For some, summer feels like it just started, but the first day of school for Knox County is right around the corner, set for Aug. 10, and other surrounding districts start even earlier. Looking forward to the fall sports seasons ahead, many high school athletics have already been ramping up practices.
However, with many teams, especially football teams, practicing outside under the sweltering summer sun, the young athletes are exposed to a greater risk of various heat-related illnesses.
The risk isn't limited to football players. Marching band members — who, like football players, often wear multiple layers and spend long periods outdoors — face an elevated risk of exertional heat exhaustion and heat stroke. Other fall athletes are also at increased
risk of heat-related illnesses.
What is exertional heat stroke?
One condition an athlete who is exercising outdoors will be at a greater risk of developing is exertional heat stroke, the leading cause of injury and death among high school and college athletes, according to the University of Connecticut's Korey Stringer Institute. EHS is caused by strenuous activity in hot environments.
The main symptom of EHS is a core body temperature of over 105 degrees Fahrenheit and multi-organ failure, but other signs include dizziness, sweating, hyperventilation, increased heartrate and loss of balance or muscle function.
Athletes are not the only people who can fall victim to EHS, if someone becomes confused, acts strangely, collapses, has a seizure or shows any significant change in mental status after intense exercise, it should be treated as if they are having a medical emergency and EMS should be called immediately.
If an athlete begins to experience nausea, a change in consciousness or stops sweating, that is when the situation has gone from a heat fatigue to a more serious heat illness, according to American Medical Response Director of Operations Jerry Harnish.
"People who are having a real emergency, they quit sweating," Harnish said.
What to do if an athlete starts to experience EHS
While waiting for EMS arrival, the most effective way to immediately cool down an athlete in the event of EHS is full body immersion in an ice bath, according to the Korey Stringer Institute.
An ice-water immersion tub should be set up in a close, accessible area prior to the start of outdoor exercise. The tub should be in a shaded area, filled halfway with water and have three to four coolers of ice next to the tub.
Before placing the athlete in the ice bath, vital signs should be taken. Once in the cooling tub, the athlete should be placed in the water up to mid-chest or neck, a cold towel should be placed on the head and neck or other unsubmerged parts to aid in the cooling process.
Both the water in the tub and the cool towel should be rotated to ensure body temperature does not warm up the water. Water should be continuously stirred in order to circulate it.
If done correctly, a cooling tub can help lower an athlete's core temperature up to five degrees Fahrenheit after 15 minutes, which will put them at a safe temperature to be transported to a hospital.
If a tub isn't available, a cold locker room shower or placing the athlete on a tarp and oscillating cold water to cool the core temperature would be the next best options.
How EMS responds to exertional heat stroke?
Once EMS crews arrive to a call for EHS, they can build on the care a cooling tub has already started.
"The benefit of any EMS crew is that they can use interventions that wouldn't be available to everyone," Harnish said.
While athletic trainers are equipped to care for athletes, EMS have access to more equipment. One of the most important ways an EMS crew can help is by intravenously administering fluids, this way an athlete who is experiencing EHS and could throw up water if they drink it, will be able to become rehydrated.
Crews can also help by reevaluating the athlete's vitals, continue cooling and determine when it is safe to transport the EHS victim to the hospital. Information athletic trainers and coaches who are on scene when EHS occurs can provide information to 911 dispatchers that will further help EMS crews to respond.
How to prevent exertional heat stroke
The Korey Stringer Institute provides guidelines on how to prevent EHS.
The most important prevention method is hydration. Athletes are encouraged to drink both water and fluids that contain sodium throughout practice. Drinks should be consumed frequently and, in the shade, especially when having multiple practices a day.
As athletes become acclimated to exercising in the heat they will sweat more and therefore need to consume more liquids to stay hydrated.
Wearing loose-fitting, absorbent clothing and avoiding working out during the hottest times of the day are other ways athletes can stay safe from EHS. During particularly hot and humid practice times, athletes should minimize clothing and equipment to stay cool.
This article originally appeared on Knoxville News Sentinel: Who is most at risk for exertional heat stroke? Warning signs to know
