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Exertional heat illness (EHI) is a leading cause of morbidity and mortality in young athletes. It is likely the second most common cause of non-traumatic death in this population1 and may affect individuals exercising in both warm and cool environments. The incidence of EHI has risen over the past three decades,2 likely due to increased recognition, greater participation in strenuous activities and environmental risk from global warming. However, the full burden of disease remains uncertain due to the diverse clinical presentations of EHI, under-reporting and limited diagnostic capabilities in the prehospital environment.