On the real-time prevention and monitoring of exertional heat illness in military personnel.

The proliferation of user-friendly low-cost wearable sensors has brought the concept of real-time physiological monitoring for exertional heat illness to the cusp of reality. This paper reviews and discusses the current state of the art in real-time physiological status monitoring for exertional heat illness mitigation within the military context. The review examines how both advanced sensor systems, models and algorithms are being combined in an international and collaborative way and how this is providing real solutions to military units to reduce the risk held by the commander. This paper provides additional detail into the process of integrating physiological status monitoring into military training, it explores the development of on-body sensors, the algorithms that can provide actionable information, the process of planning and dynamic risk assessment and describes some of the physiological monitoring systems that are currently being developed by the representative nations. It then discusses the knowledge gaps of how the technology will be integrated into military training, the importance of meaningful, accurate information that is both sensitive and specific and further developing the accuracy of the algorithms and models that are being employed. Finally, it talks about future direction and how individualizing physiological status monitoring can lead to performance enhancement in the form of individualized heat acclimatization programs. In conclusion, physiological status monitoring is at a stage of transition and integration where it can be used effectively to manage and reduce exertional heat illness to enable military personnel to train hard-train safe.