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Heat-related illness

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Updated 2024 WMS guidelines for the prevention and management of heat-related illness.

Guidelines

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The following summarized guidelines for the evaluation and management of heat-related illness are prepared by our editorial team based on guidelines from the Wilderness Medical Society (WMS 2024). ...
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Classification and risk stratification

Risk assessment: as per WMS 2024 guidelines, use the wet-bulb globe temperature if available as the preferred metric for the assessment of environmental heat risk.
A
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Diagnostic investigations

Temperature measurement: as per WMS 2024 guidelines, use rectal temperature as the preferred measure for core temperature when assessing heat illness.
B

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  • Screening for comorbidities

Medical management

Setting of care: as per WMS 2024 guidelines, offer supportive care, including rest in a cool area and replenishment of basic fluid and nutritional needs in patients with a first episode of minor heat illness.
B
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  • Rehydration

  • Intravenous cold fluids

  • Antipyretics

  • Dantrolene

Nonpharmacologic interventions

Initiation of cooling: as per WMS 2024 guidelines, initiate passive cooling measures in the field to minimize thermal strain and maximize heat loss.
B
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  • Cold water immersion

  • Ice packs

  • Evaporative cooling

  • Other methods of cooling

Preventative measures

Acclimatization: as per WMS 2024 guidelines, advise heat-exposed exertion 1-2 hours/day for at least 7 days to achieve full acclimatization to a hot environment.
B

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  • Aerobic exercise

  • Hydration

  • Clothing

  • Rest

  • Avoidance of drugs