TY - JOUR T1 - Management of exertional heat stroke: a practical update for primary care physicians JF - British Journal of General Practice JO - Br J Gen Pract SP - 153 LP - 154 DO - 10.3399/bjgp18X695273 VL - 68 IS - 668 AU - Edward Walter AU - Kiki Steel Y1 - 2018/03/01 UR - http://bjgp.org/content/68/668/153.abstract N2 - Exertional heat stroke (EHS) is a risk to athletes, the military, and others undergoing strenuous exertion, especially in temperate climates. It is defined as a core temperature of >40°C with neurological impairment. It is one of the three commonest causes of deaths in athletes, and, untreated, the mortality may be up to 80%. Even when treated, it is associated with significant short- and long-term morbidity. The number of cases of EHS appear to be on the rise; this may be due in part to increasing numbers of athletes participating in endurance events each year. Running USA estimates that 25 000 runners completed a marathon in the US during 1976; by 2016, this had grown to 507 600; similarly, the number of runners completing a half-marathon is estimated to have risen from 303 000 in 1990 to 1 900 000 in 2016.1,2 However, the incidence may also be rising; the US military has reported an eight-fold increase in the rate of hospitalisation from EHS, from 1.8 to 14.5 per 100 000 soldiers, over a 20-year period.3 There are also likely to be a number of runners who do not present to medical services, or in whom the signs are unrecognised.A GP may have contact with athletes in one of three ways: a patient … ER -