Heat Stress Information and Resources
Heat Stress and Athletic Participation Information and Resouces
Early fall football, tennis, cross-country, and marching band practices are conducted in very hot and humid weather in many parts of Texas. Due to the equipment and uniform needed in football, most of the heat problems have been associated with football. Heat emergencies have three stages: heat cramps, heat exhaustion, and heatstroke. All three stages of heat emergency are serious. During hot weather conditions, the athlete is subject to the following:
- Heat Cramps - Painful cramps involving abdominal muscles and extremities caused by intense, prolonged exercise in the heat and depletion of salt and water due to sweating.
- Heat Syncope - Weakness, fatigue and fainting due to loss of salt and water in sweat and exercise in the heat. Predisposes to heatstroke.
- Heat Exhaustion (Water Depletion) - Excessive weight loss, reduced sweating, elevated skin and core body temperature, excessive thirst, weakness, headache and sometimes unconsciousness.
- Heat Exhaustion (Salt Depletion) - Exhaustion, nausea, vomiting, muscle cramps, and dizziness due to profuse sweating and inadequate replacement of body salts.
- Heatstroke - An acute medical emergency related to thermoregulatory failure. Associated with nausea, seizures, disorientation, and possible unconsciousness or coma. It may occur suddenly without being preceded by any other clinical signs. The individual is usually unconscious with a high body temperature and a hot dry skin (heatstroke victims, contrary to popular belief, may sweat profusely).
Heat Exhaustion Individuals experiencing heat exhaustion should respond quickly to treatment. If not, exertional heat stroke should be suspected. In this case, obtain a rectal temperature and assess central nervous system function to rule out exertional heat stroke. If the person is experiencing heat exhaustion, the rectal temperature should be < 40°C/104°F. To treat heat exhaustion:
- Move the individual to a cool/shaded area and remove excess clothing
- Elevate legs to promote venous return
- Cool the individual with fans, rotating ice towels, or ice bags
- Provide oral fluids for rehydration
Heat Stroke - This is a medical emergency. ANY DELAY COULD BE FATAL.
Follow these steps to initiate emergency treatment:
- Remove all equipment and excess clothing.
- Cool the athlete as quickly as possible within 30 minutes via whole body ice water immersion (place them in a tub/stock tank with ice and water approximately 35-58°F); stir water and add ice throughout cooling process.
- If immersion is not possible (no tub or no water supply), tarps filled with ice and wrapped around individuals to rapidly cool internal body temperature (TACO method) and are encouraged to include a combination of the following options: ice sponges, towels, water misters, and shade.
- Maintain airway, breathing and circulation.
- After cooling has been initiated, activate emergency medical system by calling 911.
- Monitor vital signs such as rectal temperature, heart rate, respiratory rate, blood pressure, monitor CNS status.
- If rectal temperature is not available, DO NOT USE AN ALTERNATE METHOD (oral, tympanic, axillary, forehead sticker, etc.). These devices are not accurate and should never be used to assess an athlete exercising in the heat.
- Cease cooling when rectal temperature reaches 101-102°F (38.3-38.9°C).
Exertional heat stroke has had a 100% survival rate when immediate cooling (via cold water immersion or aggressive whole body cold water dousing) was initiated within 10 minutes of collapse
Summary - The main problem associated with exercising in the hot weather is water loss through sweating. Water loss is best replaced by allowing the athlete unrestricted access to water. Water breaks two or three times per hour are better than one break an hour. Probably the best method is to have water available at all times and to allow the athlete to drink water whenever he/she needs it. Never restrict the amount of water an athlete drinks, and be sure the athletes are drinking the water. The small amount of salt lost in sweat is adequately replaced by salting food at meals. Talk to your medical personnel concerning emergency treatment plans.
2024-2025 Recommended Heat Protocols and Procedures for Outside UIL Athletic and Marching Band Activities
Cold Body Immersion Tub Method Resources
Treating Exhertional Heat Stroke with Cold Body Immersion Tub - Video
Tarp Assisted Cooling Oscillation (TACO) Method Resources
Sports Safety Minute – The Tarp Assisted Cooling Method - Video
Method Using Tarp to Cool Person with Heat Stroke is Effective - Article
Heat Illness Resources Available from NFHS
Exertional Heat Stroke is the leading cause of preventable death in high school athletics. Exertional Heat Stroke also results in thousands of emergency room visits and hospitalizations throughout the nation each year.
NFHS Learning Center Heat Illness Prevention Course
This free course offered by the NFHS is designed to give you the critical information you need to minimize the risk of Exertional Heat Stroke among your athletes.
NFHS Position Statements on Heat Illness
The NFHS Heat Acclimatization and Heat Illness Prevention Position Statement