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Procedure for assessing patients referred to the UK’s military Heat Illness Clinic: a case series
  1. Carol House1,2,
  2. M Stacey3,4,
  3. D Woods4,5,6,
  4. A Allsopp1 and
  5. D Roiz de Sa1
  1. 1Institute of Naval Medicine, Gosport, UK
  2. 2School of Health and Exercise Science, University of Portsmouth, Portsmouth, UK
  3. 3Department of Surgery and Cancer, Imperial College, London, UK
  4. 4Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
  5. 5Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
  6. 6Northumbria NHS Foundation Trust, Newcastle-upon-Tyne, UK
  1. Correspondence to Carol House, Survival and Thermal Medicine, Institute of Naval Medicine, Gosport PO12 2DL, Hants, UK; carol.house721{at}mod.gov.uk

Abstract

Introduction The UK military operates a Heat Illness Clinic (HIC) to aid the return to exercise, training and occupational duty recommendations for individuals who have suffered exertional heat illness or heatstroke. This paper describes the process of assessment and reports representative data from n=22 patients referred to the HIC.

Method The assessment included clinical consultation, and measurement of maximal oxygen consumption (V̇O2max) and a heat tolerance test (HTT) conducted on a treadmill in an environmental chamber with an air temperature of 34°C and 44% relative humidity. Patients began the HTT wearing military clothing, carrying a rucksack (mass 15 kg) and walking at 60% V̇O2max, at 30 min the rucksack and jacket were removed and the T-shirt at 45 min, individuals continued walking for 60–90 min. Patients were considered heat tolerant if rectal temperature achieved a plateau.

Results N=14 patients were heat tolerant on the first assessment and of the n=8 patients required to return for repeat assessment, five were heat tolerant on the second assessment and the remaining three on the third assessment.

Conclusions In conjunction with patient history and clinical evaluation, the HTT provides a physiological basis to assist with decisions concerning patient management and return to duty following an episode of heat illness.

  • physiology
  • occupational & industrial medicine
  • sports medicine
  • clinical physiology

Data availability statement

Data are available upon reasonable request. Additional information can be requested from CH at carol.house721@mod.gov.uk.

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Data availability statement

Data are available upon reasonable request. Additional information can be requested from CH at carol.house721@mod.gov.uk.

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Footnotes

  • Contributors This manuscript has combined data from two protocols (MoDREC 0937/262 and 647/MoDREC15—termed 1 and 2 in the following statement), and reported these data descriptively to explain the process of assessment at the INM Heat Illness Clinic. CH assembled the data, planned and wrote the paper; submitted the protocol, planned, conducted, analysed, interpreted and reported the data for study; assisted with the data analysis for collection for study and is the guarantor for the submitted paper content. MS wrote and submitted the protocol, planned and conducted study; and gave editorial input to the submitted paper. DW was responsible for academic conception and assisted with the protocol for study; and gave editorial input to the paper. AA gave input to the protocols for both studies, developed the initial HIC protocol and gave editorial input to the submitted paper. DRdS was responsible for academic conception and assisted with protocol for the study, assisted with planning and conduct of both studies, and gave editorial input to the submitted paper.

  • Funding This work was funded by the Ministry of Defence. CC1 form reference: 20210075.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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