Severe heat injury is present when signs of heat exhaustion are present, coupled with varying degrees of CNS abnormalities (encephalopathy). The most common CNS abnormalities include changes in mentation and level of consciousness (e.g., obtunded, stupor, coma), seizures, abnormal pupil size, cortical blindness, head tremors, and ataxia. Heat stroke is a life-threatening condition. It is characterized by widespread, multiple organ injury with risk of progression to multi-organ failure.

No specific body temperature defines heat stroke in MWDs; however, temperatures as low as 105.8°F (41°C) have been associated with pathology. Most commonly, heat stroke is seen in MWDs with rectal temperatures >107°F (41.7°C). Studies report multiple serious complications and high fatality rates in heat stroke patients despite proper treatment.3-5 Table 1 describes the management of MWDs with heat-induced injury.