Heat IllnessHeat Illness

• General WarningGeneral Warning– Usually occurs during the first days of trainingUsually occurs during the first days of training– Acclimatized to heat is necessary to successfully compete in heat and Acclimatized to heat is necessary to successfully compete in heat and

humidityhumidity– Occurrence of heat illness indicates poor supervision of a sports Occurrence of heat illness indicates poor supervision of a sports

programprogram• Athletes who are the most susceptible to heat illnessAthletes who are the most susceptible to heat illness

– Individuals unaccustomed to exercising in heatIndividuals unaccustomed to exercising in heat– Overweight individuals or large athletes (linemen in football)Overweight individuals or large athletes (linemen in football)– Eager athletesEager athletes– Athletes with illness, infection, fever or gastrointestinal problemsAthletes with illness, infection, fever or gastrointestinal problems– Athletes with elevated body temperature from immunizationsAthletes with elevated body temperature from immunizations

Heat Illness PreventionHeat Illness Prevention

• Acclimatization (allow 7 to 10 days)Acclimatization (allow 7 to 10 days)• Slowly develop a base of fitnessSlowly develop a base of fitness• Adequate rest periodsAdequate rest periods• Adapt activities to environmentAdapt activities to environment• Train in cooler times in the dayTrain in cooler times in the day• Take regular measurements of Take regular measurements of

WBGT indexWBGT index• Wear appropiate clothingWear appropiate clothing

– cotton cotton

– moisture wicking fabricsmoisture wicking fabrics

• Adequate hydration and electrolyte Adequate hydration and electrolyte replacementreplacement– WaterWater

– Sports DrinksSports Drinks

– If you are not urinating you are If you are not urinating you are dehydrated (watch color of urine)dehydrated (watch color of urine)

• Keep record of body weight lossKeep record of body weight loss– Record athlete’s body weightsRecord athlete’s body weights

• before practicebefore practice• after practiceafter practice

• Educate coachesEducate coaches– Encourage athletes to replace Encourage athletes to replace

fluids and electrolytesfluids and electrolytes

– Constantly monitor athletes for Constantly monitor athletes for signs of heat illnesssigns of heat illness

• Medical screening of athletesMedical screening of athletes

– Prior heat illnessPrior heat illness

– Other medical conditionsOther medical conditions

Heat CrampsHeat Cramps• TreatmentTreatment

– Rehydration and electrolyte Rehydration and electrolyte replacement replacement

• WaterWater

• Sports drinksSports drinks

– Ice massage to affected musclesIce massage to affected muscles– Light stretchingLight stretching

• EtiologyEtiology– Imbalance between water and Imbalance between water and

electrolyteselectrolytes– Fluid loss (sweating heavilyFluid loss (sweating heavily

• High temperatureHigh temperature• High humidityHigh humidity• Combination Combination

– High temperatureHigh temperature– High humidityHigh humidity

– Electrolyte imbalanceElectrolyte imbalance

• Signs and SymptomsSigns and Symptoms– Muscle crampingMuscle cramping

• CalfCalf• HamstringsHamstrings• AbdomenAbdomen• ArmsArms

Heat Heat ExhaustionExhaustion

• TreatmentTreatment

– Rest in a cool roomRest in a cool room

– IV fluids if drinking is impairedIV fluids if drinking is impaired

– Fluid intake of 6-8 liters/dayFluid intake of 6-8 liters/day

– Sponge with cool waterSponge with cool water

– Keep record of body weightKeep record of body weight

– Keep record of fluid balanceKeep record of fluid balance

– Refer to MD as neededRefer to MD as needed

• EtiologyEtiology– DehydrationDehydration– Prolonged sweatingProlonged sweating– Diarrhea or intestinal infectionDiarrhea or intestinal infection– Inadequate replacement ofInadequate replacement of

• Bodily fluidsBodily fluids

• ElectrolytesElectrolytes

• Signs and Symptoms (WWW)Signs and Symptoms (WWW)– Excessive thirstExcessive thirst– Dry tongue and mouthDry tongue and mouth– Weight lossWeight loss– Fatigue &/or weaknessFatigue &/or weakness– Loss of coordinationLoss of coordination– Mental dullnessMental dullness– Small urine outputSmall urine output– Slightly elevated body temperatureSlightly elevated body temperature– Reduced sweatingReduced sweating

Heat StrokeHeat Stroke• EtiologyEtiology

– Sudden onset of failure of the thermoregulatory systemSudden onset of failure of the thermoregulatory system

• Signs and Symptoms (Red, Hot, Dry)Signs and Symptoms (Red, Hot, Dry)– Sudden collapse usually with LOCSudden collapse usually with LOC

– HeadacheHeadache

– VertigoVertigo

– FatigueFatigue

– Flushed (red) skinFlushed (red) skin

– Decreased or absent sweating (body can’t dissipate heat)Decreased or absent sweating (body can’t dissipate heat)

– Shallow breathingShallow breathing

– Rapid strong pulse (160-180 BPM)Rapid strong pulse (160-180 BPM)

– Core temperature rises to 104º - 106ºCore temperature rises to 104º - 106º

– Athlete feels like they are burning upAthlete feels like they are burning up

– Diarrhea &/or vomitingDiarrhea &/or vomiting

– Circulatory collapse may causeCirculatory collapse may cause• DeathDeath

• Permanent brain damagePermanent brain damage

Heat StrokeHeat Stroke

• TreatmentTreatment– True True medical emergencymedical emergency!!!!!!

– Emergency measures to reduce body temperature Emergency measures to reduce body temperature • Strip off clothingStrip off clothing

• Ice bath immersionIce bath immersion

• Ice towelsIce towels

• FanFan

– Massage limbsMassage limbs

– Risk of death significantly reduced if core temperature is returned to Risk of death significantly reduced if core temperature is returned to normal within 45 minutesnormal within 45 minutes

– Activate EMS Activate EMS

– Transport to hospital ASAPTransport to hospital ASAP

HyponatremiaHyponatremia• EtiologyEtiology

– Abnormal Abnormal low concentration of sodiumlow concentration of sodium in blood in blood

– Inadequate intake of electrolytes Inadequate intake of electrolytes

– Ingesting too much waterIngesting too much water

– Individual with low rate of sweatingIndividual with low rate of sweating

– Compromises central nervous system creating a life threatening conditionCompromises central nervous system creating a life threatening condition

– Long distance athletes more susceptibleLong distance athletes more susceptible

• Marathoners or triathletesMarathoners or triathletes

• PreventionPrevention

– Assure adequate sodium intakeAssure adequate sodium intake

– Avoid over hydrationAvoid over hydration

• TreatmentTreatment

– Immediate referral to MDImmediate referral to MD