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Be wary of too much fun in the sun

Guidelines to help prevent and treat heat exhaustion, dehydration and heat stroke.
/ Source: TODAY

Summer is a great time to play outdoor sports. But as teams gear up for August football and soccer workouts under the hot sun, about 300 Americans die in heat-related incidents each year, some of them healthy athletes and children. Douglas Casa of the National Athletic Trainers’ Association talks about guidelines to help prevent and treat heat exhaustion, dehydration and heat stroke.


These illnesses are usually due to heavy loss of fluid and salt. In many cases, the condition worsens as the athlete, afraid of “wimping out,” continues to exercise after the body starts to suffer. A sweating body needs fluids to maintain blood volume, so drink water or sports drinks (not caffeinated or alcoholic beverages) before, during and after exercise. How much you need to drink depends on how big you are and how hot it is, but as a rule of thumb, drink six to eight ounces for every 15 minutes of intense exercise in the heat. By weighing in before and after a workout, you can determine exactly how much fluid you’ve lost (a pound equals 16 ounces). Try to replace a bit more than you lose. With dehydration, blood volume decreases and the heart must work harder. During summer exertion, blood volume may drop by as much as 10 percent.


The report also recommends that athletes undergo a physical exam before beginning play. Most teams require it, but doctors don’t always do a history of heat illnesses, one of the best predictors of heat illness is a previous one. The physical should note the use of any medications. “Some children use Ephedra and other supplements. They should warn medical staff in order to avoid problems,” says Dr. Douglas Casa, chairman of the report. Ephedra, a popular weight-loss and energy-boosting dietary supplement, was linked to the heat-stroke death of Baltimore Orioles pitcher Steve Bechler. According to the Food and Drug Administration, the supplement is an adrenaline-like stimulant that can have destructive effects on the heart and nervous system.


The task force says that safety begins long before athletes head to camp. “Children should prepare their body for the heat through “acclimatization”, or exercising outside two to three hours per day for one to two weeks, then go to camp,” says Dr. Casa. “Many children aren’t prepared for long days under the sun after spending all day under air conditioning playing videogames.” Start doing more intense and longer exercise during the day before they start doing these two-a-day workouts. This is a powerful tool for preparing the body for exercise in the heat.


In general, take breaks every thirty minutes in a shady or air-conditioned place. Modify that or skip outdoor exercise in extreme humidity, which keeps sweat from evaporating to cool you off. The hotter it is, the more breaks you take. Wear a hat and use sunscreen. Sunburned skin doesn’t sweat properly. Fans, cool towels, ice packs and spraying the body with cold water can also cool down the body during exercise.


If you suspect heat stroke, call 911 and do everything possible to lower the person’s body temperature. The faster you can cool the person, the more likely they’re going to survive. There is a treatment that has 100 percent survival rate. There is a “golden hour” for heat stroke. How fast you get somebody’s body temperature down impacts if they have organ damage or not. When people die from heat stroke they usually die later the next day from organ damage. No one dies immediately from heat stroke, they die later. What matters is how long your temperature is over a critical threshold for cell damage. Ice water immersion is the best thing you can do.

If someone shows signs of heat stroke, strip them to their underwear and immerse them in ice water. If there’s no tub, use fans, ice bags or cold towels. College and professional teams Casa consults with have pools made by Rubbermaid set up right at practice. This is probably the most important point we can make in this segment. People will not die from heat stroke if treated right away.

For more mild symptoms of heat exhaustion, cramps or dehydration, move to a shaded or air-conditioned area and take off excess clothing and gear. Check the person’s pulse and temperature. A temperature of 104 or more may signal heat stroke, the most severe form of heat illness.


No one who has suffered heat stroke should be allowed to return until his or her doctor approves and gives specific return-to-play instructions. Parents should work with a child’s doctor to rule out or treat any other conditions or illnesses that may cause continued problems with heat stroke. The child should return to physical activity slowly, under the supervision of an ATC or other qualified health care professional, especially for sports with equipment.

After heat cramps or exhaustion or dehydration, get hydrated again, and then go back to activities.

For more information you can visit the National Athletic Trainers’ Association Web site at: