Heat-Related Emergenices

Heat-Related Emergenices

Heat-related emergencies such as heat stroke claim the lives of athletes every year despite being among the most preventable of sports-related health problems. Although heatrelated deaths have decreased in recent years, just one death is far too many when most of these problems can be controlled by simple measures and the proper education of health-care professionals and coaching staffs.

Body Temperature Regulation

Because the body depends on water for normal function, long duration of sweating or excessive sweating without fluid replacement could be dangerous to the athlete. Efficient function of many of the body’s various organs and systems require that core temperature be maintained within a narrow range. As the muscles work during exercise, a tremendous amount of heat is generated. The body relies on a number of different methods to help dissipate this heat and maintain core temperature within a desirable range. These include convection, conduction, evaporation, and radiation. Of these, evaporation is the most efficient method for the body to lose excess heat. However, the rate of sweat evaporation from an athlete’s skin is highly dependent on the amount of heat and humidity already present in the air. The warmer and more humid the air is, the harder it will be for sweat to evaporate and the higher an athlete’s core temperature will become. As water is lost though sweating, electrolytes and other chemicals are also lost from the body. This loss of electrolytes can also contribute to an imbalance of the cooling system.1 and lead to hyperthermia. It is important for the athlete to replace both fluids and electrolytes as they are lost through sweating associated with exercise. As the body’s core temperature rises and water and electrolytes deplete, heat illnesses can become a reality if immediate proper care does not take place.2 Recognition of the early stages of heat illness in an athlete is vital. Although heat illnesses in athletics can appear in a progressive manner, dangerous situations such as heat exhaustion and heat stroke may arise with little or no warning .

Methods of Core Temperature Regulation

■ Convection: the body will gain or lose heat depending on the temperature of the surrounding

air or water. Example: an athlete in cold water will have a decrease in body temperature.

■ Conduction: the body will gain or lose heat depending on the temperature of whatever

surface it is in contact with. Example: an athlete lying on hot artificial turf will have an increase in body temperature.

■ Evaporation: water on a surface dissipates into the atmosphere, releasing heat. Example: sweat evaporating from the skin of an athlete results in a loss of heat and a lower body temperature.

■ Radiation: heat is transferred from areas of high temperature to areas of lower temperature.

Example: blood from working muscles travels close to the surface of the skin. If the blood is warmer than the air temperature surrounding the skin, heat will be transferred from the warmer blood to the cooler atmosphere

Heat Cramps

Heat cramps are common in athletics and should not be overlooked because they can be considered as the first stage of heat-related emergencies. Heat cramps tend to occur mainly in the leg area such as the calf and hamstring muscles. They are usually recognized by intense pain with persistent muscle spasms in the working muscle during prolonged exercise.  Heat cramps are generally thought to be caused by muscle fatigue with rapid water and electrolyte loss via the sweating mechanism. Other factors may include lack of acclimatization, resulting in a less-efficient sweat mechanism and excessive sweating; irregular meals, resulting in less than optimal electrolyte stores; and a history of cramping. Treatment for cramping includes removing the athlete from activity and incorporating gentle passive stretching of the involved muscle group in combination with ice massage . It is vital that immediate water and electrolyte replacement take place to prevent further muscle cramping and the possible progression to more serious forms of heat illness.

Heat Exhaustion

Heat exhaustion is a condition when the body is near to total collapse because of dehydration and a dangerously elevated core temperature.Heat exhaustion is not considered a medical emergency, although it is a serious condition and is considered to be a precursor to heat stroke. In an athlete suffering from heat exhaustion, the body’s cooling mechanisms are intact but are no longer functioning efficiently.

Treatment of Heat Cramps

■ Remove athlete from activity.

■ Rehydrate and replace electrolyte losses.

■ Try gentle passive stretching of involved muscle.

■ Try light massage with ice to reduce the muscle spasm.

Signs and Symptoms of Heat Exhaustion

■ Athlete has elevated core body temperature.

■ Athlete may feel generally weak or fatigued.

■ Athlete may feel nauseated.

■ Athlete has sweaty/wet skin.

■ Athlete’s skin is pale.

■ Athlete’s breathing is rapid and shallow.

■ Athlete’s pulse is weak.

Treatment of Heat Exhaustion

■ Check all vital signs.

■ Measure core body temperature (rectal).

■ Remove excess clothing.

■ Cool athlete with ice towels/ice bags.

■ Place athlete in a cool or shaded area.

■ Start fluid replacement.

■ Alert team physician or transfer athlete to local emergency care facility