Parents May Miss Exertional Heat Stroke

As summer’s swelter sets in, a survey of parents in the United States shows that they may not know enough to recognize and respond to exertional heat stroke (EHS),1 a potentially life-threatening illness2,3 that may strike active kids, particularly in hot and humid conditions.4 The results support the idea that increased awareness may reduce both the incidence of this potentially fatal severe heat-related illness and the irreversible damage that can be associated with it.2,5

Because of its association with physical activity, EHS tends to strike young, physically fit individuals more than other groups6,7 and can quickly progress to life-threatening circumstances.8 Caused by an increase in body temperature to 104°F* or higher,5 EHS can result in irreversible damage to the brain and other vital organs and is sometimes fatal.2 Time is critical when it comes to treating EHS, and it is important to know the signs and symptoms and call 911 immediately so the person can receive appropriate medical attention,advises Neha Raukar, MD, an associate professor in Emergency Medicine at Brown University in Providence, Rhode Island.

“Everyone knows what to do if a concussion occurs on the field, but they may not recognize the signs and symptoms of EHS, which could also have serious, long-term effects on the brain.2,4  This survey shows that not enough people know about exertional heat stroke to recognize it, or what to do when they see it. If more people had this information, lives could be saved,” Raukar says.

EHS and related conditions are on the rise. One study found that the number of injuries associated with heat-related illness more than doubled between 1997 and 2006.9

In a survey of 1,000 parents conducted by KRC research in April 2017, less than a third of respondents said that they were able to identify the symptoms of EHS.1 And, only 18 percent said they would know what to do if they suspected their child had the condition.1

The signs and symptoms of EHS include fainting and/or dizziness; vomiting; confusion or disorientation; and unusual behavior such as aggression.5 Whenever an active person exhibits these symptoms, bystanders should call 911 immediately to receive appropriate medical attention.5 Dr. Raukar recommends that parents and coaches remember the acronym H.E.A.T. — High temperature, Exercise or activity, Acting confused, Time to call 911 — to be ready to recognize and respond to exertional heat stroke in time to help prevent serious injury or death.



1. Data on file. Eagle Pharmaceuticals, Inc.

2. Walter EJ, Carraretto M. The neurological and cognitive consequences of hyperthermia. Critical Care. 2016;20(199). doi:10.1186/s13054-016-1376-4.

3. Bouchama A, Roberts G, Al Mohanna F, et al. Inflammatory, hemostatic, and clinical changes in a baboon experimental model for heatstroke. J Appl Physiol. 2005;98(697–705). doi:10.1152/japplphysiol.00461.2004.

4. Leon LR, Helwig BG. Heat stroke: role of the systemic inflammatory response. J Appl Physiol. 2010;109:1980-1988. doi:10.1152/japplphysiol.00301.2010.

5. Casa, DJ, DeMartini JK, Bergeron MF, Csillan D, Eichner R, Lopez RM, Ferrara MS, Miller KC, O’Connor F, Sawka M, Yeargin SW. National athletic trainers’ association position statement: exertional heat illness. J Athl Train. 2015;50(9). Accessed May 9, 2017.

6. Becker JA, Stewart LK. Heat-related illness. Am Fam Physician. 2011;83(11):1325-1330.

7. Epstein Y, Moran DS, Shapiro Y. Exertional heatstroke in the Israeli defense forces. In: Pandoff KB, Burr RE, eds. Medical Aspects of Harsh Environments. Volume 1. Office of the Surgeon General, United States Army. 2002;281-292.

8. Jardine DS. Heat illness and heat stroke. Pediatr Rev Am Acad Pediatric. 2007;28(7). doi:10.1542/pir.28-7-249.

9. Nelson NG, Collins CL, Comstock RD, McKenzie LB. Exertional heat-related injuries treated in emergency departments in the U.S., 1997–2006. Am J Prev Med. 2011;40(1):54-60. doi: