From the Guidelines
The best course of treatment for an individual experiencing temperature regulation issues, specifically hyperthermia, after an endurance race is to move them from the hot environment, remove excess clothing, limit exertion, and provide cool liquids if the person is able to swallow, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Initial Assessment and Intervention
When dealing with hyperthermia after an endurance race, it's crucial to act quickly to prevent the condition from escalating to heatstroke. The initial steps should include:
- Moving the individual to a cool, shaded area to reduce further heat exposure
- Removing excess clothing to facilitate heat loss
- Limiting exertion to prevent generating more body heat
- Providing cool liquids for the person to drink if they are conscious and able to swallow, as suggested by the guidelines 1
Active Cooling Measures
For individuals with heatstroke, characterized by altered mental status, immediate active cooling is recommended, and whole-body cool- to cold-water immersion for 15 minutes or until neurological symptoms resolve is a reasonable approach, according to the guidelines 1. If water immersion is not available, other forms of active cooling such as commercial ice packs, cold showers, ice sheets and towels, cooling vests and jackets, and evaporative or fanning techniques can be used. The target core temperature to cool until is 39° C (102.2° F) 1.
Monitoring and Medical Attention
It's essential to monitor the individual's condition closely and be prepared to seek immediate medical attention if symptoms worsen or if the person shows signs of severe heatstroke, such as confusion, loss of consciousness, or a core temperature above 104°F (40°C). In such cases, IV fluids may be necessary, and medical professionals can provide the appropriate care to prevent complications like seizures, rhabdomyolysis, or kidney injury.
From the Research
Temperature Regulation Issues after Endurance Race
- Temperature regulation issues, such as hyperthermia, can occur after an endurance race due to various factors, including environmental conditions, individual health status, and physical exertion 2, 3, 4, 5.
- Hyperthermia is a life-threatening condition that requires immediate treatment to prevent long-term consequences, such as organ damage and even death 2, 3.
Treatment Options for Hyperthermia
- Ice-water immersion has been shown to be highly effective in treating exertional heat stroke, with a zero fatality rate in large case series of younger, fit patients 2.
- Evaporative plus convective cooling may be augmented by crushed ice or ice packs applied diffusely to the body, and chilled intravenous fluids may also supplement primary cooling 2.
- Cold intravenous saline infusion has been studied as a potential treatment for whole-body cooling, but the evidence is limited, and its effectiveness is still uncertain 6.
Factors Influencing Temperature Regulation
- Environmental factors, such as temperature and humidity, can significantly impact temperature regulation during endurance races 2, 4, 5.
- Individual factors, such as health status, fitness level, and hydration status, can also influence temperature regulation and the risk of hyperthermia 2, 3, 4, 5.
- The importance of fluid balance in thermoregulation is well established, and dehydration can compromise exercise heat loss and increase thermal strain 5.