Jun 30, 2017
Ready for the Heat
Rod Walters

In the event a student-athlete presents with symptoms of heat related illness, aggressive steps should be taken to assess his or her medical status and provide the appropriate treatment. Any altered level of consciousness, general fatigue, or other symptoms must be noted. Core body temperature assessment (rectal monitoring) is recommended, and those with temperatures above 103 degrees are submerged in a cold-water tank. The athlete is monitored while in the tank, and removed from the water when their temperature lowers to 101. This procedure allows aggressive treatment in the event the condition progresses to heat stroke.

Here are more details on how to treat heat-related illnesses:

Heat cramps: Fluids must be replaced to resolve cramps. Therefore, start by reestablishing normal hydration status and replacing sodium losses. Next, stretch and massage the involved muscles to help reduce the acute pain of the cramp.

Heat exhaustion: Remove athletes from activity and take them to a shaded or air-conditioned area, removing excess clothing and equipment. Then:

  • Assess body temperature rectally. Those with temperatures above 103 degrees are placed in a cold-water tank.
  • Keep athletes in the tank until rectal temperature is less than 101 degrees. Then lay them comfortably with legs propped above heart level.
  • Rehydrate athletes orally with cool water or sports drinks, if they can tolerate fluids. If athletes can’t tolerate oral fluids, physicians may use intravenous normal saline.
  • Monitor heart rate, blood pressure, respiratory rate, core temperature and central nervous system (CNS) status.
  • If rapid improvement is not seen, transport the athlete to an emergency medical facility.

Exertional heat stroke: Start by removing the athlete’s clothing and equipment and immediately immersing him in cold water (approx. 60 degrees). If cold-water immersion is not possible, move him to a shaded area or air-conditioned facility and begin alternative cooling strategies such as spraying the body with cold water, placing ice bags on the neck and groin, or applying ice over the entire body. Then:

  • Call 911
  • Closely monitor ABCs, core temperature, and CNS status.
  • Place an intravenous line using normal saline (if medical staff is available).
  • Cease aggressive cooling when core temperature drops to 101 degrees.
  • Transport to a medical facility.

Rod Walters, DA, ATC, is the former Assistant Athletic Director for Sports Medicine at the University of South Carolina. He served on the NATA's Board of Directors from 1997-2003 and has been inducted into the NATA Hall of Fame.

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