Staying Safe in the Heat

8/21/2019
Kestrel High WBGT

As preseason progresses there is one key factor we often overlook....THE HEAT! Exertional heat stroke is the third leading cause of sudden death in athletes. THIS IS TOTALLY PREVENTABLE! Whether you are a college athlete or weekend warrior monitoring the temperature is crucial to ensure safe participation. Coaches, athletes, and parents should be aware of rules and regulations that influence participation in the heat. How should I monitor the temperature? When is it too hot to participate? How to identify and treat exertional heat stroke? Here’s what you need to know.

How to monitor the temperature?

The gold standard to monitor temperature is Wet Bulb Globe Temperature (WBGT). WBGT takes into account the air temperature, humidity, and sun radiation. This gives the athlete a true idea of “what it feels like” when training at a location. Sports medicine professionals in high school, college, and professional sports monitor WBGT throughout practice to determine the level of heat illness risk. WBGT can vary based on location. Two different sites less than 5-10 miles apart can have very different readings. Due to the fact WBGT readings vary greatly, most weather stations do not report the data. 

WBGT is often read by and athletic trainer via an electronic device. This can be difficult for the average individual. So what should they do? There are several options to give an estimated WBGT reading. The chart below gives an estimate of the WBGT based on temperature and humidity.

There are also several apps available that give you an estimate of the WBGT. The gold standard is using a WBGT device but the apps and chart give someone a general idea of the heat illness risk. Far more accurate than temperature or humidity alone. 

When is it too hot to participate?

Several states and athletic organizations have their own guidelines for participation in the heat. The New Jersey State Interscholastic Athletic Association (NJSIAA) recently implemented a Heat Participation Policy that affects all high school athletes. The policy sets practice time and equipment restrictions based on the WBGT. The main WBGT numbers to remember are 85, 88, and 90 degrees Fahrenheit. At 85 WBGT practice time is limited to 2 hours with no equipment worn (helmets or shoulder pads). Four rest breaks are required per hour. At 88 WBGT practice is limited to 1 hour with no equipment worn. No conditioning is allowed and 20 minutes of rest are required per hour. At 90 WBGT no outdoor activities are permitted. This policy is in effect for all practices and scrimmages. NJSIAA Games are allowed to continue in WBGT 85-90 with increased rest breaks. Equipment must be removed during rest breaks. Games must be suspended for 30 minutes if the WBGT reaches 90. A game can not resume until the WBGT drops below 90. 

NCAA and professional athletes often adhere to guidelines established by the National Athletic Trainers’ Association (NATA) Positional Statement on Heat Illness. Similar to the NJSIAA guidelines, the NATA uses WBGT to determine participation and equipment restrictions. The main WBGT numbers to remember are 87, 90, and 92 degrees Fahrenheit. At 87 practice time is limited to 2 hours and football players are restricted to helmets and shoulder pads only. At 90 practice is limited to 1 hour with no equipment worn and no conditioning activities permitted. Above 92 no outdoor activities are permitted. Although these athletes are better conditioned than high school, their activity still needs to be modified throughout preseason training camp. 

WBGT IS DIFFERENT THAN HEAT INDEX!

How to Identify and Treat Exertional Heat Stroke?

Exertional heat stroke (EHS) is a life threatening condition and needs to be identified and treated quickly. Someone suffering from EHS is categorized as having a core temperature above 104-105 degrees Fahrenheit. Other key indicators include:

  • Emotional/irrational behavior

  • Disoriented/altered consciousness

  • Collapse, staggering or sluggish feeling

  • Profuse sweating

An athlete exhibiting these symptoms, while competing in a hot environment, needs to be treated immediately! 

The main concept to understand when treating EHS is COOL FIRST, TRANSPORT SECOND! The faster the core temperature is lowered the greater chance of recovery. Follow these steps when treating an athlete with EHS:

  • Remove any equipment and excess clothing.

  • Place athlete is cold tub to decrease core temperature (approximately 20-30 minutes until core temp is 101-102).

  • If cold tub is not available, use ice bags and cold towels along neck and core of the body. Remove athlete from hot environment to shade or air conditioned area.  

  • Activate EMS once cooling has begun.  

EHS has had a 100% survival rate when immediate cooling was initiated (via cold water immersion or aggressive whole body cold water dousing) within 30 minutes of collapse!

EHS is the 3rd leading leading cause of sudden death in athletes…...IT’S PREVENTABLE!

 

References

https://ksi.uconn.edu/prevention/wet-bulb-globe-temperature-monitoring/

https://ksi.uconn.edu/emergency-conditions/heat-illnesses/exertional-heat-stroke/heat-stroke-recognition/

https://www.njsiaa.org/sites/default/files/document/Heat%20Participation%20Policy%202018-19.pdf

https://natajournals.org/doi/pdf/10.4085/1062-6050-50.9.07

https://www.ncbi.nlm.nih.gov/pubmed/17473783

http://www.ncaapublications.com/productdownloads/MD15.pdf