Photo Credit: Liudmila Chernetska
The following is a summary of “Exertional heat stroke best practices in U.S. emergency medical services guidelines,” published in the October 2024 issue of Emergency Medicine by Tishukaj et al.
A leading cause of non-accidental death among U.S. laborers is Exertional heat illnesses (EHIs), particularly exertional heat stroke (EHS). Effective management requires a coordinated approach between Emergency Medical Services (EMS) and workplace officials for immediate cold-water immersion (CWI) and cool first, transport second (CFTS).
Researchers conducted a retrospective study to assess the effectiveness of statewide EMS guidelines for EHI in laborers.
They assessed EMS websites and the Paramedic Protocol Provider database for statewide EMS guidelines in the U.S for the states with guidelines, EHI outcomes were analyzed using a 2-way χ2 test with odds ratios, and 3 reviewers analyzed guideline content for EHS best practices with significance set at priori at P<0.05.
The results showed that out of 50 states, the District of Columbia and Puerto Rico, 57.7% (n = 30) had statewide EMS guidelines, while 42.3% (n = 22) did not. A significant association was found between EHI outcomes and states that recommended CWI as a cooling method compared to those that did not (χ2₁ = 3.336; P= 0.049). Laborers in states without CWI in their EMS protocols had a 3.0 times higher likelihood of EHS fatalities. Additionally, a significant association was observed for EHI outcomes in states without CFTS protocols (χ2₁ = 5.051; P=0.017), where the odds of EHS deaths for laborers were 3.7 times higher compared to states with CFTS.
They concluded that laborers were 3.0 and 3.7 times less likely to die from EHS when statewide EMS guidelines included CWI and CFTS.
Source: sciencedirect.com/science/article/abs/pii/S0736467924001367
