title: Exertional heat illness: the role of heat tolerance testing.
abstract: Exertional heat stroke (EHS) is a common clinical problem for both athletes and warriors; however, evidence-based guidance for return-to-play/duty (RTP/RTD) decisions is limited. Heat tolerance testing (HTT) has been proposed as a potential tool that, when combined with appropriate clinical information, may assist in RTP/RTD decisions. However, currently, no standard of care is available for performing HTT. The Israeli Defense Forces (IDF) HTT protocol, which was developed over decades of careful research, has proven useful for IDF warriors and is utilized by other militaries to assist in RTD decisions. The present case studies are used to discuss the efficacy of the IDF HTT in determining RTD for two warriors who experienced EHS. Strengths and limitations of the IDF HTT, along with current and potential roles in clinical decision-making and in future thermoregulation research, are discussed.
authors.affiliation: Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD 20814, USA. josh.kazman@usuhs.edu
authors.forename: Josh Ben
authors.initials: JB
authors.lastname: Kazman
authors.forename: Yuval
authors.initials: Y
authors.lastname: Heled
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Lisman
authors.forename: Amit
authors.initials: A
authors.lastname: Druyan
authors.forename: Patricia Anne
authors.initials: PA
authors.lastname: Deuster
authors.forename: Francis G
authors.initials: FG
authors.lastname: O'Connor
mesh_terms: D000293:Adolescent; D001833:Body Temperature Regulation / Q000502:physiology; D005080:Exercise Test / Q000379:methods / Q000592:standards*; D018883:Heat Stroke / Q000175:diagnosis* / Q000503:physiopathology* / Q000517:prevention & control; D006801:Humans; D007557:Israel; D008297:Male; D008887:Military Medicine / Q000379:methods / Q000592:standards*; D008889:Military Personnel; D005082:Physical Exertion / Q000502:physiology*; D014481:United States; D055815:Young Adult