Coaches hear about awareness of, treatment for heat-related illnesses

More than 400 coaches from the Northwest Arkansas area spent Thursday (July 25) learning about heat-related illness and other physical ailments that will claim more than 658 lives this year. The event was Mercy’s annual Coaching Summit held at John Q. Hammons Center in Rogers.

Mercy Northwest spokeswoman Jennifer Cook said this is the eighth year for the event which only takes place in Northwest Arkansas and not other regions where Mercy operates. She said Mercy Northwest holds the event to assist area coaches and educators with relevant information regarding sports injury and heat-related illnesses. It is also a way for coaches to get the required continuing education credits as well as certification in CPR and AED – automated external defibrillator – which is now required in all Arkansas public schools.

The full-day event featured multiple training sessions on topics from understanding the mental health of teens to chronic traumatic encephalopathy, which is the degeneration of brain functions caused by repeated head traumas. Several breakout sessions focused on heat-related illnesses, which are largely preventable.

Dr. Whitley Atkins, a doctoral research student at the University of Arkansas, updated coaches on the latest protocol on preventing heat exhaustion. Atkins said much of the standard on preventing dehydration and heat exhaustion in students and the general public is out of date. She said the past five years have been the most deadly for heat-related illnesses than in the past 35 years. She said a warmer climate along with increased obesity are two of the likely reasons for the increase in deaths. She said children up to age 4, people over 65 and overweight individuals can be at the greatest risk for heat-related illnesses. Young, healthy individuals can also succumb to heat if they participate in strenuous physical activities during hot weather. She said alcohol use and certain medications raise the risk.

Early signs of heat-related illness include muscle cramps which can signal poor hydration, low sodium and muscle fatigue. Heat syncope occurs when there is limited blood flow to the heart and brain and someone faints. She said heat exhaustion is the ability to discontinue exercise due to fatigue, nausea and vomiting. Rest, shade and cooling fluids should help within 10 minutes. People experiencing heat exhaustion should not return to work for 24 hours. Atkins said if any of the symptoms present during physical activity, the core body temperature should be checked with a rectal thermometer. Heatstroke can occur when core body temps reach 103. At that point, ice baths are the first defense until the temp is 102, then transport to the hospital.

Heat-related illnesses can begin with heat cramps and escalate to heat stroke if a person’s core body temperature rises to 104 or higher. Atkins said too often those trying to render aid in heat-related illnesses will try and transport the person to the hospital or wait on emergency professionals.

“In the meantime, those with core body temps of 104 are baking from the inside and even if they survive there can be a major impact on their renal systems and other body functions for years later,” Atkins said.

Atkins attended the Boston Marathon this past year to conduct research on heat-related illnesses. She said a few participants who trained for months for the event and were in good shape experienced heat exhaustion and presented core body temperatures of 106. She said the only way to bring that body temperature down fast enough is with an ice bath. Atkins said covering someone in an ice bath starting with the head is the fastest and most successful way to effectively treat serious heat stroke/exhaustion. She said wrapping the head in ice wet towels is not effective as it would take 48 minutes to cool the core temp from 108 to 102 degrees. She also said those assessing temperature should use only a rectal thermometer because it is the only method that can accurately detect seriously high temperatures.

“All schools, gyms, workout centers used by the public and high-intensity sporting events should have rectal thermometers and tubs of ice water ready anytime there is a chance of heat exhaustion. It doesn’t have the be that hot if the humidity is high,” Atkins said, adding later that if “there are no ice buckets for bathing, at the very minimum you lay a tarp on the ground and cover it with ice and then wrap the person in it like a taco. This can save their life.”

Proper hydration is also key to reducing heat-related illness. She said some colleges are posting urine charts in locker rooms that allow athletes to be able to check their urine in private to see if they are properly hydrated before and after workouts.

“Many times athletes and adults who are actively working out will drink while they are biking or lifting or hiking, but they fail to properly hydrate after they finish the activity. It’s just as important to hydrate after the workout and while sodas and tea do replace fluids it’s not the same as flushing the body with water,” Atkins said.

She said 95% of deaths related to heatstroke occur within the first two days of training camp. She said the next most risky time during extensive training is between days 5 and 6 which are most prominent in college. Atkins told the coaches athletes must acclimate to the heat before extensive training. She said heat acclimation can take between 10 to 14 days. When the body gets properly acclimated to the heat, then it can properly sweat to cool down.

Atkins said cooling vests are not yet reliable and there is no substitute for ice baths, rectal thermometers and the practice of heat acclimation. She said there are several ways to guard against heat exhaustion and that can begin with proper hydration. She said the loss of sleep, being overweight, having concurrent illnesses, poor physical fitness, and cumbersome uniforms can raise the risk of heat-related illnesses among athletes and the general public.

She said football is where most heat-related illnesses occur, likely because of the heavy pads and uniforms that constrict a player’s ability to sweat properly. She said bulky size is also a benefit in football but if players don’t get properly acclimated to the heat they are more likely to become sick in the earning stages of training. The sport that is least susceptible is cross-country running because Atkins said athletes wear loose cool clothing that allows their bodies to sweat.

Atkins said medications including over-the-counter pain relievers can also interfere with a body’s ability to handle heat-related stress and it’s important for everyone to know the warning signs and rapid response protocol for heat-related illness.