Heat Illness and Prevention in Sports: A Comprehensive Guide

1. Heat Illness • General Warning • Usually occurs during the first days of training • Acclimatized to heat is necessary to successfully compete in heat and humidity • Occurrence of heat illness indicates poor supervision of a sports program • Athletes who are the most susceptible to heat illness • Individuals unaccustomed to exercising in heat • Overweight individuals or large athletes (linemen in football) • Eager athletes • Athletes with illness, infection, fever or gastrointestinal problems • Athletes with elevated body temperature from immunizations

2. Heat Illness Prevention • Keep record of body weight loss • Record athlete’s body weights • before practice • after practice • Educate coaches • Encourage athletes to replace fluids and electrolytes • Constantly monitor athletes for signs of heat illness • Medical screening of athletes • Prior heat illness • Other medical conditions • Acclimatization (allow 7 to 10 days) • Slowly develop a base of fitness • Adequate rest periods • Adapt activities to environment • Train in cooler times in the day • Take regular measurements of WBGT index • Wear appropiate clothing • cotton • moisture wicking fabrics • Adequate hydration and electrolyte replacement • Water • Sports Drinks • If you are not urinating you are dehydrated (watch color of urine)

3. Heat Cramps • Etiology • Imbalance between water and electrolytes • Fluid loss (sweating heavily • High temperature • High humidity • Combination • High temperature • High humidity • Electrolyte imbalance • Signs and Symptoms • Muscle cramping • Calf • Hamstrings • Abdomen • Arms • Treatment • Rehydration and electrolyte replacement • Water • Sports drinks • Ice massage to affected muscles • Light stretching

4. Etiology • Dehydration • Prolonged sweating • Diarrhea or intestinal infection • Inadequate replacement of • Bodily fluids • Electrolytes • Signs and Symptoms (WWW) • Excessive thirst • Dry tongue and mouth • Weight loss • Fatigue &/or weakness • Loss of coordination • Mental dullness • Small urine output • Slightly elevated body temperature • Reduced sweating Heat Exhaustion • Treatment • Rest in a cool room • IV fluids if drinking is impaired • Fluid intake of 6-8 liters/day • Sponge with cool water • Keep record of body weight • Keep record of fluid balance • Refer to MD as needed

5. Heat Stroke • Etiology • Sudden onset of failure of the thermoregulatory system • Signs and Symptoms (Red, Hot, Dry) • Sudden collapse usually with LOC • Headache • Vertigo • Fatigue • Flushed (red) skin • Decreased or absent sweating (body can’t dissipate heat) • Shallow breathing • Rapid strong pulse (160-180 BPM) • Core temperature rises to 104º - 106º • Athlete feels like they are burning up • Diarrhea &/or vomiting • Circulatory collapse may cause • Death • Permanent brain damage

6. Heat Stroke • Treatment • True medical emergency!!! • Emergency measures to reduce body temperature • Strip off clothing • Ice bath immersion • Ice towels • Fan • Massage limbs • Risk of death significantly reduced if core temperature is returned to normal within 45 minutes • Activate EMS • Transport to hospital ASAP

7. Hyponatremia • Etiology • Abnormal low concentration of sodium in blood • Inadequate intake of electrolytes • Ingesting too much water • Individual with low rate of sweating • Compromises central nervous system creating a life threatening condition • Long distance athletes more susceptible • Marathoners or triathletes • Prevention • Assure adequate sodium intake • Avoid over hydration • Treatment • Immediate referral to MD