I saw a statistic about exertional heat stroke recently that surprised me. Athletic trainers across the country were surveyed during the 2011 high school football preseason. They were asked questions about heat stroke events and management strategies utilized. The study found that an average of 0.5 exertional heat stroke events occurred at each athletic program. 20.3% treated at least one exertional heat stroke event that preseason.

While it is possible that some of the athletic trainers who responded in the survey actually treated milder cases of heat illness and not true heat stroke, those numbers above are still very high. We need to ensure that everyone involved in sports become educated about the signs and symptoms of heat illness and ensure treatment strategies are in place in case such events occur.

Also read:
Prevent heat deaths in summer football practice now
Practice changes a good start to prevent heat illness

Athlete exhausted from training at risk for heat stroke

What is exertional heat stroke?

Exertional heat stroke occurs when an athlete’s core body temperature rises to greater than 105°F (40.5°C). Symptoms such as nausea, vomiting, dizziness, rapid breathing and heart rate and convulsions can develop. Multisystem organ failure can occur if the athlete’s core body temperature isn’t corrected. Exertional heat stroke can lead to death.

Heat illness is essentially a preventable condition. I have previously discussed some efforts to prevent heat illness in football and other sports during hot and humid conditions. This study shows that an emphasis on its treatment is important as well.

Also read:
Prepare early to prevent heat deaths from summer sports
Hydration key in summer heat
Can spectators protect themselves from extreme heat and humidity?

Treatment strategies for heat stroke

Most of the athletic trainers who were surveyed reported strategies such as removing the player’s clothing and football equipment. Moving the athlete to a shaded area was also common. Use of a rectal thermometer, contacting emergency medical services, moving the athlete to an air-conditioned environment, and cooling the athlete by immersing him in an ice bath were not as common.

Start planning now

Schools have some time this summer to prepare for heat issues before formal practices begin. Even if not mandatory in certain states, schools can adopt guidelines to acclimate players to the heat in the first few weeks of practice.

But just as important as strategies to prevent exertional heat stroke are, plans to treat these events are critical as well. Athletic trainers can work with doctors and coaches to develop emergency action plans. They can develop and obtain resources – ice baths, rectal thermometers, EMS notification and others – and implement a plan to use them if needed.

EMS plays a role in the treatment of heat stroke.

As the temperatures rise and sports ramp up, our awareness of exertional heat stroke and ability to treat it if it occurs should rise as well.

Also listen to these related podcast discussions:
Episode 145: How can you best prepare for fall sports during the summer?
Episode 144: How can you safely exercise in the summer heat and humidity?
Episode 51: How can you safely exercise or play sports in the heat?

Kerr ZY, Marshall SW, Comstock RD, Casa DJ. Exertional Heat Stroke Management Strategies. in United States High School Football. 2014 Jan;42(1):70-7.