Victims of exertional heat stroke (EHS) in whom treatment is delayed have higher rates of multi-organ failure and a greater number of fatalities. Death related to EHS is preventable, through immediate treatment via cold-water immersion (CWI). To date little is known about the influence of treatment delays on core cooling following EHS. Thus we sought to examine the effects of treatment delays on cardiovascular and thermal responses prior to, during, and following CWI treatment in individuals with exercise-induced hyperthermia. Our findings demonstrate that treatment delays resulted in a sustained level of hyperthermia and cardiovascular strain that significantly increased the time an individual is at risk to the potential lethal effects of EHS. Moreover, we report that cold water immersion treatment is powerful enough to overcome the adverse effects of treatment delays and rapidly reduce core temperatures while facilitating the re-establishment of blood pressure towards normal resting levels.

This thesis examined the effect of differences in body surface area-to-lean body mass ratio (AD/LBM) on core temperature cooling rates during cold water immersion (2°C, CWI) and temperate water immersion (26°C, TWI) following exercise-induced hyperthermia (end-exercise rectal temperature of 40°C). Individuals with a High AD/LBM (315 cm2/kg) had a ~1.7-fold greater overall rectal cooling rate relative to those with Low AD/LBM (275 cm2/kg) during both CWI and TWI. Further, overall rectal cooling rates during CWI were ~2.7-fold greater than during TWI for both the High and Low AD/LBM groups. Study findings show that AD/LBM must be considered when determining the duration of the immersion period. However, CWI provides the most effective cooling treatment for EHS patients irrespective of physical differences between individuals.

Victims of exertional heat stroke (EHS) in whom treatment is delayed have higher rates of multi-organ failure and a greater number of fatalities. Death related to EHS is preventable, through immediate treatment via cold-water immersion (CWI). To date little is known about the influence of treatment delays on core cooling following EHS. Thus we sought to examine the effects of treatment delays on cardiovascular and thermal responses prior to, during, and following CWI treatment in individuals with exercise-induced hyperthermia. Our findings demonstrate that treatment delays resulted in a sustained level of hyperthermia and cardiovascular strain that significantly increased the time an individual is at risk to the potential lethal effects of EHS. Moreover, we report that cold water immersion treatment is powerful enough to overcome the adverse effects of treatment delays and rapidly reduce core temperatures while facilitating the re-establishment of blood pressure towards normal resting levels.

This thesis examined the effect of differences in body surface area-to-lean body mass ratio (AD/LBM) on core temperature cooling rates during cold water immersion (2°C, CWI) and temperate water immersion (26°C, TWI) following exercise-induced hyperthermia (end-exercise rectal temperature of 40°C). Individuals with a High AD/LBM (315 cm2/kg) had a ~1.7-fold greater overall rectal cooling rate relative to those with Low AD/LBM (275 cm2/kg) during both CWI and TWI. Further, overall rectal cooling rates during CWI were ~2.7-fold greater than during TWI for both the High and Low AD/LBM groups. Study findings show that AD/LBM must be considered when determining the duration of the immersion period. However, CWI provides the most effective cooling treatment for EHS patients irrespective of physical differences between individuals.

The purpose of this study was to assess and determine the current level of knowledge that National Collegiate Athletic Association (NCAA) Strength and Conditioning Coaches (SCCs) possess regarding exertional heat stroke (EHS) prevention and recognition and to determine if SCC certification type had any effect. Major findings of this study support the view that SCCs need more preparation, education and training to increase their competency in preventing and recognizing EHS. Research found that there was no significant difference in scores on the EHS scale based on SCC certification (CSCS vs. SCCC) after accounting for experience, education or division but the CSCS certified professionals scored higher on all the factors as compared to SCCs without the CSCS.. The major key finding was that SCCs lacked essential knowledge to prevent or recognize EHS. Furthermore, the study defines relevant EHS prevention and recognition competencies that an undergraduate curriculum, graduate curriculum and professional certification providers, should include and emphasize in their preparation programs.