Elite athletes competing at high-intensity in the hot and humid ambient conditions of the upcoming Games of the XXXII Olympiad (Tokyo 2020) are likely to reach elevated core temperature (≈41.5°C) as previously reported in elite competitions in the heat and the risk of exertional heat stroke (EHS) is heightened.1 EHS is a medical condition defined as an internal body temperature exceeding 40.5°C with central nervous system dysfunction (eg, disorientation, aggressiveness, hysteria, delirium, altered consciousness, irrational behaviour).2 3 Survival and sequela from EHS depend on the duration of hyperthermia.4 In 2020, evidence-based consensus suggests whole-body cooling until 39°C within the first 30 min of collapse as the critical requirement to maximise patient outcome.2 3 5 Whole-body cold water immersion (CWI) was associated with 100% survival rate in 274 runners diagnosed with EHS over the 18 years of patients treated at the New Balance Falmouth Road Race, with average cooling rate of 0.22°C min–1.5 In a different study, CWI using circulated water controlled at 2°C demonstrated an average cooling rate of 0.35°C min–1.6 To achieve the clinical target, medical providers at Tokyo 2020 must: 1. provide on-site assessment of …

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将循证实践转化为东京 2020 的临床实践：如何诊断和管理劳力性中暑

在即将举行的第三十二届奥林匹克运动会（东京 2020）的炎热和潮湿环境条件下进行高强度比赛的精英运动员可能会达到核心温度升高 (≈41.5°C)，如先前在高温和高温的精英比赛中所报告的那样劳力性中暑 (EHS) 的风险增加。1 EHS 是一种医学状况，定义为内部体温超过 40.5°C 并伴有中枢神经系统功能障碍（例如定向障碍、攻击性、歇斯底里、谵妄、意识改变、非理性行为）。 2 3 EHS 的生存和后遗症取决于热疗的持续时间。4 到 2020 年，基于证据的共识建议全身冷却至 39°C 在崩溃的前 30 分钟内作为最大化患者结果的关键要求。2 3 5 全身冷水浸泡 (CWI) 与 274 名被诊断患有 EHS 的跑步者在 18 年间接受新百伦法尔茅斯公路赛治疗的患者的 100% 存活率相关，平均降温速率为 0.22°C min– 1.5 在另一项研究中，使用控制在 2°C 的循环水的 CWI 显示平均冷却速率为 0.35°C min–1.6 为实现临床目标，东京 2020 的医疗提供者必须：1. 提供对……的现场评估