Identifying and treating dehydration, heat exhaustion and heat stroke

By Frank Bartscheck | Posted 8/8/2016

The serious nature of heat stroke made its way onto the national radar 15 years ago on Aug. 1, 2001. The death of the Minnesota Vikings’ Korey Stringer due to heat stroke ignited changes in the NFL policies regarding player care.

However, dehydration and heat stroke are still significant issues that continue to affect athletes today.

Football season is back and NFL training camps opened this past Friday. It only took a few days and already there are reports of multiple cases of dehydration.

Minnesota Vikings wide receiver Stefon Diggs, New York Jets corner back Dee Milliner and Los Angeles Rams dual-threat playmaker Tavon Austin all suffered from dehydration over the first days of training camp.

Further, Philadelphia Eagles head coach Doug Pederson admitted the team was dealing with dehydration. Jacksonville Jaguars GM Dave Caldwell shared that his team was struggling with it as well.

 “It’s difficult, it has been an intense summer with heat, ” Caldwell said.

Dehydration is a very common issue for athletes who are exerting themselves during the summer heat. Coaches need to be cognizant of young athletes who are dehydrated because it can quickly lead to heat exhaustion or heat stroke, if not properly diagnosed and addressed.

Even though NFL players and teams are dealing with dehydration, the true risk is among young athletes. According to the Mayo Clinic, the central nervous system in young adults “…is not fully developed…which makes your body less able to cope with changes in body temperature.”

Heat stroke is defined by the Mayo Clinic as, “A condition caused by your body overheating, usually as a result of prolonged exposure to or physical exertion in high temperatures. This most serious form of heat injury, heatstroke can occur if your body temperature rises to 104 F (40 C) or higher.”

The human body is continuously trying to maintain a body temperature of approximately 98.6 degrees. The body attains this constant temperature by stabilizing heat gain with heat loss. Importantly, according to the American Academy of Pediatrics, 10- to 20-times more heat is generated by exercising muscles versus muscles at rest.

Further, while sweating is the primary way the body attempts to rid itself of excess heat, this biological process is rendered less effective in humid environments. If the body is unable to expel excess heat, then heat exhaustion or heat stroke may occur.

The topic of heat stroke is timely. According to published research in the American Journal of Sports Medicine, “The 5-year period of 2005-2009 saw more exertional heat stroke–related deaths in organized sports than any other 5-year period in the past 35 years. The risk of exertional heat stroke appears highest in football, particularly during the preseason.”

WARNING SIGNS

Once the body is dehydrated, the next phase prior to heat stroke, is referred to as heat exhaustion. According to the CDC, the signs of heat exhaustion include:

  • Heavy sweating
  • Weakness
  • Cold, pale, and clammy skin
  • Fast, weak pulse
  • Nausea or vomiting
  • Fainting

If the proper treatment is not quickly administered, heat exhaustion can quickly lead to heat stroke. According to the CDC, the signs of heat stroke include:

  • High body temperature (above 103°F)*
  • Hot, red, dry or moist skin
  • Rapid and strong pulse
  • Possible unconsciousness

The American Academy of Pediatrics also points to additional signs of heat stroke, which include, “confusion, combativeness, seizures and/or stroke, shock, coma (unresponsive), and/or heart failure/cardiac arrest.”

PROPER TREATMENT

According to the American Academy of Pediatrics, if you suspect a player of possible dehydration or heat exhaustion, it is important that you take these immediate steps:

  • Immediately stop exercising and move the player to a cooler/shaded area
  • When possible, immediately move the player into an air-conditioned environment
  • Replace water loss by drinking cool fluids (nothing with sugar or caffeine)
  • “If the athlete does not quickly improve or is unable to drink fluids, then the athlete should be immediately taken to the nearest emergency facility.”

If you suspect a player of having possible heat stroke, take the immediate steps:

  • Call 911 or your local emergency response phone number.
  • Don’t wait for help to arrive, immediately begin cooling the body (this can be done with ice packs or cold water).
  • Remember, this is a life-threatening issue that needs immediate medical attention.

Youth and high school football coaches need to become more aware of the potentially catastrophic and fatal consequences of heat exhaustion. A recent study published in the American Journal of Sports Medicine examined heat exhaustion in high school football.

What they found was staggering, “exertional heat stroke events, which are likely to be fatal if untreated, were reported by one fifth of all athletic trainers in high school football programs… there is an urgent need for improved education and awareness of exertional heat stroke in high school football."

Make sure that you have the proper protocols and precautions in place before beginning your summer football training camps.

SEE ALSO: Heat Preparedness and Hydration

SEE ALSO: 6 Tips to Stay Hydrated During the Football Season

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