No significant harm is sustained by the patient during appropriately managed ice water immersion therapy. |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
