Heat Illness Update

The NATA and the National Safe Kids Campaign have prepared guidelines for use by parents and coaches for combating heat-related illness, including an activity schedule based on temperature and humidity levels:

Parent and Coaches Guide to Heat

With the record-breaking heat wave that has recently swept the south, athletes and coaches need to take extra precautions when exercising outdoors. As the temperatures remain in the 90s and the humidity is high, the risk of suffering a heat related illness increases. In addition to football players, athletes involved in other sports like cross country, summer baseball, softball, lacrosse, soccer and marching band members are also at risk.

The main mechanism the body cools itself is by evaporation through sweating. Exercising muscle produces heat that needs to leave the body through evaporation of sweat. If the humidity is high, and the air is already saturated with water, the sweat will not evaporate effectively and the body’s cooling system is inefficient. Heavy pads, hats and helmets, as well as heavy clothing already saturated can also hinder evaporative cooling.

Hydration status is also vital to maintaining cooling efficiency. As the body’s fluid stores become depleted, the ability to get fluid to the skin surface for evaporation decreases, and body heat builds up.

When the body’s ability to dissipate heat and cool itself fails, heat illness results.

Heat illness can be categorized based on severity or the symptoms

Dehydration – the earliest and most mild form of heat related illness, but still serious. Symptoms include:

• Thirst
• Dry mouth
• Nausea
• Headache
• Dizzy or disoriented
• Muscle or abdominal cramps

Treatment for dehydration is immediate removal from exercise and placement in the shade or air-conditioned environment, removal of equipment and unnecessary clothing and very close observation for progression of symptoms.

Heat Exhaustion – the body’s cooling mechanisms begin to fail as exercise continues. Symptoms include:

• Excessive thirst
• Profuse sweating
• Headache, abdominal pain, nausea, vomiting
• Dizziness and disorientation
• Fainting or passing out

Immediate treatment for heat exhaustion is the same for dehydration with arrangements to be made to transport to an Emergency Department. While awaiting transport, elevate the legs and cool rapidly with cold water, wet towels, ice packs in armpits and neck, or fans. Monitor very closely for deterioration.

Heat Stroke – the body’s cooling mechanism has failed and the core body temperature begins to rapidly rise. This condition is life-threatening.

• Nausea, vomiting, diarrhea
• Disorientation, headache
• Hot skin (wet or dry)
• Rapid heart rate, rapid breathing
• Seizures
• Coma

Treatment consists of rapid cooling, calling 911, support with CPR until ambulance arrives.

Heat related illness is a preventable condition that, when it does occur, requires immediate recognition and treatment. The most effective way to treat heat illness is to prevent it. Below are some guidelines for heat illness prevention.

1. Schedule frequent water breaks, as often as every 20-30 minutes, with removal of equipment, including shoulder pads.
2. Schedule workouts during cooler times of the day.
3. Allow overweight or non-acclimated kids to adjust to the heat through shorter, less strenuous workouts.
4. Encourage kids to drink water or Gatorade throughout the day during school to maintain their hydration. Encourage school administration to allow players to carry water bottles with them in school.
5. Implement a “buddy system” where each player is assigned to keep an eye on a teammate to recognize early signs or heat illness.
6. Follow the guidelines set forth by the National Athletic Trainers’ Association (NATA) for altering outdoor practice length, intensity and equipment use based on the temperature and humidity (heat index).
7. Have an emergency action plan posted.
   
   1. AED location and knowledge of use
   2. Charged cell phone
   3. Specific directions for ambulance (unlock gates)
   4. Parent contact information for all players
   5. Locate shade and have ice bags available for rapid cooling