Warrior Heat- and Exertion-Related Events CollaborativeCHAMP initiates subspecialty evaluations of ERIs through USU’s Multidisciplinary Case Review Committee (MDCRC). MDCRC has been in existence for 6 years and consists of 7 physicians and 6 doctorals who have appointments at either USU or Walter Reed National Military Medical Center (WRNMMC). Members of MDCRC have expertise in sports medicine, family medicine, neuromuscular medicine, genetics, cardiology, pulmonology, nutrition, or combinations of these. Note that MDCRC operates outside of any research protocols, and their services are also available to Military Service Members who do not wish to participate in the current study.

Upon receiving a referral from a treating physician at an MTF, MDCRC reviews the Military Service Member’s record and makes a joint clinical recommendation regarding whether the patient should be rested and returned to duty or sent for further evaluation. For those who require further evaluation, additional tests are recommended by MDCRC to include neurologic examination with electromyography (EMG), exercise intolerance panel (EIP), muscle biopsy with caffeine-halothane contracture testing (CHCT), myoglobinuria panel, exercise testing (such as heat tolerance testing [HTT], step testing, and VO2max testing), or combinations of these. Results from these tests help MDCRC and a Military Service Member’s treating physician make return-to-duty decisions.

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