Environment-dependent sports emergencies.

As more individuals participate in sports and outdoor activities, the frequency of environmentally related illnesses will increase. Participants in sporting events of long duration and those requiring particularly inclement weather and adverse conditions are especially prone to developing injury. Hypothermia, heat-related illnesses, and high-altitude illnesses are multisystem emergencies that require immediate, specific therapeutic maneuvers. Physicians must be able to recognize the signs and symptoms of these medical emergencies and institute definitive care. Rapid core rewarming, airway control, and prolonged cardiopulmonary resuscitation are the key factors in managing the hypothermic patient. Adequate cooling and volume resuscitation provide the basis for treating the hyperthermic patient. The patient with high altitude-related illness should be returned to a lower elevation and given supplemental oxygen. Specific intervention depends on the patient's presentation. Environmental illnesses cause severe morbidity and mortality and are frequently within the control of the sport participant. Thus physicians must educate their patients on basic preventive measures if they are going to participate in outdoor sporting activities.