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Scientists say to brace for more extreme weather and possibly a record-warm 2023 amid unprecedented temperatures.

A 14-year-old female high school cross country runner (height = 154 cm, mass = 48.1 kg) with no history of exertional heat stroke (EHS) collapsed at the end of a race. An athletic trainer (AT) assessed the patient, who presented with difficulty breathing then other signs of EHS (i.e. confusion, agitation). The patient was taken to the medical area, draped with a towel, and a rectal temperature (Tre) of 106.9°F(41.6°C) was obtained. The emergency action plan was activated and emergency medical services (EMS) were called. The patient was submerged in a cold-water immersion tub until EMS arrived (~15 minutes; Tre = 100.1°F; cooling rate: 0.41°F·min−1[0.25°C·min−1]). At the hospital, the patient received intravenous fluids, and urine and blood tests were normal. The patient was not admitted and returned to running without sequelae. Following best practices, AT's in secondary schools can prevent death from EHS by properly recognizing EHS and providing rapid cooling before transport.

Corresponding author's email: jasalonia@chpnet.org Introduction: A paucity of data exists regarding the use of an intravascular cooling catheter to treat hyperthermia in patient's suffering from severe heat stroke. During a prolonged ICU course, the patient developed multiple organ dysfunction with acute respiratory distress syndrome, distributive shock, acute heart failure, acute renal failure, acute hepatic failure, and disseminated intravascular coagulation.

Parts of the Greater Toronto Area (GTA) are under an air quality warning on Monday alongside an ongoing heat warning in the region, Environment Canada says. \"During heavy smoke conditions, everyone's health is at risk regardless of their age or health status,\" Environment Canada said. \"While you wait for medical attention, try to cool the person by moving them to a cool place, removing extra clothing, applying cold water or ice packs around the body,\" Environment Canada said in Monday's warning.

Exertional heatstroke, brought on by strenuous activity, is usually seen in young, active people; classic heatstroke, associated with heat waves, is more common in the elderly and may be epidemic. Cooling and fluids are keys to management; sometimes, intensive care is needed.

Phillips said the seasonal norm for this time of year is around 24 C. While Barrie, Collingwood and Hillsdale are also under a heat warning Monday, Environment Canada says it appears conditions will fall below the heat warning criteria on Tuesday. Myers, who is chair of the TTC board, said staff are doing regular performance checks on outdoor parts of the subway rail tracks to check for any defects caused by the extreme heat. \"While you wait for medical attention, try to cool the person by moving them to a cool place, removing extra clothing, applying cold water or ice packs around the body,\" Environment Canada said in Monday's warning.