ACSM/DOD Roundtable: Heat Illness: ACSM/DOD Roundtable: Heat Illness: Return to Duty/Return to PlayReturn to Duty/Return to Play

Francis G. O’Connor, MD, MPH

Associate Professor of Military and Emergency Medicine

Department of Military and Emergency Medicine

Medical Director, Consortium for Health and Human Performance

Uniformed Services University of the Health Sciences

The Challenge of The Challenge of Exertional Heat IllnessExertional Heat Illness

Clinical Clinical QuestionsQuestions

• Was it a heat stroke or a heat exhaustion? Does it make a difference?

• What criteria are used to establish clinical recovery?

• Is it possible to risk stratify and mitigate risk for a future event?

• How does one ease someone safely back to play or duty?

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• Objectives– Review the definition, epidemiology, and pathophysiology of

heat stroke.– Review the diagnosis and management of exertional heat

stroke.– Describe current civilian and military guidelines that discuss

return to duty/play as pertaining to heat stroke.– Discuss the roles of thermal tolerance testing, genetic and

biomarker evaluation in return to duty/play as pertaining to heatstroke.

– Describe the process of rehabilitation, clearance and prevention in return to duty/play as pertaining to heat stroke.

– Construct a group consensus document that identifies current concepts with regards to return to duty/play as pertaining to heat stroke, and outlines required areas for further research.

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• Partners

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• Format– The format for the two-day conference will be focused

on seven one hour topic blocks. – Each block will have one speaker and two

discussants. – Each speaker will be allotted 20 minutes; each

discussant 10 minutes; 20 minutes of the balance would be designated for discussion (experts and observers).

– James Whitehead, the executive director of the ACSM will lead the roundtable in formation of consensus as well as outline a strategy for the future.

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• Program– EXERTIONAL HEAT STROKE: DEFINITION AND BASIC

EPIDEMIOLOGY– EXERTIONAL HEAT STROKE: PATHOPHYSIOLOGY– EXERTIONAL HEAT STROKE: RECOGNITION AND

TREATMENT– THE ROLE OF THERMAL TOLERANCE TESTING IN

RECOVERY AND RETURN TO PLAY/DUTY– THE ROLE OF GENETIC AND BIOMARKER TESTING IN

RECOVERY AND RETURN TO PLAY/DUTY– PREVENTION OF AN ENSUING INCIDENT OF EXERTIONAL

HEAT STROKE – EXERTIONAL HEAT STROKE: CURRENT CIVILIAN AND

MILITARY GUIDELINES FOR RETURN TO PLAY/DUTY

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• Goal

– MSSE Publication that addresses consensus agreement in the following areas:• Definition of Exertional Heat

Illness• Return to Duty/Play• Research Agenda• Future Initiatives and Products

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• Many Thanks

– Doug Casa– Jane Senior and

Lynn Walters– Karen O’Brien– Jim Whitehead– Jenn Davis– USUHS

Pfc. David M. Kirchhoff Cedar Rapids, Iowa