An Update on Best Practices for the Prehospital Management of Exertional Heat Illness

Exertional heat illness (EHI) describes a spectrum of acute medical disorders, frequently encountered in Servicemembers throughout the Armed Forces, that poses a pervasive threat to individual and unit military readiness. In June 2024, the Consortium for Health and Military Performance Warrior Heat and Exertion Related Event Collaborative published a Joint Clinical Practice Guideline for the prevention, diagnosis, and management of exertional heat illness, which outlines best practices in the diagnosis and management of EHI, including prevention, prehospital care, emergency department care, inpatient hospital care, and return to duty guidelines. In the Special Operations community, recognition and early treatment via rapid cooling to a body core temperature of 39.0–39.2°C (102.0–102.5°F) within 30 minutes from the time of injury recognition are the most crucial concepts to follow to reduce the morbidity and mortality of EHI. This article introduces the recommended best practices from the Clinical Practice Guideline, which are most relevant to the Special Operations community.