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
Dump Kits and Checklists: Why Expert Paramedics Still Crash [not-audio_url] [/not-audio_url]

Duration: 18:14
Miss your first intubation attempt and your patient's risk of adverse events jumps sevenfold. By the third attempt? Nearly guaranteed complications. This isn't about your anatomical knowledge or practice hours—expert cli…
Stupidity in EMS: The causes and remedies [not-audio_url] [/not-audio_url]

Duration: 23:21
You're not making mistakes because you're dumb. You're making mistakes because of seven predictable factors—and once you know them, you can control them. Kris Kaull delivered a masterclass at FASTCAN on the hidden forces…
Hypothermia Rescue: Cardiac Arrest in a Tree Well [not-audio_url] [/not-audio_url]

Duration: 39:59
What happens when a 24-year-old woman is found frozen in a tree well after last being seen 8 hours prior, with a core temperature of 62°F (17°C)? In this extraordinary case, paramedic Miles Randell and his team performed…
When The Anatomy Is Gone: Facial Trauma Airway Management [not-audio_url] [/not-audio_url]

Duration: 24:21
What do you do when the anatomy you've memorized simply doesn't exist anymore? When a patient's entire face is gone, and your standard airway management tools won't work? This is where training meets reality. Critical ca…
Stop Building Resilience, Strengthen Your Resistance [not-audio_url] [/not-audio_url]

Duration: 25:14
Discover the difference between resistance (your daily shield built through sleep, nutrition, relationships, and spiritual wellness) and resilience (the anaerobic sprint you can't maintain forever). Recorded on-site at F…
What If They Find Out I'm A Fraud? - Imposter Syndrome in EMS [not-audio_url] [/not-audio_url]

Duration: 23:02
Ever cried in the ambulance because you felt completely overwhelmed? Sophie Fuller has—and she's done something powerful with that experience. In this raw discussion, the Life and Sirens podcast host shares her most vuln…