Heat injuries present on a spectrum from mild (eg, miliaria rubra) to severe and life-threatening (heat stroke). The two main classifications of heat injury are exertional, which affects mainly young to middle-age individuals undergoing physical activity in hot environments, and classic, which typically affects young children and the elderly and results from an inability to dissipate heat. This review details the assessment and stabilization, diagnosis, treatments, disposition, and outcomes for patients with heat injury. Figures show the four mechanisms of passive heat transfer, physiologic responses to heat, the spectrum of heat injuries, risk factors for exertional versus classic heat stroke, a clinical algorithm to provide guidance in the diagnosis and management of heat stroke, the general pattern of organ dysfunction, and two evidence-based methods of rapid cooling for patients with heat stroke. Tables list factors affecting the efficiency of the mechanisms of passive heat transfer; minor to moderate heat injuries; exertional versus classic heat stroke; predisposing medical conditions, medications, and drugs for heat stroke; systemic inflammatory response criteria; key histori
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