EXERTIONAL HEAT ILLNESS POLICY
- Activity in hot or humid environments can easily cause a number of heat related illnesses. Heat illness can occur in anyone at any time. The signs and symptoms listed below usually do not occur in a stepwise manner and can change rapidly dependent on the person, situation, and activity. All signs and symptoms should be treated as serious and help sought in a timely manner. Categories of heat illness include:
- Heat Syncope – generally referred to as fainting because of exposure to high environmental temperatures, vasodilatation, reduced cardiac output, and dehydration. This can occur due to long periods of standing, cessation of activity, or movement from a seated to standing position. A person who has suffered syncope will usually be dizzy, pale, and have cool, damp skin.
- Heat Cramps – painful muscle cramping of the body usually localized to lower or upper legs, abdomen, or upper extremities. A person suffering from heat cramps will be sweating and thirsty.
- Heat Exhaustion – A person suffering from heat exhaustion will have an elevated body temperature but cool damp skin and will continue to sweat. They will be weak, dizzy, and may feel as if they will faint. Other symptoms include nausea, headache, chills, hyperventilation, and thirst.
- Heat Stroke – Emergency help is needed immediately! A person suffering from heat stroke will be hot to the touch with dry or non-sweating skin. Due to central nervous system changes they may be disoriented, hysterical, delirious, or unconscious. Heart rate and respiration will be elevated with a decrease in blood pressure.
- Hyponatremia – Signs and symptoms of hyponatremia include nausea and vomiting, swelling of hands and feet, headache, confusion, apathy and lethargy, and altered consciousness. In severe cases seizures, pulmonary edema, and coma could occur.
2. Preventing heat illness is a team responsibility. The athlete, coach, and certified athletic trainer must all do their part to keep each athlete safe.
- Athletes – must complete the pre-participation physical examination prior to any practice, conditioning session, weightlifting, or competition; are encouraged to attend all workouts, wear the proper clothing and equipment, hydrate their body prior to physical activity, and be aware of how they are feeling while participating in hot weather.
- Coaches – should design their pre-season workouts to acclimatize athletes properly so that their bodies can handle the demands of performing in hot weather; are encouraged to constantly monitor athletes during all practices, games, conditioning sessions, and weightlifting sessions.
- Certified athletic trainer – will monitor the environmental conditions at specific venues prior to the start of practice (see 1.c below for protocol).
- Daily monitoring of environmental conditions:
- The protocol calls for the determination of environmental conditions at the practice/contest site using the Kestrel 4400 Wet Bulb Globe Thermometer (WBGT).
i. Media-related temperature readings (such as the Weather Channel, local radio, etc.), or even other readings in the general proximity may not yield adequate results. The readings must be made at the site.
- Thirty (30) minutes prior to the start of activity, environmental readings will be taken at the practice/competition site.
- The WBGT will indicate the level of risk for that specific site. See chart, “Guidance for Athletic Trainers” at right.
- Athletic department personnel should follow the “Guidance for High School Athletics” chart on the right.
- In the event an athlete suffers from heat syncope, heat cramps, heat exhaustion, heat stroke, or hyponatremia the following protocol will be followed:
- Heat Syncope - The athlete should stop all activity, be moved indoors, or to a shaded area, with the legs elevated above the level of the head. Vital signs will be monitored, and the athlete should begin to rehydrate.
- Heat Cramps - The athlete should stop all activity, move to a cool location, replace lost fluids with fluids containing sodium, and begin mild stretching with massage of the muscle spasm.
- Heat Exhaustion - Core body temperature will be measured using oral or axillary temperature. Cognitive function and vital signs will be assessed. Excess clothing and uniforms will be removed. The athlete will be moved to the athletic training room where cold whirlpool immersion will begin. Fluid replacement will begin at this time. Transfer to a physician’s care will be facilitated if recovery is not rapid and uneventful.
- Heat Stroke - Core body temperature will be measured using oral or axillary temperature. Cognitive function and vital signs will be assessed. Excess clothing and uniforms will be removed. The athlete will be covered in crushed ice and cold water on site. When the athlete begins to stabilize, they will be moved to the athletic training room where cold whirlpool immersion will begin. Fluid replacement will begin at this time. The Emergency Action Plan will be initiated. Cognitive function and vital signs will be monitored. The athlete will be removed from further competition until clearance from a physician (MD or DO only) is obtained.
- Hyponatremia - The athlete will be assessed for differentiation between hyponatremia and heat stroke. If hyponatremia is suspected, immediate activation of EMS will occur per the guidelines of the Emergency Action Plan. The athlete with suspected hyponatremia should not be administered fluids until a physician is consulted.