The following material is summarized from the NFL's Play Safe! brochures. For the complete series, visit NFLHS.com.
Heat Illness, Warning Signs & Response
Heat-related illnesses are caused when an individual is subjected to extreme temperatures and humidity, and is unable to cool down. Dehydration also can be a factor. Dehydration can lead to loss of appetite, production of dark urine, and muscle cramps. Coaches working with kids should know children may be less tolerant of heat stress than are adults, and may be at greater risk for heat illness. The acute warning signs of heat illness can include nausea, headache, weakness, fainting, poor concentration, flushed skin, light headedness, loss of muscle coordination, fatigue, nausea, and vomiting.
Heavy sweating and electrolyte loss often precedes heat cramps. The player should stop the activity, find a cool spot where he or she can gently stretch and massage the muscle, and drink appropriate fluids that contain sodium.
Heat exhaustion is another type of heat illness. Conditions and signs of this problem can include profuse sweating, dehydration, fatigue, lightheadedness, rapid pulse and low blood pressure. Body temperature may be slightly elevated. The player should lie in a cool place with legs elevated, have cool, wet towels applied to the body, drink cool fluids, and have someone monitor his vital signs. Often an ill player feels better when he or she rests in a cool place and drinks cool liquids. Continue to monitor the athlete. If signs are present that the illness is severe or progressing, activate the emergency action plan and follow the emergency action steps, Check-Call-Care. Check the player for signs. Call 911 or the local emergency number immediately. Have someone administer your emergency care plan.
With heat stroke, the most serious heat illness, a player will have a high body temperature - 104° F or higher - and could have red, hot, dry or moist skin, vomit, be incoherent or lose consciousness, have shallow breathing and/or a weak pulse. He or she might experience mild shock, convulsions, or a coma, and can die from heat stroke. If he or she goes into respiratory or cardiac arrest, begin rescue breathing or CPR, as appropriate. Cool by any means possible, as quickly as possible. Place player in an ice bath, or apply ice bags to the body, or (if ice is not available) continually place very cold towels on the body of the player. While treating, call for emergency medical services (EMS) and continue cooling and monitoring the player while awaiting EMS.
Playing in the sun can be fun, but the best thing to do is play it safe. Heat-related illnesses are preventable if coaches and players know their signs and stay cool and hydrated.
What Coaches Should Know
When players are practicing or competing, coaches should follow the following steps to help prevent heat-related illnesses:
Overexposure to high temperature and humidity can cause heat-related illnesses. The National Weather Service issues heat alerts when the daytime heat index (a combination of temperature and humidity) is 105° F or more, which can dramatically increase the risk of the most serious heat-related illnesses. At 80-105° F, fatigue and heat stroke are also possible with prolonged exposure. Athletes playing in the heat for long periods of time wearing protective padding are especially at risk.
Primary contributors to heat-related emergencies include:
Certain types of players might be at a higher risk for heat-related illness and should be monitored closely. These types of players include those with a prior history of heat illness, overweight or obese players, those with a medical history of gastrointestinal, diabetic, kidney, or heart problems. They require special attention by coaches and quick action if any symptom of heat illness is noticed.
When necessary, coaches should instruct players to do the following:
Without taking precautionary measures, a player might experience a heat-related illness. In some cases, they might be unaware he is experiencing this condition and continue practicing. Coaches should periodically check players during practice or workouts for symptoms related to heat exhaustion.
Hot Weather Safety Tips
- Players should have unrestricted access to appropriate fluids. Thirst is not a good indicator of the need to hydrate.
- The best approach, particularly in hot environments, is to have players weigh in and out each day to help determine adequate fluid replacement needs. Following a competition or workout, the coach should have players weigh in and out, and drink enough to match their weight. Remember 16 ounces is one pound. A player may need to consume 20-24 ounces to replace each pound lost during practice or a game.
- Players should consume food and drinks that contain a liberal amount of salt. Sports drinks might provide some benefit over water because of the electrolytes and energy.
- Ideally, a player should be fully hydrated before beginning practice or competition. Fluids lost through sweat and breathing should be replaced by fluid consumption.
- Flavored, cold, lightly salted, and/or sweetened commercial drinks might improve voluntary fluid replacement by players, especially the younger athletes.
- Drinks sweetened with a carbohydrate such as glucose or sucrose (sugar) might help a player maintain energy during activities that last more than one hour. In addition, fluids containing the electrolytes sodium, potassium, and chloride can promote fluid retention to help ensure rehydration is complete.