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Heat illness can range from mild to severe and all athletes are at risk, but it is preventable and survivable when the proper steps are taken.

What is heat illness?

Heat illness occurs when an individual’s core body temperature increases, and the body’s methods to cool down are not sufficient. There are several types of heat illness ranging in severity. Although heat illness can be fatal, death is preventable if quickly recognized and properly treated. Heat illness is separated into five categories, Exercise-Associated Muscle Cramps, Heat Syncope, Heat Exhaustion, Exertional Heat Stroke, and Exertional Heat Injury. Each type of heat illness has different signs and symptoms which will be discussed. It is important to be able to recognize the signs and symptoms so that the heat illness can be treated appropriately.


Who is at risk of experiencing heat illness?

Hot and humid environmental conditions can predispose an individual to heat illness. In humid weather, it is harder for the body to cool itself down. Individuals who have not been educated on the signs and symptoms of heat illness could also be at an increased risk. High intensity exercises should always have sufficient rest time as to not put individuals at a higher risk as well. Finally, a dehydrated athlete is at increased risk. Using the color of the urine can help to determine if the individual is hydrated. The goal is to have urine light, like lemonade, not dark, like apple juice.


How to recognize heat illness

The gold standard of assessing a heat illness is through a rectal thermometer body temperature. If it is not possible to obtain an accurate body temperature, the following signs and symptoms are associated with each category of heat illness.

Exercise Associated Cramps

  • Cramping in all or part of the muscle groups
  • Dehydration/thirst

Heat Syncope

  • Brief episodes of fainting associated with dizziness
  • Tunnel vision
  • Pale or sweaty skin
  • Decreased pulse rate

Exertional Heat Exhaustion

  • Excessive fatigue, fainting or collapse
  • Altered mental status, confusion, disorientation
  • Weakness, dizziness, headache, vomiting
  • Rectal temperature less than 105

Heat Stroke

  • Rectal temperature above 105
  • Central nervous system dysfunction
  • Hot, wet skin
  • Hyperventilation

Heat Injury

  • Dark, cola-colored, urine
  • Severe muscle pain
  • Abnormal blood chemistry levels


How do you treat heat illness?

The quicker the treatment, the better, which is why it is important to have an athletic trainer or health care professional at all practices and games. These medical professionals are trained in identifying individuals who may be suffering from a heat illness and providing quick treatment.

Exercise Associated Cramps

  • Recommended treatment includes rest and static stretching. Ice massage may also help to alleviate some of the discomfort. The individual should also ingest sodium containing fluids or foods.

Heat Syncope

  • Recommended treatment is to move the individual to a shaded area, monitor vitals, and elevate the legs above the level of the heart. It is also important to cool the skin and rehydrate.

Exertional Heat Exhaustion

  • Recommended treatment is to remove any excess clothing or equipment to allow the body to cool. The individual should be moved to a cool, shaded area and further cooled with ice towels or a fan. Like heat syncope, the individual should have their legs raised above the level of the heart. If possible, an IV may be needed for additional fluids. If the condition worsens, activate EMS and get the individual to the nearest medical facility.

Exertional Heat Stroke

  • First, the patient needs a rectal temperature to assess core body temperature. The core body temperature needs to be lowered as quickly as possible, most effectively done by full body, cold water immersion. If cold-water immersion is not possible, then the use of wet ice towels can be used, however it is not as effective. The individual should then be transported to the nearest medical facility by EMS.


How reduce risk of heat illness?

The most effective way to reduce the risk, is to educate coaches, parents, officials, and athletes about the seriousness of heat illness. Heat illness can be completely avoidable if the correct precautions are taken. Individuals should be acclimatized to the heat gradually over 7-14 days. Heat acclimatization involves progressively increasing the intensity and duration of physical activity and phasing in protective equipment. Individuals should also be well hydrated and have free access to water during training and competition. To assist in assessing hydration, Coaches or the athletic trainer should weigh athletes before and after practices to determine individual fluid losses and monitor them to ensure they replace every pound lost with approximately 20 ounces of fluid. Coaches can also schedule practices during a cooler time of day. It could be helpful to Have sports drinks on hand for workout sessions lasting longer than an hour and to remove unnecessary equipment, such as helmets and padding, when environmental conditions become extreme. Finally, always have a plan in place in case a heat illness occurs, so treatment can begin quickly.