Heat Related Illness

1. Heat Related Illness Diane King, MS, RD, CSSD, ATC

2. What is Heat Illness? • It is an accumulation of body heat that results when the body’s ability to cool itself is overwhelming. • Body heat increases during exercise naturally and can cool itself through sweat evaporation.

3. Why is Heat Illness a Problem in the South? • The risk of developing heat illness significantly increases in hot, humid environmental conditions because the evaporation of sweat is hindered. • Exercise in our conditions can cause dehydration in as little as 30 minutes.

4. Three Levels of Heat Illness • Heat Cramps • Heat Exhaustion • Heat Stroke

5. What are Heat Cramps? Painful, involuntary muscle spasms that occur during heavy exercise in hot environments. Inadequate fluid intake is often the cause. Muscles most often affected are your calves, quads, arms, abdomen and back.

6. Heat Cramps: First Aid • Rest and cool down in the shade. • Drink water or sports drinks. Sip! • Massage and stretch affected area. • If cramps do not go away in one hour, call a doctor.

7. Heat Cramps Recognition at this point is critical to prevent further illness.

8. What is Heat Exhaustion? This is what develops after heat cramps have been left untreated. Symptoms include: • Extreme thirst • Feeling faint • Nausea • Heavy sweating • Ashen or grey appearance • Rapid, weak heart beat • Low blood pressure • Cool, moist skin • Low-grade fever

9. Heat Exhaustion: First Aid • Get the student out of the sun and into a shady or air conditioned location. • Lay the student down with feet up. • Remove excessive clothing or equipment. • Drink small amounts of water, often. • Cool the student by spraying or sponging them off with cool water. ***Monitor carefully!! Heat exhaustion can quickly become Heat stroke, when in doubt, call 911.

10. What is Heatstroke? Like heat cramps and heat exhaustion, Heatstroke is often caused from heavy work in hot, humid environments, usually from inadequate fluid intake. The difference is thermoregulatory capacity is exceeded, and extreme metabolic stresses produce tissue damage, and physiological dysfunction that can result in death.

11. Heatstroke Symptoms • Dry, hot, red skin • Rapid heart beat, shallow breathing • Dizziness, nausea • Loss of coordination • Irritability, belligerence • Seizures • Coma ***Remember, your heart is a muscle.

12. Heatstroke: First aid • CALL 911!! While waiting on EMS • Get the student in a cool place or shade. • Remove unnecessary clothing and shoes. • Rapid cooling such as ice towels or ice packs on neck, groin and head. • Monitor ABC’s airway breathing circulation

13. How To Adjust For The Heat Index • Modifying practice sessions for exercising adolescents WBGT Restraints on Activities °F °C ____________________________________ <75.0 <24.0 All activities allowed, but be alert for signs and symptoms of heat-related illness in prolonged events 75.0 - 78.6 24.0 -25.9 Longer rest periods in the shade; enforce drinking every 15 minutes 79.0 – 84.0 26.0 – 29.0 Stop activity of unacclimatized persons and high-risk persons; limit activities of all others (disallow long distance races, cut the duration of other activities) > 85.0 > 29.0 Cancel all athletic activities

14. Prevention is the key… • Stress to your students they have to come to PE already hydrated. • Have water available within arms reach. • Drink every 15 minutes. • Take frequent breaks. • Dress for the weather. ****Coaches- Allow for acclimation.

15. Such A Lovely Sight –When It’s Hot, Cool ‘Em Down

16. After exercise… Fluid replacement • 20oz. of fluid per pound of weight loss within 2 hours of exercise. (Coaches- weigh athletes before and after practices, when the temperature is above 90 degrees) • Encourage students to drink water, or sports drinks, when they are at home and not soft drinks or tea.

17. Water vs. Sports drinks Water • Hydrates, but some believe it “washes out electrolytes”. • Hyponatremia Sports Drinks • Hydrates, but some believe they have too much sugar that can cause nausea and diarrhea. • Fast electrolyte replacement. ***Use both!!!

18. Early “Quick Fixes” • Bananas • Salty foods • Sports drinks (not energy drinks) • Yellow mustard • Salt or salt substitute ***ALWAYS follow quick fixes with proper hydration.

19. What About MRSA? • To answer the question what are the symptoms of MRSA, it is important to understand that most MRSA symptoms are identical to traditional staph infection symptoms; MRSA is simply a sub-category of staph infection • Only a professional bacterial culture or bacterial DNA test can confirm if you have an MRSA or staph infection. • MRSA and staph infection are often diagnosed as causing one of several conditions.

20. What About MRSA? Staph infection symptoms and signs of MRSA infection can show up any place on your body but are more common in the following specific areas: • Areas of clothing friction and irritation, such as the legs, buttocks and shaving areas and places where football pads touch the skin • Sweaty areas like armpits, neck, face, groin and feet • Deeper infections like cellulitis are most common on the arms, hands, lower legs and face.

21. Images • Cellulitis

22. Staph • Clusters

23. MRSA • Hand • Knee

24. What Does MRSA Look Like? • The most common visible MRSA symptoms are bumps, pimple-like lumps, or blisters on the skin (these are also the symptoms of staph aureus infection in general). • Lumps on the skin are often accompanied by swelling and reddening of the surrounding skin area. • The center of the lump often has a white or yellow pus filled head, which sometimes drains on its own.

25. What Does MRSA Look Like? • The lumps are often tender, itchy and warm to the touch and can become deep sores with increasing pain and swelling if left unchecked. • The color of the surrounding skin area is often red to purple and may begin to spread as the infection progresses. • Available on-line at: http://www.cdc.gov/ncidod/hip/aresist/ca_mrsa_public.htm

26. Is It Really “A Big Deal?” • Most MRSA and staph infections are limited to the skin. However, staph can also enter your bloodstream and spread to internal organs. More serious staph infections symptoms that can result from an internal infection are: • Fever • Chills • Weakness or fatigue • Shortness of breath • Rashes • Headache • Muscle aches • Nausea • Acute pain

27. Conclusion • Prevention • Education • Early recognition • Quick response • Have necessary tools readily available.

28. Conclusion Questions??? Resources – www.nata.org/statements/index.htm www.nata.org/youthsports/index.htm www.ghsa.net/sportsmedicine www.gssiweb.org

29. Nutrition:Fueling Your Performance Diane King, MS, RD, CSSD, ATC

30. Know Your Limits For Giving Advice • Recommendations should be Basic • Teach them to Avoid Skipping Meals or Snacks • Fluids Are Important • Eat Every 3-4 Hours When Possible

31. Secret To Optimal Performance • “The real secret of effective training is conditioning your brain to recognize what kind of foods your body needs.”

32. Energy Requirements • Another Estimate for Active, Male Athletes: (your body weight x 21) + activity = calories/day A 200-pound male practicing soccer for 2 hours can use approximately 630 calories ; a 150-pound athlete can burn about 475 calories

33. Myth Buster • I need extra protein because I’m trying to build muscle • There’s no such thing as to much muscle

34. Pre-Practice Snack Ideas • CRUNCHY – Pretzels, Popcorn, Animal Crackers, Trail Mix, Granola Bars, Baked Chips • CHEWY – Raisins, Dried Fruit, Bagels, Breakfast Bars, Rice Krispie Treats • CREAMY – Pudding, Yogurt, Peanut Butter, Milkshakes • Juicy – Fresh Fruits, Applesauce, Juice Packs, Jello

35. Fast Food • Plan Ahead For The Days When You Know You Need To Stop. • Portion Control and Balanced Food Choices Can Be The Key. • Skip The Empty Calories.

36. Recovery Nutrition • Within the FIRST 30 minutes of completing practice. • Quantity is based on the age and size of child. • Fluids are okay, but don’t get too full. • Should include Carbs plus Protein

37. Recovery Fluids • Sports Drinks, like Gatorade • Accelerade • Chocolate Milk • Fruit Smoothies • Fruit Juice • NOT ENERGY DRINKS • NOT DILUTED FRUIT JUICES • NOT SODA

38. Recommended Intakes for Kids • TimingAmount 2 hours before 2 cups 10-15 minutes before 2 – 2 ½ cups Every 15-20 minutes during ½ - 1 cup After Activity 2 cups for every pound lost

39. Color Scale • Pale like Lemonade • Not Dark Like Apple Juice

40. Game Day Nutrition • 2 to 3 hours before event • Meal should include • 2/3 high-carbohydrate options for quick energy • 1/3 lean protein to build and help repair muscle • Food should be salted to replace sodium lost through sweating • Game Day Meal Ideas

41. Game Day Nutrition • If Schedule Does Not Permit Going Home Between School and Game, Pack Foods Like: • Sports drinks • Energy bars • Sub sandwiches • Snack pack cans of tuna/chicken • Dried fruit • Whole fruit • Crackers and Bagels

42. Pure Evil? Pure Fun Pure Nutrition? Not Always “Cool” Half-Time Snacks Won’t Fix Otherwise Poor Eating Habits.

43. Food is Fuel - Summary Strategies To Help Maintain “Fuel Tanks” • Encourage Athletes to Eat Breakfast Even If It Is Small. • Focus On “Grab & Go” Foods. • Focus on Foods With Protein and Carbohydrate.