Despite advancements in research and education, heightened awareness, modifications in governing body policies such as the National Collegiate Athletic Association (NCAA) and the National Federation of High Schools (NFHS) and the presence of Athletic Trainers (ATs) at more schools, there have been more heat stroke deaths in the past five years than in any other five-year block over the past 35 years, according to Douglas Casa, PhD, ATC, FACSM, FNATA.
Several stories about heat illness were featured in the news throughout the month of August. Dr. Casa of the Korey Stringer Institute was featured on the Today Show and in the USA Today about exertional heat stroke (EHS) and preventing sudden death in sports. Dr. Casa, has successfully treated more than 140 cases of EHS and has published numerous publications and presentations on the subjects related to exertional heat stroke, heat-related illnesses, preventing sudden death in sport, and hydration.
According to the Korey Stringer Institute’s (KSI) website, EHS death is one of the leading causes of sudden death in sport. During certain times of the year, it is likely the leading cause of death. Many cases of EHS could be prevented if strategies to enhance the health and safety of athletes i.e., focus on hydration, phase-in programs for heat acclimatization, access to on-site medical care, etc., were improved. Additionally, when an EHS does occur – not all cases could ever be prevented within the confines of athletes performing intense exercise in the heat – proper recognition, treatment and emergency action-plans need to be in place to assure athlete survival.
It is essential for ATs to be knowledgeable in the prevention, recognition, and treatment of EHS.
It is crucial to stress that EHS is a true medical emergency. ATs are one of the first medical professionals on the scene when dealing with EHS, so it is important to Be Certain.™ of the most successful ways to prevent, recognize and treat EHS. Domain 1 of the Role Delineation Study/Practice Analysis, Sixth Edition is Injury/Illness Prevention and Wellness Protection. Educating participants and managing risk for safe performance and function is job ONE for the AT!
Program Directors can use this four-part series as a resource for best practices when educating athletic training students regarding the recognition and treatment of EHS while providing them with the most current and supported knowledge in this area. A new book, written by Dr. Casa called Preventing Sudden Death in Sport and Physical Activity, published in cooperation with the American College of Sports Medicine (ACSM), is also available and will arm readers with the knowledge and skills they need to make the correct decision when confronted with an emergency situation. Additionally, the Korey Stringer Institute is available to assist.
Coaches, school leadership, parents and legislators must push their states to establish mandatory heat illness guidelines. Most states have inadequate guidelines to help reduce the number of fatalities associated and to provide a critical standard to protect athletes against EHS. Current polices for decreasing the incidence of heat illness are extremely ineffective, and the potential for inappropriate care continues to be a large threat. To date, according to the KSI, New Jersey is the only state to have adopted the Inter-Association Task Force Guidelines on heat acclimatization for secondary schools in full. View the KSI Heat Acclumatization Guidelines by State.