Core temperature and mental status of two runners experiencing exertional heat stroke after a road race.

Prehospital management of exertional heat stroke (EHS) consists of monitoring rectal temperature (Tre) while aggressively cooling via cold water immersion. Recent recommendations suggest using central nervous system (CNS) dysfunction to determine cessation of cooling when Tre is not available. We examined cognitive responses of two runners with EHS after a road race. This comparison illustrates the need to use caution with this recommendation, as the manifestation of CNS responses in EHS patients can be unpredictable. The variables in both cases highlight the importance of avoiding using mental status alone when cooling EHS patients and support Tre serving as the main clinical indicator during treatment.