CIP 3

Exertional Heat illness prevention

Whole team

Educate whole team what EHI is, why its dangerous, and the importance of maintaining and
monitoring hydration, and how the temperature is taken in the event of an EHI. Continue to
remind the team during the season that hydration is still important despite the weather
changing.
Go over or plan with coaches the amount, intensity, and equipment allowed for safe practice
during the heat acclimation period.
Talk to coaches and agree on amount of time between water breaks for each sport and
according to weather. (Guidelines in NATA position statement)
Monitor the weather and change activity or time of practice if needed.
o WBGT under 82 F: normal activities, 3 or more sepreate breaks (min 3 minutes)
o 82.1-86.9: discretion for intense or prolong activity, monitor at risk players closely, 3 or
more breaks (min 4 minutes)
o 87.0-89.9: Max practice time 2 hours, remove some protective equipment for practice,
all equipment off for conditioning, 4 or more breaks (min 4 minutes)
o 90.0-92: Max practice time 1 hour, no protecting equipment during practice, no
conditioning, 20 min total of rest breaks
o 92.1+: no outdoor workouts, postpone practice until a cooler WBGT reading.
Put a scale and weight chart in the locker room to track weight changes.
o If a scale is not preferred or contraindicated by sport/gender a Urine color chart may be
used with recommendations on how much to drink based on color
Place a cooler of Water in the locker room for before and after Practice.
Hold athletes from participation with current viral infections or conditions with a fever (100 F
until fever free for 24 hours.
Have an EAP for EHI, and practice with coaches, athletes, and other supporting personnel.
Go over PPE for athletes predisposed to EHI.
o Predispositions include:
Increase BMI: less efficient at dissipating heat, increase metabolic heat.
Poor Physical conditioning: decreased VO2 max decreases ability to with stand
heat stress.
Overzealous Athletes: Will ignore warning signs and push on during practice.
Illness: increased body temperature, dehydration and medications.
Dehydration: negatively effects thermoregulation, increased heart rate and
temperature.
Previous EHI: greater risk of returning EHI, from impaired thermoregulatory,
cardiovascular, neural, hepatic and renal systems.
Medications/Drugs: may have a dehydrating effect, such as stimulants, anti-
histamines and anti-psychoatics
Athletes with previous history of EHI

Monitor during practice.

o EHS: severe hyperthermia, hot sweaty/dry skin, confusion, temp greater than 105 F
o Heat exhaustion: unable to continue practice, confusion, hot sweaty skin, temp greater
than 102 F but not greater than 105 f
o HS: Collapsing in the heat, LOC
o EAMC: acute, painful, invoultary muscle contractions. Athlete may feel tightness before
cramping
AT should have emergency equipment
o Cold Tub
o Rectal Thermometer
o Shaded/cool area
o Phone/communication device
o Physcian on call
o Ice towels
o Water and Gatorade with electrolyte packets

RTP
Anyone with an exertional heat illness should be evaluated by a doctor before being cleared to
RTP
Exertional heat exhaustion should avoid same day return
o This may take weeks to months to return despite doctor clearance.
o Will need to reacclimatize to heat, at a slower rate than the rest of the team.
EHS
o Should be asymptomatic with normal bloodwork results
o Needs a 7-21 day rest period
o Once normal, Athlete may begin a gradual progression of physical activity, while
monitory signs and symptoms of EHI.

EAP

For EAMCs
o Stop exercise immediately
o Provide sodium contacting drinks, if athlete is unable to drink have a qualified medical
professionals start an IV
o Move into a shaded area and passively stretch the spasaming muscle
o Ice may also be used to relieve discomfort of EAMC
Heat Syncope
o Move to cool, shaded area
o Monitor vital signs
o Rehydrate
o Lay athlete supine and elevate legs to improve venous return
 Heat Exhaustion
o Stop exercise immediately
o Move to a cool, shaded place
o Provide fluids
o Cool the athlete with Fans or ice towels
o Elevate legs
Heat Stroke
o When EHS is suspected prepare to cool the patient and contact EMS
o Determine vital signs before immersion
o Immediate whole body cold water immersion
o Circulate the water constantly to enhance water to skin contact
o If whole body is not available cover as much of the torso as possible in water or other
cooling modalities
o Use Ice towels if a cold tub is unavailable
o Obtain a core temperature (rectal thermometer), if this isnt available cool for 10-15
minutes and transport
o Push fluids on athlete if they are able to drink, if not have a qualified medical
professional start an IV
o Remove athlete from cold once the temperature is below 102 F to prevent over cooling
o Athlete should be transported or seen by a physician after cooling to 102 F