1. ACSM/DOD Roundtable: Heat Illness: Return to Duty/Return to Play Francis G. O’Connor, MD, MPH Associate Professor of Military and Emergency Medicine Department of Military and Emergency Medicine Medical Director, Consortium for Health and Human Performance Uniformed Services University of the Health Sciences

2. The Challenge of Exertional Heat Illness

3. Clinical Questions Was it a heat stroke or a heat exhaustion? Does it make a difference? What criteria are used to establish clinical recovery? Is it possible to risk stratify and mitigate risk for a future event? How does one ease someone safely back to play or duty?

4. ACSM Roundtable Objectives –Review the definition, epidemiology, and pathophysiology of heat stroke. –Review the diagnosis and management of exertional heat stroke. –Describe current civilian and military guidelines that discuss return to duty/play as pertaining to heat stroke. –Discuss the roles of thermal tolerance testing, genetic and biomarker evaluation in return to duty/play as pertaining to heatstroke. –Describe the process of rehabilitation, clearance and prevention in return to duty/play as pertaining to heat stroke. –Construct a group consensus document that identifies current concepts with regards to return to duty/play as pertaining to heat stroke, and outlines required areas for further research.

5. ACSM Roundtable Partners

6. ACSM Roundtable Format –The format for the two-day conference will be focused on seven one hour topic blocks. –Each block will have one speaker and two discussants. –Each speaker will be allotted 20 minutes; each discussant 10 minutes; 20 minutes of the balance would be designated for discussion (experts and observers). –James Whitehead, the executive director of the ACSM will lead the roundtable in formation of consensus as well as outline a strategy for the future.

7. ACSM Roundtable Program –EXERTIONAL HEAT STROKE: DEFINITION AND BASIC EPIDEMIOLOGY –EXERTIONAL HEAT STROKE: PATHOPHYSIOLOGY –EXERTIONAL HEAT STROKE: RECOGNITION AND TREATMENT –THE ROLE OF THERMAL TOLERANCE TESTING IN RECOVERY AND RETURN TO PLAY/DUTY –THE ROLE OF GENETIC AND BIOMARKER TESTING IN RECOVERY AND RETURN TO PLAY/DUTY –PREVENTION OF AN ENSUING INCIDENT OF EXERTIONAL HEAT STROKE –EXERTIONAL HEAT STROKE: CURRENT CIVILIAN AND MILITARY GUIDELINES FOR RETURN TO PLAY/DUTY

8. ACSM Roundtable Goal –MSSE Publication that addresses consensus agreement in the following areas: Definition of Exertional Heat Illness Return to Duty/Play Research Agenda Future Initiatives and Products

9. ACSM Roundtable Many Thanks –Doug Casa –Jane Senior and Lynn Walters –Karen O’Brien –Jim Whitehead –Jenn Davis –USUHS

10. Pfc. David M. Kirchhoff Cedar Rapids, Iowa