Code (Heat) Stroke (Climate Change and Health, and Wilderness Medicine Interest Group Sponsored)
2023 proved to be the hottest summer on record yet. As we continue to experience the effects of a destabilized climate, intermittent and prolonged exposure to extreme heat will become more common in our patients. Heat stroke is a life-threatening illness with high mortality. Its presenting symptoms can be subtle, further complicated by comorbidities or perceived lack of “heat exposure.” Comorbid conditions, humidity, and existing adaptation all modify risk of developing heat illness. Identifying and cooling patients early and rapidly is essential to improving survival. Enter Code (Heat) Stroke. The ED is used to rapid, efficient, comprehensive treatment of life-threatning illness - think code stroke, code STEMI, code sepsis. With its high mortality, implementation of a similar response to patients presenting with possible heat stroke to initiate rapid cooling is a clear next step in pursuing excellent patient care.
The didactic will begin with a lecture touching on changing climate and historical changes in heat, then to heat illness treatment and finally to a proposed code heat team design. This will include a brief description of the cold water immersion protocol one of the local presenters has implemented in their ED, covering protocol description and pearls and pitfalls of establishing multiple heat injury treatment pathways. Another presenter will discuss their institution’s attempt at implementing a code heat team. The second half of the didactic will be small group discussion to encourage folks to bring forth challenges and successes they have had in managing heat illness in their own institutions. Ultimately, the goal will be to outline a framework for institutions to implement their own version of code heat. During the breakout sessions, we will also discuss ways in which the code heat team design can be adapted to different settings with a focus on austere and wilderness medicine practice.
Presenters:
- Gayle Kouklis, MD
- Kyle Denison Denison Martin, DO, MPH
- Hillary R. Irons, MD PhD
- Geoff B. Comp, DO, FACEP
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Gayle Kouklis, MD
University of California (San Francisco)/Fresno
Gayle Kouklis graduated from UCSF Fresno Emergency Medicine Residency where she spent her four years pursuing both wilderness and climate and health medicine outside of clinical practice. She continues to work closely with the Parkmedic program, having spent time teaching both national courses and local courses in Yosemite, Sequoia/Kings Canyon, and Rocky Mountain National Parks. She and several colleagues were awarded a grant from the California Resilience Challenge to design a climate vulnerability and adaptation assessment of Fresno County. She currently is working with FEMA and the Environmental Defense Fund as a fellow with University of Colorado Climate Change and Health Science Policy program. She remains on faculty at UCSF Fresno and works in the community in Southern Oregon.
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Kyle D. Martin, DO, MPH
Assistant Professor
Brown University
Dr. Kyle Denison Martin is an assistant professor of emergency medicine at the Warren Alpert Medical School of Brown University. He received his Doctorate of Osteopathy from the Michigan State University College of Osteopathic Medicine. He also received a Masters of Arts in bioethics and Masters of Public Health from Michigan State University. Dr. Martin completed his specialty training in Emergency Medicine at Henry Ford Health System in Detroit, Michigan. He completed a Diploma in Tropical Medicine & Hygiene from the London School of Hygiene & Tropical Medicine and has a Certificate of Knowledge in Clinical Tropical Medicine and Travelers' Health from the American Society of Tropical Medicine & Hygiene. Dr. Martin is an Affiliate Faculty of the Institute at Brown University for Environment and Society (IBES). He is also Affiliate Faculty at the Global Health Institute (GHI) of Brown University.
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Hillary R. Irons, MD, PhD
UMass Chan Medicial School
Hillary Irons, MD PhD FACEP, is an Assistant Professor in Emergency Medicine at University of Massachusetts. She received her MD from Medical College of Georgia, PhD in Biomedical Engineering from Georgia Tech and Emory, and completed EM residency at Michigan State University/Sparrow Hospital in Lansing, Michigan. She completed a Wilderness Medicine Fellowship at Massachusetts General Hospital during which she spent a season working at the Himalayan Rescue Association in the Everest Region in Nepal, trip physician to the Siberian arctic, and doing multiple research projects on altitude illness. She has taught wilderness medicine for many years both with lectures, hands-on courses including AWLS, and simulation-based teaching. She is also the Expansion Race Coordinator for MedWAR (Medical Wilderness Adventure Races) which teaches and tests wilderness medicine through scenario-based adventure races since 2003. She has held national leadership positions in SAEM’s wilderness medicine interest group and ACEP wilderness medicine section. Her current research involves the cognitive deficits in hypoxic brain states specifically acute mountain illness and traumatic brain injury.
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Geoff B. Comp, DO, FACEP
Valleywise Hospital
Dr. Geoff Comp is currently an Associate Program Director for the Creighton University School of Medicine Emergency Medicine Residency at the Valleywise Health Medical Center in Phoenix, Arizona. Geoff participates as a leader, mentor, and advocate for wilderness medicine and EM medical education with experience lecturing and teaching locally, regionally, and nationally. His professional and research focus includes wilderness medicine, physician wellness, mentorship, as well as innovation in medical education. He constantly seeks opportunities to combine his interests through collaboration with others and outdoor exploration. Outside of medicine, Geoff can be found running or road biking, trying to find the best Mexican food in Arizona, or chasing his two-year-old twin boys (Austin and Carter) with his wife, Mackenzie.