Heat Illness & August can be the dog days of summer, preseason training is in full swing for fall Heat sports, and one concern among athletes is is characterized by , and dehydration. In this tip of dizziness, followed by a fainting spell. the month we will cover the basics of all the Causes of heat syncope are postural heat illnesses, and proper hydration levels pooling of the blood, diminished venous return, dehydration, reduction in cardiac Heat Illness output. Often occurs in the first five days of By definition there are three categories of acclimatization, often happens when heat illness… standing for long periods of time, - Heat cramps immediately after cessation of activity, or - Heat exhaustion after rapid assumption of upright posture - after resting or being seated. - Heat syncope Signs and Symptoms of heat syncope Heat Cramps - Dehydration Heat cramps are represented as a - condition that presents during or after - Tunnel vision intense exercise sessions as a quick, painful, - Pale or sweaty skin involuntary muscle contraction. - Decreased pulse Causes of heat cramps include - Dizziness dehydration, electrolyte imbalance, - Lightheadness neuromuscular fatigue, or a combination of - Fainting all these factors. Treatment of heat syncope Signs and symptoms of heat cramps - Move athlete to shaded area - Dehydration - Monitor vital signs - Thirst - Elevate the legs above the head - Sweating - Rehydrate - Muscle cramps - Fatigue Heat Exhaustion Treatment of Heat Cramps Heat exhaustion is classified as the - Athlete must stop activity inability to continue exercise because of any - Replace lost fluids with sodium combination of heavy sweating, containing fluids, such as dehydration, sodium loss and energy Gatorade and PowerAde depletion. - Begin mild stretching with Causes of heat exhaustion are hot, massage of the muscle spasm humid conditions. - Salt tablets dissolved in water - IV maybe required if not able to keep fluids down

Heat Illness & Dehydration Signs and symptoms of heat exhaustion Exertional Heat Stroke - Normal or elevated body – core Exertional heat stroke is an elevated temperature core body temperature around 104°F, - Dehydration associated with signs of organ system failure - Dizziness due to . - Lightheadedness Exertional heat stroke occurs when - Syncope the temperature regulation system is - Headache overwhelmed due to excessive heat - Nausea production or inhibited heat loss in - Anorexia challenging environmental conditions, can - Diarrhea progress to complete thermoregulatory - Decreased urine output system failure. This condition is life - Persistent muscle cramps threatening and can be fatal unless - Profuse sweating promptly recognized and treated! - Chills - Cool clammy skin Signs and symptoms of exertional heat - Intestinal cramps stroke - Weakness - High core body temperature - Central nervous system changes Treatment of heat exhaustion o Dizziness - Mental changes are usually o Drowsiness minimal but need to assess the o Irrational behavior central nervous system function o for : o Irritability o Bizarre behavior o Emotional instability o Hallucinations o Hysteria o Altered mental status o Apathy o Confusion o Aggressiveness o Disorientation o Delirium - If feasible measure core body o Disorientation temperature o Staggering - If temperature is elevated remove o Seizures clothing to increase the o Loss of consciousness evaporation and cooling process o - Cool athlete with fans, ice - Dehydration towels, or ice bags - Weakness - Put athlete in a cool or shaded - Hot and wet or dry skin – environment if possible inability to sweat - Start fluid replacement - Fast beating heart - Transfer to a doctor if IV’s are - Hyperventilation needed or if recovery is not rapid - Vomiting and is uneventful - Diarrhea

Heat Illness & Dehydration Treatment of exertional heat stroke practice in those conditions. - Measure rectal temperature if http://www.nata.org/sites/default/ possible files/ExternalHeatIllnesses.pdf - Assess cognitive function - Monitor weight loss – by having - Lower core body temperature as weigh ins before and after quickly as possible, by removing practice clothes and equipment and immersing the body into a pool Nonenviormental Risk Factors or tub of cold water that can lead heat illness - Monitor the temperature during - Being ill the cooling therapy and recovery - History of heat illness - Activate the emergency medical - Increase of body fat system - A poor physical condition - Monitor athlete’s vital signs and - Wearing dark clothing other symptoms of heat stroke - Over exerting oneself - Transport to the Emergency - Medications and drugs Room - Lack of acclimatization to the heat Prevention of Heat Illness - Electrolyte imbalance. - Acclimatize athlete’s to the hotter temperatures - Teach proper hydration and fluid replacement - Proper sleep patterns of 6-8 hours a night - Practice in proper conditions based on temperature and humidity

- This graph shows what type of clothing to wear in conditions based on temperatures and humidity - See the following link for the risk of heat exposure and the humidity and whether or not to Heat Illness & Dehydration Fluid Replacement for athlete’s References - Make sure that athlete’s are taking time to rehydrate during All references are from the National Athletic practice and every so often Trainers Associations Position Statements - Before all practices athletes must be well hydrated http://www.nata.org/sites/default/files/Ext o Athlete should drink 17- ernalHeatIllnesses.pdf 20 oz of water or a sports drink 2-3 hours before http://www.nata.org/sites/default/files/Flu practice and 7-10 oz of idReplacementsForAthletes.pdf water or sports drink 10- 20 minutes before exercise - Fluid replacement during exercise should be at 7-10 oz every 10 to 20 mins - Post exercise hydration should be done within 2 hours of practice ending and should be 16 oz per pound of body weight loss, it should also include… o Water to restore hydration status o Carbohydrates to replenish glycogen stores o Electrolytes to speed rehydration

Signs and symptoms of dehydration include - Thirst - Irritability - General discomfort - Headache - Weakness - Dizziness - Cramps - Chills - Vomiting - Nausea - Head or neck heat sensations - Decreased performance