Heat Stroke: Recognition, Cooling, and Transport Decisions

Heat Stroke: Recognition, Cooling, and Transport Decisions

Author: Ross Orpet, Paramedic turned EMS Physician August 10, 2026 Duration: 47:32
What differentiates heat stroke from heat exhaustion? Once central nervous system dysfunction appears, every minute spent at an elevated core temperature increases the risk of permanent neurologic injury or death.Ross and Will talk with emergency physician and wilderness medicine specialist Dr. Greg Doctor about the full spectrum of heat-related illness – from heat cramps, rash, and edema to syncope, exhaustion, and life-threatening heat stroke. They discuss how to avoid anchoring on the heat when a patient loses consciousness and what the critical dividing line between heat exhaustion and heat stroke is. They also examine exercise-associated hyponatremia, drug-related hyperthermia, fluid selection, and the patients who may remain at risk even after they initially appear to recover.In this episode, you’ll learn: How to distinguish heat syncope, heat exhaustion, and heat stroke Why central nervous system dysfunction and an elevated core temperature matter most How to choose between cold-water immersion, continuous water and fanning, ice sheets, and ice-water slurry techniques When transport should be delayed for on-scene cooling, and when cooling should continue   Resources:Wilderness Medical Society Clinical Practice Guidelines for the Prevention & Treatment of Heat Illness: 2024 UpdateUnlocking Syncope with Matt MendesThe Critical Care of the Sick Runner: A Comprehensive Guide with Dr. Whitney BarrettWant more? Sign up for our weekly newsletter, The Confidence Dispatch.Want individualized coaching and mentorship? Check out The Loud & Clear Fellowship.Just have a question and want some personalized help? Book a free coaching call with us.Interested in ABLS Now? Our listeners get 10% off through the end of August. Guests:Dr. Greg Doctor, emergency physician and wilderness medicine specialist

Stepping out of the classroom and into the rig is where the real learning begins, but that transition often leaves even seasoned providers with a lingering doubt. Loud & Clear: EMS Guiding Principles addresses that gap directly, moving past the basic protocols to explore the foundational reasoning that makes for excellent prehospital care. Hosted by Ross Orpet, a paramedic who now practices as an EMS physician, this podcast digs into the "why" behind the algorithms. It’s built on the understanding that no textbook can possibly cover every unique scenario you’ll encounter on the road. Instead of just listing steps, each episode examines the core principles that guide critical decisions when the situation doesn't fit a neat checklist. You’ll hear discussions that bridge the gap between field experience and medical rationale, focusing on the adaptive thinking required for complex emergencies. This is advanced continuing education designed for paramedics, EMTs, and all prehospital providers who feel that standard training was just the beginning. The conversations in this series aim to solidify your clinical judgment, helping you build confidence through comprehension. By tuning in, you gain access to a deeper level of professional development, where the objective is to think clearer and act more decisively, no matter how many days you have on the job. This podcast serves as a vital resource for those committed to mastering their craft beyond the basics.
Author: Language: English Episodes: 50

Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers
Podcast Episodes
The First 60 Seconds After ROSC: How To Prevent Re-Arrest [not-audio_url] [/not-audio_url]

Duration: 35:52
The First 60 Seconds After ROSC: How To Prevent Re-Arrest How do you improve your resuscitation systems beyond the ACLS algorithm? Will talks with Ian Blanchard, Senior Scientist for Alberta’s provincial EMS system about…
Post-ROSC Care and Pacing: Prove the Perfusion [not-audio_url] [/not-audio_url]

Duration: 1:06:06
Getting a pulse back feels like a win. Seeing pacer spikes and something that resembles a pulse feels reassuring. But in both situations, the monitor can make you feel better before the patient actually is.Geoff Murphy o…
Burn Care in EMS: What Actually Matters in the First 15 Minutes [not-audio_url] [/not-audio_url]

Duration: 1:02:04
Burn patients can create a disproportionate amount of anxiety. The calls are uncommon, the injuries can be visually overwhelming, and it is easy to get distracted by the burn itself.Ross and Will talk with Mark Johnston,…
The Three Building Blocks of Trust in EMS [not-audio_url] [/not-audio_url]

Duration: 1:08:37
Trust is the architecture behind every patient interaction you run. Dr. Cory Scheer, author of Closing the Trust Gap, has identified three evidence-based building blocks of trust: competency, problem-solving, and care fo…
The Skill Is Not The Hard Part [not-audio_url] [/not-audio_url]

Duration: 29:33
The hardest part of a bad call is rarely the algorithm. In two different interviews I explore some human traps of running an EMS call. I talk with Danny and Rance from DNR Prehospital Education about a choking arrest, a…