How to Recognize and Treat Heat-Related Illness

How to Recognize and Treat Heat-Related Illness

The death of Minnesota Vikings' offensive tackle Korey Stringer Wednesday due to heat stroke - just six days after University of Florida football freshman Eraste Autin died of for similar reasons - has amplified the risks athletes face as they practice in sometimes oppressive heat.

As most high school and college teams begin practice in coming weeks, coaches, athletes, and parents should join with athletic trainers to know the warning signs of heat-related illnesses, and what to do if they see any symptoms during or after activity.

Staying active in the summer's heat causes the body's temperature to rise. Combined with humidity, the temperature rise makes the body sweat - with the perspiration being the body's mechanism for cooling itself. Excessive sweating in high heat activity should put people on alert.

"Sweating causes the body to lose water and electrolytes. If the fluid is not replaced, an individual may become ill with a heat-related injury," says Robert Stelma, supervisor of athletic training services for the Geisinger-Wyoming Valley Human Motion Institute in Wilkes-Barre, PA.

Stelma says there are three main heat-related injuries - heat cramps, heat exhaustion, and heat stroke.

Heat cramps are caused by an imbalance of water and electrolytes. "They can affect any muscle group, but usually occur in the calf and abdomen," says Stelma. "Treatment for heat cramps involves drinking large amounts of water, gentle stretching and ice massage."

Heat exhaustion can also occur if fluid is not replaced during activity. Victims of heat exhaustion will exhibit some of the following symptoms: cool, moist, flushed or pale skin; slight increase in body temperature; headache; dizziness; rapid, strong pulse; profuse sweating; hyperventilation; and possibly collapse. "Treatment of a victim of heat exhaustion includes replacement of fluids; moving the victim to a cool area; loosening of tight clothing; and rest," says Stelma. "The individuals may or may not need intravenous fluids."

Heat stroke is a life-threatening emergency in which the body loses its ability to dissipate heat through sweating - like Stringer did following Tuesday's practice with the Vikings. "It must be treated quickly by health care professionals," Stelma says. "Heat exhaustion, if left unrecognized and untreated, can develop into heat stroke."

Some symptoms of heat stroke include a significant rise in body temperature; hot, dry, red skin; the absence of sweat; nausea; headache; changes in mental state; refusal to drink water; disorientation; stumbling; collapse; and a rapid, weak pulse.

"An individual who has signs of heat stroke should be transported immediately to the hospital emergency room. Measures to cool the body such as moving the victim to a cool environment, loosening clothing; and covering with cool, wet towels should be taken immediately, but do not take the place of getting the individual to the emergency room," says Stelma.

The best way to avoid heat-related injuries is to take preventive measures. Monitoring the heat and humidity, fluid replacement, gradual acclimation to the heat, frequent breaks, proper nutrition, and monitoring of body weight are ways to try to prevent heat-related injuries.

Mike Keeney is head athletic trainer at Susquehanna University in Selinsgrove, Pa., and will be on guard for signs of heat-related illness when his eight fall sports teams begin practice beginning with the 90-player football team, which opens camp on Friday, August 17. Appointed by the Pennsylvania Trainers' Society to the state's Athletic Training Advisory Committee, Keeney agrees that preparation is the key to beating the heat.

"Athletes should acclimate themselves to hot conditions prior to the start of practice. They can do this by working out in a high heat climate and progressing the intensity several weeks before the first practice," says Keeney.

He also recommends proper hydration before, during and after each workout.

"Thirst is not a reliable indicator of an athlete's need to replace water lost during exercise," he says. "Drink freely about two hours before an event. Drink about a cup of water or sports drink every 15 to 20 minutes of exercise. Remember to drink fluids before you get thirsty.

"It's also important for proper rehydration. Drink approximately two cups or water or sports drink for every pound lost during a practice or workout."

Once a team begins practice, coaches and athletic training staff have to be aware of how dangerous high heat conditions could be to their athletes. Geisinger's Stelma offers the following guidelines for activity level in high heat environments.

Temperature Humidity Recommendation80-90F greater than 70% OR Take a 10 minute water break every 30 minutes. 90-100F less than 70% Have water available at all times. Athletes should be under close supervision.90-100F greater than 70% Suspend or modify practice. A short, easy practice in shorts and t-shirts would be beneficial.

Susquehanna's Keeney recommends that coaches should also consider practicing at times of the day that are the coolest - like early morning or early evening. "If it's very hot and humid, limit the intensity of the workouts and have the athletes wear loose fitting shorts and t-shirts," he says. "If conditions are too hot and humid, they (coaches) should consider moving indoors or rescheduling practice at a cooler time."

"Fluids should be readily available at all times. Water or non-carbonated, caffeine-free, low sugar sports drink should be consumed before, during, and after the exercise session," says Stelma. "Weighing yourself before and after practice will help with fluid replacement. If an athlete loses three percent or greater of their body weight during a session, he or she should be evaluated by a health care professional."

While increasing awareness of the dangers of heat-related illness might help avoid a repeat of the recent football tragedies, it can't guarantee it - particularly for males. That's because the greatest danger to athletes in high heat conditions may come from society's approval of the macho stereotype of the male athlete. That produces athletes who knowingly push themselves beyond their limits to impress their coaches and fellow teammates with their toughness.

"Males learn that aggression and violence are not only acceptable, but that they should take pride in aggression and violence because that's how they prove themselves men. Males are taught to be tough, daring, fearless, assertive, to respond to threats with anger, and never back down from challenges - all of which conspire to propel males into life-threatening violent situations and prevent them from retreating or fleeing once they're in them," says Dr. Ronald Levant, dean of the Center for Psychological Studies at Nova Southeastern University in Ft. Lauderdale, Fla. He is author of the book Masculinity Reconstructed (Dutton, 1995).

"When anxious, frustrated, threatened, or dared, in other words, an unfortunately large percentage of males are still reacting in accordance with traditional masculine dictates that require they act out aggressively rather than risk the shame attached to admitting fear or vulnerability."

Levant believes that the culture and conditioning that produced this traditional masculinity is the main reason the average male life span is seven years shorter than the average female life span (72.0 for males, compared to 78.9 for females). It possibly was at work when Stringer opted to return to the practice field Tuesday, after suffering from heat exhaustion just one day before.

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EDITORS: contact Stelma by calling (570) 826-6046, or arranging an interview through Dave Jolley in Geisinger's Media and Community Relations Office by calling (570) 826-7889, or e-mailing him at [email protected]. Keeney may be reached by calling his office at (570) 372-4278, his home at (570) 743-5016, or e-mailing him at [email protected]. Levant may be reached by calling his office at (954) 262-5701, or e-mailing him at [email protected].

Feel free to call us at (814) 867-1963 if you have additional question or needs. Dick Jones Communications assists Geisinger, Nova Southeastern and Susquehanna with their public affairs work.