Keeping athletes safe in the heat

Summer is an active time of the year for children, especially high school athletes. When kids are playing sports or enjoying other physical activities outdoors, it’s crucial that parents and coaches ensure children are adequately hydrated in order to avoid heat-related illnesses. It is also essential that schools where athletes are training outdoors have an emergency action plan in place.

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Heat-related illnesses are caused by prolonged exposure to high temperatures or doing physical activity in hot weather. The most serious is heat stroke, a life-threatening condition that occurs when body temperature reaches 104 degrees or higher. It follows less serious heat-related conditions such as heat cramps and heat exhaustion if those conditions are not treated. The risk of heat stroke can increase due to high humidity, dehydration, certain health issues and some medications. Heat stroke symptoms include hot, dry skin; nausea and vomiting; rapid breathing; racing heartbeat; headache; confusion; muscle cramps or weakness; and dizziness or fainting.

In June, the National Athletic Trainers’ Association released new guidelines for treating heat-related illnesses. The guidelines emphasize the need for immediate, aggressive cooling when an athlete’s core body temperature reaches 104 degrees.

According to guidelines co-author Rebecca M. Lopez, Ph.D., assistant professor in the department of orthopedics and sports medicine at the University of South Florida, “Someone suffering from an exertional heat stroke is not going to get better just by sitting down and drinking water. They need to be cooled.”

It is important to call 911 and work to cool the person while waiting for medical help to arrive. Cold water immersion is the most effective way to treat a patient with exertional heat stroke. The water should be 35-39 degrees and continuously stirred to maximize cooling. Other cooling methods include removing excess clothing; placing ice packs or cold, wet towels on the head, neck, armpits and groin; and misting the person with water while fanning air over him or her. Heat stroke victims should be cooled until body temperature is below 102.5 degrees, preferably within 30 minutes of collapse.

The association states that since 2005, there have been an estimated 40 deaths related to physical exertion in the heat. These deaths are largely preventable when proper protocols are in place, according to Douglas J. Casa, Ph.D., director of athletic training education at the University of Connecticut and chief operating officer of the Korey Stringer Institute, an organization dedicated to preventing sudden sports deaths from heat stroke and other causes.

Additionally, the association updated their specific recommendations for pre-season heat acclimatization protocol to help prevent athletes from suffering heat-related illness. A pre-season heat acclimatization policy should be implemented to allow athletes to be acclimatized to the heat gradually over a period of 7 to 14 days. Specific recommendations include:

  • Days 1-2: Single three hour practice OR single two hour practice and single one hour field session; only helmets may be worn
  • Days 3-4: Single three hour practice OR single two hour practice and single one hour field session; only helmets and shoulder pads may be worn
  • Day 5: Single three hour practice OR single two hour practice and single one hour field session; full equipment may be worn
  • Days 1-5: Equipment guidelines for preseason participation only impact days 1-5 of the acclimatization period

Read more about the new Exertional Heat Illness Guidelines from the National Athletic Trainers’ Association here.

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