How does anesthesia work?

If you've had surgery, you might remember starting to count backwards from ten, nine, eight and then waking up with the surgery already over before you even got to five.
And it might seem like you were asleep, but you weren't.
You were under anesthesia, which is much more complicated.
You were unconscious, but you also couldn't move, form memories, or, hopefully, feel pain.
Without being able to block all those processes at once, many surgeries would be way too traumatic to perform.
Ancient medical texts from Egypt, Asia and the Middle East all describe early anesthetis containing things like opium poppy, mandrake fruit, and alcohol.
Today, anesthesiologists often combine regional, inhalational and intravenous agents to get the right balance for a surgery.
Regional anesthesia blocks pain signals from a specific part of the body from getting to the brain.
Pain and other messages travel through the nervous system as electrical impulses.
Regional anesthetics work by setting up an electrical barricade.
They bind to the proteins in neuron's cell membranes that let charged particles in and out, and lock out positively charged particles.
One compound that does this is cocaine, whose painkilling effects were discovered by accident when an ophthalmology intern got some on his tongue.
It's still occasionally used as an anesthetic, but many of the more common regional anesthetics have a similar chemical structure and work the same way.
But for major surgeries where you need to be unconscious, you'll want something that acts on the entire nervous system, including the brain.
That's what inhalational anesthetics do.
In Western medicine, diethyl ether was the first common one.
It was best known as a recreational drug until doctors started to realize that people sometimes didn't notice injuries they received under the influence.
In the 1840s, they started sedating patients with ether during dental extractions and surgeries.
Nitrous oxide became popular in the decades that followed and is still used today, although ether derivatives, like sevoflurane, are more common.
Inhalational anesthesia is usually supplemented with intravenous anesthesia, which was developed in the 1870s.
Common intravenous agents include sedatives, like propofol, which induce unconsciousness, and opioids, like fentanyl, which reduce pain.
These general anesthetics also seem to work by affecting electrical signals in the nervous system.
Normally, the brain's electrical signals are a chaotic chorus as different parts of the brain communicate with each other.
That connectivity keeps you awake and aware.
But as someone becomes anesthetize, those signals become calmer and more organized, suggesting that different parts of the brain aren't talking to each other anymore.
There's a lot we still don't know about exactly how this happens.
Several common anesthetics bind to the GABA-A receptor in the brain's neurons.
They hold the gateway open, letting negatively charged particles flow into the cell.
Negative charge builds up and acts like a log jam, keeping the neuron from transmitting electrical signals.
The nervous system has lots of these gated channels, controlling pathways for movement, memory, and consciousness.
Most anesthetics probably act on more than one, and they don't act on just the nervous system.
Many anesthetics also affect the heart, lungs, and other vital organs.
Just like early anesthetics, which included familiar poisons like hemlock and aconite, modern drugs can have serious side effects.
So an anesthesiologist has to mix just the right balance of drugs to create all the features of anesthesia, while carefully monitoring the patient's vital signs, and adjusting the drug mixture as needed.
Anesthesia is complicated, but figuring out how to use it allowed for the development of new and better surgical techniques.
Surgeons could learn how to routinely and safely perform C-sections, reopen blocked arteries, replace damaged livers and kidneys, and many other life savings operations.
And each year, new anesthesia techniques are developed that will ensure more and more patients survive the trauma of surgery.

Why do blood types matter?

It's often said that despite humanity's many conflicts, we all bleed the same blood.
It's a nice thought but not quite accurate.
In fact, our blood comes in a few different varieties.
Our red blood cells contain a protein called hemoglobin that binds to oxygen, allowing the cells to transport it throughout the body.
But they also have another kind of complex protein on the outside of the cell membrane.
These proteins, known as antigens, communicate with white blood cells, immune cells that protect against infection.
Antigens serve as identifying markers, allowing the immune system to recognize your body's own cells without attacking them as foreign bodies.
The two main kinds of antigens, A and B, determine your blood type.
But how do we get four blood types from only two antigens?
Well, the antigens are coded for by three different alleles, varieties of a particular gene.
While the A and B alleles code for A and B antigens, the O allele codes for neither, and because we inherit one copy of each gene from each parent, every individual has two alleles determining blood type.
When these happen to be different, one overrides the other depending on their relative dominance.
For blood types, the A and B alleles are both dominant, while O is recessive.
So A and A gives you type A blood, while B and B gives you type B.
If you inherit one of each, the resulting codominance will produce both A and B antigens, which is type AB.
The O allele is recessive, so either of the other will override it when they're paired, resulting in either type A or type B.
But if you happen to inherit two Os, instructions will be expressed that make blood cells without the A or B antigen.
Because of these interactions, knowing both parents' blood types lets us predict the relative probability of their children's blood types.
Why do blood types matter?
For blood transfusions, finding the correct one is a matter of life and death.
If someone with type A blood is given type B blood, or vice versa, their antibodies will reject the foreign antigens and attack them, potentially causing the transfused blood to clot.
But because people with type AB blood produce both A and B antigens, they don't make antibodies against them, so they will recognize either as safe, making them universal recipients.
On the other hand, people with blood type O do not produce either antigen, which makes them universal donors, but will cause their immune system to make antibodies that reject any other blood type.
Unfortunately, matching donors and recipients is a bit more complicated due to additional antigen systems, particular the Rh factor, named after the Rhesus monkeys in which it was first isolated.
Rh+ or Rhｰ refers to the presence or absence of the D antigen of the Rh blood group system.
And in addition to impeding some blood transfusions, it can cause severe complications in pregnancy.
If an Rhｰ mother is carrying an Rh+ child, her body will produce Rh antibodies that may cross the placenta and attack the fetus, a condition known as hemolytic disease of the newborn.
Some cultures believe blood type to be associated with personality, though this is not supported by science.
And though the proportions of different blood types vary between human populations, scientists aren't sure why they evolved; perhaps as protection against blood born diseases, or due to random genetic drift.
Finally, different species have different sets of antigens.
In fact, the four main blood types shared by us apes seem paltry in comparison to the thirteen types found in dogs.

How does cancer spread through the body?

The onset of cancer usually begins as a solitary tumor in a specific area of the body.
If the tumor is not removed, cancer has the ability to spread to nearby organs, as well as places far away from the origin, such as the brain.
So how does cancer move to new areas, and why are some organs more likely to get infected than others?
The process of cancer spreading across the body is known as metastasis.
It begins when cancer cells from an initial tumor invade nearby normal tissue.
As the cells proliferate, they spread via one of the three common routes of metastasis: transcoelomic, lymphatic, or hematogenous spread.
In transcoelomic spread, malignant cells penetrate the covering surfaces of cavities in our body.
These surfaces are known as peritoneum and serve as walls to segment the body cavity.
Malignant cells in ovarian cancer, for example, spread through peritoneum, which connects the ovary to the liver,  resulting in metastasis on the liver surface.
Next, cancerous cells invaded blood vessels when they undergo hematogenous spread.
As there are blood vessels almost everywhere in the body, malignant cells utilize this to reach more distant parts of the body.
Finally, lymphatic spread occurs when the cancer invades the lymph nodes, and travels to other parts of the body via the lymphatic system.
As this system drains many parts of the body, it also provides a large network for the cancer.
In addition, the lymphatic vessels empty into the blood circulation, allowing the malignant cells to undergo hematogenous spread.
Once at a new site, the cells once again undergo proliferation, and form small tumors known as micrometastases.
These small tumors then grow into full-fledged tumors, and complete the metastatic process.
Different cancers have been known to have specific sites of metastasis.
For example, prostate cancer commonly metastasizes to the bone, while colon cancer metastasizes to the liver.
Various theories have been proposed to explain the migration pattern of malignant cells.
Of particular interest are two conflicting theories.
Stephen Paget, an English surgeon, came up with the seed and soil theory of metastasis.
The seed and soil theory stated that cancer cells die easily in the wrong micro environment, hence they only metastasize to a location with similar characteristics.
However, James Ewing, the first professor of pathology at Cornell University, challenged the seed and soil theory, and proposed that the site of metastasis was determined by the location of the vascular and lymphatic channels which drain the primary tumor.
Patients with primary tumors that were drained by vessels leading to the lung would eventually develop lung metastases.
Today, we know that both theories contain valuable truths.
Yet the full stories of metastasis is much more complicated than either of the two proposed theories.
Factors like the cancer cell's properties, and the effectiveness of the immune system in eliminating the cancer cells, also play a role in determining the success of metastasis.
Unfortunately, many questions about metastasis remain unanswered until today.
Understanding the exact mechanism holds an important key to finding a cure for advanced stage cancers.
By studying both the genetic and environmental factors, which contribute to successful metastasis, we can pinpoint ways to shut down the process.
The war against cancer is a constant struggle, and scientists are hard at work developing new methods against metastasis.
Of recent interest is immunotherapy, a modality which involves harnessing the power of immune system to destroy the migrating cells.
This can be done in different ways, such as training immune cells to recognize cancerous cells via vaccines.
The growth and activity of the immune cells can also be stimulated by injecting man-made interleukins, chemicals which are usually secreted by the immune cells of the body.
These two treatments are only the tip of the iceberg.
With the collaborated research efforts of governments, companies and scientists, perhaps the process of metastasis will be stopped for good.

How does anesthesia work?

If you've had surgery, you might remember starting to count backwards from ten, nine, eight and then waking up with the surgery already over before you even got to five.
And it might seem like you were asleep, but you weren't.
You were under anesthesia, which is much more complicated.
You were unconscious, but you also couldn't move, form memories, or, hopefully, feel pain.
Without being able to block all those processes at once, many surgeries would be way too traumatic to perform.
Ancient medical texts from Egypt, Asia and the Middle East all describe early anesthetis containing things like opium poppy, mandrake fruit, and alcohol.
Today, anesthesiologists often combine regional, inhalational and intravenous agents to get the right balance for a surgery.
Regional anesthesia blocks pain signals from a specific part of the body from getting to the brain.
Pain and other messages travel through the nervous system as electrical impulses.
Regional anesthetics work by setting up an electrical barricade.
They bind to the proteins in neuron's cell membranes that let charged particles in and out, and lock out positively charged particles.
One compound that does this is cocaine, whose painkilling effects were discovered by accident when an ophthalmology intern got some on his tongue.
It's still occasionally used as an anesthetic, but many of the more common regional anesthetics have a similar chemical structure and work the same way.
But for major surgeries where you need to be unconscious, you'll want something that acts on the entire nervous system, including the brain.
That's what inhalational anesthetics do.
In Western medicine, diethyl ether was the first common one.
It was best known as a recreational drug until doctors started to realize that people sometimes didn't notice injuries they received under the influence.
In the 1840s, they started sedating patients with ether during dental extractions and surgeries.
Nitrous oxide became popular in the decades that followed and is still used today, although ether derivatives, like sevoflurane, are more common.
Inhalational anesthesia is usually supplemented with intravenous anesthesia, which was developed in the 1870s.
Common intravenous agents include sedatives, like propofol, which induce unconsciousness, and opioids, like fentanyl, which reduce pain.
These general anesthetics also seem to work by affecting electrical signals in the nervous system.
Normally, the brain's electrical signals are a chaotic chorus as different parts of the brain communicate with each other.
That connectivity keeps you awake and aware.
But as someone becomes anesthetize, those signals become calmer and more organized, suggesting that different parts of the brain aren't talking to each other anymore.
There's a lot we still don't know about exactly how this happens.
Several common anesthetics bind to the GABA-A receptor in the brain's neurons.
They hold the gateway open, letting negatively charged particles flow into the cell.
Negative charge builds up and acts like a log jam, keeping the neuron from transmitting electrical signals.
The nervous system has lots of these gated channels, controlling pathways for movement, memory, and consciousness.
Most anesthetics probably act on more than one, and they don't act on just the nervous system.
Many anesthetics also affect the heart, lungs, and other vital organs.
Just like early anesthetics, which included familiar poisons like hemlock and aconite, modern drugs can have serious side effects.
So an anesthesiologist has to mix just the right balance of drugs to create all the features of anesthesia, while carefully monitoring the patient's vital signs, and adjusting the drug mixture as needed.
Anesthesia is complicated, but figuring out how to use it allowed for the development of new and better surgical techniques.
Surgeons could learn how to routinely and safely perform C-sections, reopen blocked arteries, replace damaged livers and kidneys, and many other life savings operations.
And each year, new anesthesia techniques are developed that will ensure more and more patients survive the trauma of surgery.

What causes bad breath?

There is a curse that plagued humanity since ancient times.
The Greeks fought it by chewing aromatic resins, while the Chinese resorted to egg shells.
In the ancient Jewish Talmud, it's even considered legal grounds for divorce.
This horrible scourge is halitosis, otherwise known as bad breath.
But what causes it, and why is it so universally terrifying?
Well, think of some of the worst odors you can imagine, like garbage, feces or rotting meat.
All of these smells come from the activity of microorganisms, particularly bacteria, and, as disgusting as it may sound, similar bacteria live in the moisture-rich environment of your mouth.
Don't panic.
The presence of bacteria in your body is not only normal, it's actually vital for all sorts of things, like digestion and disease prevention.
But like all living things, bacteria need to eat.
The bacteria in your mouth feed of of mucus, food remnants, and dead tissue cells.
In order to absorb nutrients through their cell membranes,  they must break down the organic matter into much smaller molecules.
For example, they'll break proteins into their component amino acids and then break those down even further into various compounds.
Some of the foul-smelling byproducts of these reactions, such as hydrogen sulfide and cadaverine, escape into the air and waft their way towards unsuspecting noses.
Our sensitivity to these odors and interpretation of them as bad smells may be evolutionary mechanism warning us of rotten food and the presence of disease.

Smell is one of our most intimate and primal senses, playing a huge role in our attraction to potential mates.
In one poll, 59%of men and 70% of women said they wouldn't go on a date with someone who has bad breath, which may be Americans alone spend $1 billion a year on various breath products.
Fortunately, most bad breath is easily treated.
The worst smelling byproducts come from gram-negative bacteria that live in spaces between gums and teeth and on the back of the tongue.
By brushing and flossing our teeth,using antibacterial mouthwash at bedtime,gently cleaning the back of the tongue with a plastic scraper and even just eating a healthy breakfast,we can remove many of these bacteria and their food sources.
In some cases, these measures may not be enough due to dental problems, nasal conditions, or rarer ailments, such as liver disease and uncontrolled diabetes.
Behaviors like smoking and excessive alcohol consumption also have a very recognizable odor.
Regardless of cause, the bad smell almost always originates in the mouth and not the stomach or elsewhere in the body.
But one of the biggest challenges lies in actually determining how our breath smells in the first place, and it's unclear why.
It may be that we're too acclimatized to the smell inside our own mouths to judge it.
And methods like cupping your hands over your mouth, or licking and smelling your wrist don't work perfectly either.
One study showed that even when people do this, they tend to rate the smell subjectively according to how bad they thought is was going to be.
But there's one simple, if socially difficult, way of finding out how your breath smells; just take a deep breath and ask a friend.

How a wound heals itself?

The largest organ in your body isn't your liver or your brain.
It's your skin, with a surface area of about 20 square feet in adults.
Thought different areas of the skin have different characteristics, much of this surface performs similar functions, such as sweating, feeling heart and cold, and growing hair.
But after a deep cut or wound, the newly healed skin will look different from the surrounding area, and may not fully regain all its abilities for a while, or at all.
To understand why this happens, we need to look at the structure of the human skin.
The top layer, called the epidermis, consists mostly of hardened cells , called keratinocytes, and provides protection.
Since its outer layer is constantly being shed and renewed, it's pretty easy to repair.
But sometimes a wound penetrates into the dermis, which contains blood vessels and the various grounds and nerve endings that enable the skin's many functions.
And when that happens, it triggers the four overlapping stages of the regenerative process.
The first stage, hemostasis, is the skins response to two immediate threats: that you're now losing blood and that the physical barrier of the epidermis has been compromised.
As the blood vessels tighten to minimize the bleeding, in a process known as vasoconstriction, both threats are averted by forming a blood clot.
A special protein known as fibrin forms cross-links on the top of the skin, preventing blood from flowing out and bacteria or pathogens from getting in.
After about three hours of this, the skin begins to turn red, signaling the next stage, inflammation.
With bleeding under control and the barrier secured, the body sends special cells to fight any pathogens that may have gotten through.
Among the most important of these are white blood cells, known as macrophages, which devour bacteria and damage tissue through a process known as phagocytosis, in addition to producing growth factors to spur healing.
And because these tiny soldiers need to travel through the blood to get to the wound site, the previously constricted blood vessels now expand in a process called vasodilation.
About two to three days after the wound, the proliferative stage occurs, when fibroblast cells begin to enter the wound.
In the process of collagen deposition, they produce a fibrous protein called collagen in the wound site, forming connective skin tissue to replace the fibrin from before.
As epidermal cells divide to reform the outer layer of skin, the dermis contracts to close the wound.
Finally, in the forth stage of remodeling, the wound matures as the newly deposited collagen is rearranged and converted into specific types.
Through this process, which can take over a year, the tensile strength of the new skin is improved, and blood vessels and other connections are strengthened.
With time, the new tissue can reach from 50-80% of some of its original healthy function, depending on the severity of the initial wound and on the function itself.
But because the skin does not fully recover, scarring continues to be a major clinical issue for doctors around the world.
And even though researchers have made significant strides in understanding the healing process, many fundamental mysteries remain unresolved.
For instance, do fibroblast cells arrive from the blood vessels or from skin tissue adjacent to the wound?
And why do some other mammals, such as deer, heal their wounds much more efficiently and completely than humans?
By finding the answers to these questions and others, we may one day be able to heal ourselves so well that scars will be just a memory.

What is Alzheimer's disese?

Every four seconds, someone is diagnosed with Alzheimer's disease.
It's the most common cause of dementia, affecting over 40 million people worldwide, and yet finding a cure is something that still eludes researchers today.
Dr. Alois Alzheimer, a German psychiatrist, first described the symptoms in 1901 when he noticed that a particular hospital patient had some peculiar problems, including difficulty sleeping, disturbed memory, drastic mood changes, and increasing confusion.
When the patient passed away, Alzheimer was able to do an autopsy and test his idea that perhaps her symptoms were caused by irregularities in the brain's structure.
What he found beneath the microscope were visible differences in brain tissue in the from of misfolded proteins called plaques, and neurofibrillary tangles.
Those plaques and tangles work together to break down the brain's structure.
Plaques arise when another protein in the fatty membrane surrounding nerve cells gets sliced up by a particular enzyme, resulting in beta-amyloid proteins, which are sticky and have a tendency to clump together.
That clumping is what forms the things we know as plaques.
These clumps block signaling and, therefore, communication between cells, and also seem to trigger immune reactions that cause the destruction of disabled nerve cells.
In Alzheimer's disease, neurofibrillary tangles are built from a protein know as tau.
The brain's nerve cells contain a network of tubes that act like a highway for food molecules among other things.
Usually, the tau protein ensures that these tubes are straight, allowing molecules to pass through freely.  But in Alzheimer's disease, the protein collapses into twisted strands or tangles, making the tubes disintegrate, obstructing nutrients from reaching the nerve cell and leading to cell death.

The destructive pairing of plaques and tangles start in a region called the hippocampus, which is responsible for forming memories.
That's why short-term memory loss is usually the first symptom of Alzheimer's.
The proteins then progressively invade other parts of the brain, creating unique changes that signal various stages of the disease.
At the front of the brain, the proteins destroy the ability to process logical thoughts.
Next, they shift to the region that controls emotions, resulting in erratic mood changes.
At the top of the brain, they cause paranoia and hallucinations, and once they reach the brain's rear, the plaques and tangles work together to erase the mind's deepest memories.
Eventually the control centers governing heart rate and breathing are overpowered as well resulting in death.
The immensely destructive nature of this disease has inspired many researchers to look for a cure but currently they’re focused slowing its progression.
One temporary treatment helps reduce the break down of acetylcholine, an important chemical messenger in the brain which is decreased in Alzheimer's patients due to the death of the nerve cells that make it.
Another possible solution is a vaccine that trains the body's immune system to attack beta-amyloid plaques before they can form clumps.
But we still need to find an actual cure.
Alzheimer's disease was discovered more than a century ago, and yet still it is not well understood.
Perhaps one day we'll grasp the exact mechanisms at work behind this threat and a solution will be unearthed.

What does the liver do?

There's a factory Inside you that weighs about 1.4 kilograms and runs for 24 hours a day.
This is your liver, the heaviest organ in your body, and one of the most crucial.
This industrious structure simultaneously acts as a storehouse, a manufacturing hub, and a processing plant.
And each of these functions involve so many important subtasks that without the liver, our bodies would simply stop working.
One of the liver's main functionality is to filter the body's blood, which it receives in regular shipments from two sources: the hepatic artery delivers blood from the heart, while the hepatic portal vein brings it from the intestine.
This double delivery fills the liver with nutrients, that it then sorts, processes and stores with the help of thousands of tiny internal processing plants, known as lobules.
Both blood flows also deliver the oxygen that the liver needs to function.
The blood that is received from the intestine contains carbohydrates, fats, and vitamins and other nutrients dissolved in it from the food you've consumed.
These must be processed in different ways.
In the case of carbohydrates, the liver breaks them down and converts them into sugars for the body to use as energy when the filtered blood is sent back out.
Sometimes the body has leftovers of nutrients that it doesn't immediately require.
When that happens, the liver holds some back, and stacks them in its storage facility.
This facility works like a pantry for future cases when the body might be need of nutrients.
But the blood flowing into the liver isn't always full of good things.
It also contains toxins and byproducts that the body can't use.
And the liver monitors these strictly.
When it spots a useless or toxic substance, it either converts it into a product that can't hurt the body or isolates it and whisks it away, channeling it through the kidneys and intestine to be excreted.
Of course, we wouldn't consider the liver a factory if it didn't also manufacture things.
This organ makes everything from various blood plasma proteins that transport fatty acids and help form blood clots, to the cholesterol that helps the body create hormones.
It also makes vitamin D and substances that help digestion.
But one of its most vital products is bile.
Like an eco-friendly treatment plant, the liver uses cells called hepatocytes to convert toxic waste products into this bitter greenish liquid.
As it's produced, bile is funneled into a small container below the liver, called the gallbladder, before being trickled into the intestine to help break down fats, destroy microbes, and neutralize extra stomach acid.
Bile also helps carry other toxins and byproducts from the liver out of the body.
So as you can see, the liver is an extremely efficient industrial site, performing multiple tasks that support each other.
But such a completed system needs to be kept running smoothly by keeping it healthy and not overloading it with more toxins than it can handle.
This is one factory we simply can't afford to shut down.

What happens when you get heat stroke?

In 1985, 16-year-old Douglas Casa, ran the championship 10,000 meter track race at the Empire State Games.
Suddenly, with just 200 meters to go, he collapsed, got back up and then collapsed again on the final straightaway, with his body temperature at dangerous levels.
He had suffered an exertional heat stroke.
Fortunately, with immediate and proper treatment, he survived the potentially fatal episode and has since helped save  167 people in similar circumstances.
From ancient soldiers on the battlefield to modem day warriors on the gridiron, exertional heat stroke,or sunstroke, has long been a serious concern.
And unlike classical heat stroke,witch affects vulnerable people such as infants and the elderly during heat waves, exertional heat stroke is caused by intense exercise in the heat, and is one of the top three killers of athletes and soldiers in training.
When you exercise, nearly 80% of the energy you use is transformed into heat.
In normal circumstances, this is what's known as compensable heat stress.
And your body can dissipate the heat as quickly as it's generated through cooling methods like the evaporation  of sweat.
But with uncompensable heat  stress,your body unable to lose enough heat due to over exertion or high temperatures in humidity which raises your core temperature beyond normal levels.
This causes the proteins and cell membranes  to denature,creating cells that no longer function properly and begin to leak their contents.
If these leaky cells proliferate though the body,
the results can be devastating.
Including liver damage,blood clot formation in the kidneys.
damage to the gastrointestinal tract and even the failure of vital organs.
So how do you diagnose an exertions heat stroke?
The main criterion is a core body temperature greater than 40 degrees Celsius observed along with physical symptoms such as increased heart rate,low blood pressure and rapid breathing or signs of central nervous system distinction such as confused behavior,aggression or loss of consciousness.
The most feasible and accurate way to assess core body temperature is with a rectal thermometer.
as other common temperature-taking methods are not accurate in these circumstances.
As far as treatment goes.
the most important thing to remember is cool first, transport second.
Because the human body can withstand a core temperature above 40 degrees Celsius for about 30 minutes before cell damage sets in, it's essential to initiate rapid cooling on site in order to  lower it as quickly as possible.
After any athletic or protective gear has been removed  from the victim,place them in an ice water tub while stirring the water and monitoring vitals continuously.
If this is not possible,dousing in ice water and applying wet towels over the entire body can help.
But before you start.
emergency services should be called.
As you wait,It's important to keep the victim calm until emergency personnel arrive.
If medical staff are available on site.
cooling should continue
until a core temperature of 38.9 degrees Celsius is reached.
The sun is known for giving life,  but it can also take life away if we're not careful,even affecting the strongest among us.
As Dr. JJ Levick wrote of exertional heat stroke in 1859, "It strikes down its victim with
his full armor on.  Youth, health and strength oppose no obstacle to its power."
But although this condition is one of the top three leading causes of death in sports, it has been 100% survivable with proper care.