Return to activity: Customize the approach
Each heat-related injury case is different; thus, return to activity should be individualized. In patients whose heat injury was believed to be secondary to a modifiable risk factor, efforts should be made to correct the predisposing factors that placed the patient at increased risk in the first place.
Additionally, the patient should allow sufficient time to recover. Guidelines recommend at least 1 to 2 weeks recovery before return to activity after heat stroke.8 Moreover, a graded return to activity, starting in a cool environment, is recommended. Gradual introduction of activity in the heat with close monitoring can help with acclimatization and help identify participants who continue to have cooling dysregulation. In the military and among athletes, tools such as heat-tolerance testing can be used to gauge the person’s readiness to return to play or duty.8 Heat tolerance testing is performed in a lab using continuous core temperature monitoring while having the subject exercise in a heated room.
CORRESPONDENCE
Scott Kinkade, MD, EdD, MA303 Medical Sciences Building, DC032.00, Columbia, MO 65212; Kinkades@health.missouri.edu.