NCAA Sports Medicine Handbook: Practice or competition in hot and/or humid environmental conditions poses special problems for student-athletes. Read more »
The difference between heat exhaustion and heat stroke:
Heat exhaustion is a form of shock or inability to continue exercising due to depletion of body fluids. Treatment normally consists of cooling down, resting and rehydration. In some cases, additional medical care may be needed. Heat stroke is a medical emergency characterized by very high body temperatures, bizarre behaviors, confusion or collapse. Treatment includes early recognition, rapid cooling and immediate medical care.
By Chris Radford
Sickle cell trait is not a disease and will not turn into sickle cell disease. Sickle cell trait is a life-long condition that will not change over time. Generally, people with the trait live without complications.
However, during intense exercise, particularly in the heat, student-athletes with sickle cell trait have experienced significant physical distress, collapsed, and even died. Experts believe that with knowledge of sickle cell trait status and proper conditioning regimens that allow for sport-specific workouts and ample recovery that the risk for sudden death can be minimized.
Heat, dehydration, altitude and asthma can increase the risk for and worsen complications associated with sickle cell trait, even when exercise is not intense. Athletes with sickle cell trait should not be excluded from participation as precautions can be put into place.
Last April, the Division I membership decided that all incoming Division I student-athletes must be tested for sickle cell trait, show proof of a prior test or sign a waiver releasing an institution from liability if they decline to be tested. The new rule will be in effect for the 2010-11 academic year. The legislation applies to student-athletes who are beginning their initial season of eligibility and to students who are trying out for the team.
For more information about sickle cell trait, visit the NCAA educational materials available at www.NCAA.org/health-safety.
As preseason football practice kicks into gear across campuses, NCAA institutions are encouraged to take steps to reduce the risk factors for heat-related illness.
While heat illness can occur in any sport – and no single risk factor can predict when it will occur – understanding the multiple factors involved and taking the proper precautions can minimize the risks.
Practice or competition in hot and humid environmental conditions poses special problems for student-athletes. Heat stress and resulting heat illness is a primary concern in these conditions – 96 percent of all heat illnesses in football occur in the month of August, for example.
Although deaths from heat illness are rare, exertional heat stroke is the third-leading cause of on-the-field sudden death in student-athletes. Constant surveillance and education are necessary to prevent heat-related problems.
The NCAA has taken steps to provide a safer environment for student-athletes with the adoption of football practice season regulations and wrestling weight management policies. Most notably, institutions are required to conduct a five-day, single practice acclimatization period at the beginning of fall practice followed by a maximum 2-1-2 practice per day schedule that allows student-athletes to acclimate to the new stresses of the hot and humid weather, intensity and duration of exercise, and the impact of equipment on body heat retention.
Heat illnesses are often due to a combination of risk factors. Risk factors associated with heat illness include:
The NCAA has recommended that member institutions follow best practices when training in hot conditions. They include:
Heat exhaustion is a moderate illness characterized by the inability to sustain adequate cardiac output, resulting from strenuous physical exercise and environmental heat stress. Symptoms usually include profound weakness and exhaustion, and often dizziness, syncope, muscle cramps, nausea and a core temperature below 104 degrees Fahrenheit with excessive sweating and flushed appearance.
First aid should include removal from activity, taking off all equipment and placing the student-athlete in a cool, shaded environment. Fluids should be given orally. Core temperature and vital signs should be serially assessed. The student-athlete should be cooled by ice immersion and ice towels, and IV fluid replacement should be determined by a physician.
Although rapid recovery is typical, student-athletes should not be allowed to practice or compete for the remainder of that day.
Heatstroke is a medical emergency. Medical care must be obtained at once; a delay in treatment can be fatal. This condition is characterized by a very high body temperature (104 degrees Fahrenheit or greater) and sometimes, but not always, hot, dry skin, which indicates failure of the primary temperature-regulating mechanism (sweating), and CNS dysfunction (for example, altered consciousness, seizure, coma).
First aid includes activation of the emergency action plan, assessment of core temperature/vital signs and immediate cooling of the body with cold water immersion. Another method for cooling includes using or cold, wet ice towels on a rotating basis. Student-athletes who incur heatstroke should be hospitalized and monitored carefully.
Athletes presenting with any of these signs and symptoms should be referred to a healthcare professional and basic steps taken while awaiting such medical care. Many other potentially life threatening conditions can present as a heat illness and emphasis should be placed on proper medical diagnosis.