Heat Illness: Prevention and Treatment

1. Heat Illness: Prevention and Treatment Perry Baker Supervisor of Athletics and Extracurricular Activities

2. Dangerous Conditions • Heat Index – Know Temperature and Humidity Level • Test Air with WBGT Heat Index Monitor 65-73 Moderate Risk 73-82 High Risk 82+ Very High Risk

3. NOAA’s National Weather Service Heat Index Courtesy of NOAA’s National Weather Service www.nws.noaa.gov

4. Signs of Dehydration • Dry mouth • Thirst • Irritable or cranky • Headache • Bored or disinterested • Dizziness • Cramps • Excessive fatigue • Not able to keep up • Dark yellow urine

5. Other factors for Illness from Heat • Low fitness levels • High body fat • Sickness • Previous dehydration or heat illnesses • Inadequate heat acclimatization • Salt deficiency • Medications/Dietary supplements

6. Serious Health Risks • Dehydration Can Result In: • Heat Cramps • Heat Exhaustion • Heat Stroke • Recognize Warning Signs of Heat Illness

7. Heat Cramps • Are a mild heat illness that can be treated easily. • Intense muscle spasms can develop after exercising and losing large amounts of fluid and salt from sweating. • Athletes who sweat a lot or have a high concentration of salt may be more likely to get heat cramps.

8. Heat Cramps • Signs/Symptoms • Intense pain • Persistent muscle contractions • Treatment • Hydration (sports drink and/or water) • Possibly extra sodium • Stretching, relaxation, massage

9. Heat Cramps When can the athlete play again? • As soon as they are symptom free. • Important to continue to monitor. • May need to change eating and drinking habits, become more fit, or get better adjusted to the heat.

10. Heat Exhaustion • Is a moderate Heat Illness that occurs when an athlete continues to be physically active even after suffering from ill effects of the heat. • The body struggles to keep up with the demands, leading to heat exhaustion.

11. Heat Exhaustion • Signs/Symptoms • Loss of coordination, dizziness or fainting • Dehydration • Profuse sweating or pale skin • Headache, nausea, vomiting or diarrhea • Stomach/Intestinal cramps or muscle cramps • Treatment • Shade or air conditioned area • Remove excess clothing and equipment • Lie comfortably with feet above heart level • If not nauseous, rehydrate with water or sports drink • Monitor heart rate, blood pressure, CNS status and core temperature

12. Heat Exhaustion When can the athlete play again? • Should not be allowed to return until all symptoms are gone. • Avoid intense practice in heat for a few days. • If received medical treatment, not until doctor approves and gives specific return to play instructions.

13. Heat Stroke • Is a severe heat illness that occurs when an athlete’s body creates more heat than it can release, due to the strain of exercising in the heat. • Results in rapid increase in core body temperature. • Can lead to permanent disability or death.

14. Heat Stroke • Signs/Symptoms • Core body temperature 104°F+ • CNS dysfunction • Nausea, vomiting or diarrhea • Headache, dizziness or weakness • Hot & wet or dry skin • Increased heart rate, decreased blood pressure or fast breathing • Dehydration • Combativeness • Treatment • 911 • Aggressive whole-body cooling (cold water immersion) • Fans/ice/cold towels over much of the body if immersion is not available.

15. Heat Stroke When can an athlete play again? • When the doctor approves and gives specific return to play instructions. • Parents should work with doctors to rule out or treat other conditions that may cause continued problems. • Should return very slowly under the supervision of health care professional.

16. Prevention • Meet with prospective players and parents to educate them. • Discuss pre-season conditioning program • Avoid mid-day heat • Take regular breaks in shade • Slowly increase practice time and intensity • Pre-participation physical • Emergency action plan • ATC on site if possible.

17. Activity Guidelines • 5-10 minute rest & fluid break after 25-30 minutes of activity • 5-10 minute rest & fluid break after 25-30 minutes of activity/should be in shorts & t-shirt with helmet & should pads. • 5-10 minute rest & fluid break after every 15-20 minutes of activity/shorts & t-shirt only. • Cancel or postpone all outdoor practices. Practice in air conditioned space.

18. Acclimation to Heat • Promote conditioning • Usually takes 10-14 days • Carefully observe athletes

19. Hydration • Encourage athletes to drink before, during and after exercise • Take regular drink breaks in shade • Helpful Beverages: water and sports drinks with adequate electrolytes • Harmful Beverages: fruit juice, CHO gels, soda, sports drinks 8%+CHO, caffeinated drinks

20. Monitor Weight Loss • Athletes should weigh before and after practice • Check weight charts • Up to 3 percent weight loss through sweating is normal

21. Use Caution • Health and safety of our athletes comes before anything else • Recognize signs and symptoms • Be prepared for treatment

22. Resources Heat Stress and Athletic Participation. National Federation of State High School Associations.16 July 2008. http:www.nfhs.org/web/2005/03/sports_medicine_heat_stress_and_athletic_participation.asp How to Recognize, Prevent & Treat Exertional Heat Illnesses. National Athletic Trainers’ Association. 16 July 2008 http://www.nata.org/newsrelease/archives/000056.htm Kendrick Fincher Memorial Foundation. 16 July 2008. http://www.kendrickfincher.org/index.htm National Oceanic and Atmospheric Administration’s National Weather Service Heat Index. United States Department of Commerce. Chart. 23 July 2008. http://www.weather.gov/os/heat/index.shtml Parents’and Coaches’ Guide to Dehydration and Other Heat Illnessess in Children. National Athletic Trainers’ Association. June 2003. http://www.nata.org/industryresources/heatillnessconcensusstatement.pdf. Preseason Heat-Acclimatization Guidelines for Secondary School Athletics. Journal of Athletic Training Volume 44 Number 3 June 2009. National Athletic Trainers Association http://www.nata.org/jat Recommendations for Hydration to Prevent Heat Illness. National Federation of State High School Associations. 16 July 2008. http://www.nfhs.org/core/contentmanager/uploads/heatstressflyers.pdf Heat Illness: Prevention and Treatment. Lynn Carr. August 2008.