title: Acute care for exercise-induced hyperthermia to avoid adverse outcome from exertional heat stroke.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Medical Branch, Ground Forces Command, Israel Defense Forces, Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Marom
authors.forename: David
authors.initials: D
authors.lastname: Itskoviz
authors.forename: Haim
authors.initials: H
authors.lastname: Lavon
authors.forename: Ishay
authors.initials: I
authors.lastname: Ostfeld
mesh_terms: D005334:Fever / Q000175:diagnosis* / Q000628:therapy*; D018883:Heat Stroke / Q000517:prevention & control*; D006801:Humans; D007557:Israel; D008297:Male; D008889:Military Personnel; D005082:Physical Exertion; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult