Hezekiah Walters

Sports Medicine
Educational Plan
on Hydration & Heat Illness
Hillsborough County Public Schools

Sports Medicine Advisory Committee Members:

Lanness Robinson, County Athletic Director
Timothy Leeseberg, APA/AD, Plant City High School
Evanitta Omensetter, APA/AD, Alonso High School
Jasmine Tramel, APA/AD, Strawberry Crest High School
Lauren Heiser, Certified Athletic Trainer, Select PT
Christina Krcmar, Certified Athletic Trainer, PT Solutions
Raena Steffen, Certified Athletic Trainer, The USF SMART Institute
HYDRATION
HYDRATE TO ELEVATE
 Are you hydrated?
Dehydrated?
If you are thirsty,
you are already dehydrated.

What are you drinking?

HYDRATE TO ELEVATE
Over-hydrated: a state of excessive total body
water content. NO physiological or
performance advantages.

HYDRATED: HAVING ADEQUATE

FLUIDS THAT ALLOW THE BODY TO
FUNCTION AT MAXIMUM CAPACITY

Dehydrated: is a deficiency of body water,

with an accompanying disruption of
metabolic processes, performance and may
lead to heat-related illnesses

HYDRATE TO ELEVATE
WHAT EFFECTS HYDRATION LEVEL?

Hydration habits, urination,

breathing, activity,
and most significantly……

SWEATING
HYDRATE TO ELEVATE
WHAT EFFECTS ONE’S SWEAT RATE?

 Ambient temperature
 Humidity

 Genetics

 Gender

 Body weight

 Fitness level

 Intensity

HYDRATE TO ELEVATE
SIGNS & SYMPTOMS OF DEHYDRATION

Thirst, Headache, Fatigue, Confusion, Nausea,

Flushed Skin, Cramps, Dizziness

Decreased Stamina, Speed, Energy, and Muscular

Strength

HYDRATE TO ELEVATE
MONITOR YOUR HYDRATION
Check your urine color Measure your water
weight loss

GAME
PRACTICE

BEFORE AFTER

HYDRATE TO ELEVATE
DECREASE IN ATHLETIC
PERFORMANCE
 2-4% weight loss - reduced
muscular endurance time
 150lbs= 3-6lb loss; 200lbs= 4-8lb loss
 4-6% weight loss - reduced
muscular strength & endurance,
heat cramps
 150lbs= 6-9lb loss; 200lbs= 8-12lb
loss
 >6% weight loss - severe heat
cramps, heat exhaustion, heat
stroke, coma, DEATH
 150lbs= >9lb loss; 200lbs= >12lb loss

HYDRATE TO ELEVATE
HOW TO GET AND STAY HYDRATED…

Drink plenty of water

EVERYDAY

Include drinks with

electrolytes, like Gatorade

AVOID or LIMIT sugary

and caffeinated drinks

HYDRATE TO ELEVATE
 NOTE:
GAME DAY
Room temperature fluids
GENERAL RULE OF THUMB absorb more quickly.
➢ Pre-Game
At least 16 oz. 4 hours BEFORE game time
&
At least 8 oz. 2 hours BEFORE game time

➢ During Game:
7-10 oz. every 15 minutes
throughout the game

➢ Post Game (within 2 hours):

16 oz. bottle of sports drink (Gatorade)
and a snack to replace electrolytes, carbs,
and proteins

HYDRATE TO ELEVATE
HYDRATE TO ELEVATE
YOUR PERFORMANCE

THINK TO DRINK
PROPOSED ACTION STEPS
 Chart containing timeline of hydration for pre-game,
during game, and post-game measures.
 Emphasis to players of how hydration is directly tied
to athletic performance.
 Explanation to athletes of what not to drink such as
caffeine and energy drinks.
 Chart for athletes to monitor hydration through urine
color.
 Educate athletes about the need to monitor weight
loss during/following activity.

HYDRATE TO ELEVATE
HEAT ILLNESS
Cool FIRST, treat SECOND,
then TRANSPORT for additional care
HOW HEAT EFFECTS YOUR BODY
 Decreases performance
 Places extra stress on the body

 Increases core body temperature

 Increases heart rate

Cool first, treat second!

(INSERT SDHC HEAT STRESS POLICY)
 InsertSDHC Heat
stress policy
 Recommended time(s)
for WBGT
measurement(s)
 Recommended
method(s) of advising
coaches
 Recommended
procedures for
preparing CWI tub(s)

Cool first, treat second!

 HEAT RELATED ILLNESS
 Exertional Heat Illness is
100% PREVENTABLE & 100% TREATABLE
 Body temperatures can rise to dangerous levels.

 Can occur ANY time of the year in ANY kind of

weather.
 Florida has the highest number of heat-related
deaths of high school student-athletes in the nation!
 All high schools in Hillsborough County have a
Certified Athletic Trainer (AT) on-site every day

Cool first, treat second!

TYPES OF HEAT RELATED ILLNESS

Exercise-Associated Muscle Cramps

Heat Syncope (fainting)

Heat Exhaustion

Exertional Heat Stroke

Cool first, treat second!

HEAT RELATED ILLNESS:
EXERCISE-ASSOCIATED MUSCLE CRAMPS
 Symptoms
 Painful, involuntary
muscle spasms
 Most likely to occur in
larger muscle groups
 Affected muscles firm
to touch.
 Body temperature
may be normal
Cool first, treat second!
 Method of Treatment:
 Rest, cool down, & apply
ice to the area
 Hydrate! Drink water or
an electrolyte-
containing drink
(Gatorade/Powerade)
 Gently stretch and
massage affected area
 Advise AT when cramps
begin for assistance
with treatment
HEAT RELATED ILLNESS:
HEAT SYNCOPE (FAINTING)
 Occurs as a result of  Methods of Treatment:
dehydration  Move to a shaded area
 Usually occurs within  Elevate legs above the
the first 5 days of heat heart
exposure  Cool the skin
 Symptoms include:
 Rehydrate
 Fainting
 Dizziness
 Tunnel vision
 Pale or sweaty skin

Cool first, treat second!

HEAT RELATED ILLNESS: HEAT EXHAUSTION
 Definition:
 Body Temperatures rise as high as 104°F
 Cause: exposure to high temperatures, particularly
when combined with high humidity, and
strenuous physical activity
 Can lead to exertional heat stroke if left untreated

Cool first, treat second!

HEAT RELATED ILLNESS: HEAT EXHAUSTION
 Symptoms:
 Fatigue
 Weakness
 Vomiting/nausea
 Lightheadedness/dizziness
 Heavy sweating
 Dehydration
 Headache
 Confusion/disorientation
 Muscle cramps
 Impaired muscle coordination

Cool first, treat second!

RISK FACTORS OF HEAT EXHAUSTION
 Certain Factors Increase Sensitivity to Heat:
 Young or old age
 Certain medications
 Obesity
 Hot, humid environments
 Wearing too much clothing
 Wearing clothing that
prevents the body from
cooling off
 Poor fitness level

Cool first, treat second!

HEAT ILLNESS: HEAT EXHAUSTION
 Treatment:
 Immediately notify the AT when symptoms start!
 Stop all activity and rest in a cool place
 Drink cool water or sports drink
 Apply cool water or ice towels
to the skin
 Remove excess clothing and
equipment
 Lay the athlete down with
legs elevated above the heart

Cool first, treat second!

HEAT ILLNESS: EXERTIONAL HEAT STROKE
 The most severe heat illness
 Caused by the production of high body heat, high
environmental heat stress, and inhibited heat loss
 Life-threatening condition that occurs when a
person’s body temperature reaches >104°F
 Seek immediate medical attention to prevent
brain damage, organ failure, or even death
 Advise the AT immediately at the start of
symptoms
 AT is trained to measure core temperature

Cool first, treat second!

HEAT ILLNESS: EXERTIONAL HEAT STROKE
 Symptoms:  Irrational or unusual
 Collapse behavior
 Aggressiveness
 Loss of consciousness
 Hysteria
 Vomiting/nausea  Delirium
 Hot and dry skin  Irritability

 Racing heart rate

 Rapid breathing
 Disorientation/confusion
 Not making sense when
they speak
 Dizziness
 Loss of balance/staggering
Cool first, treat second!
HEAT ILLNESS: TIME MATTERS
 Immediately submerse athlete in cold tub up to
their neck
 Remove equipment and excess clothing
 Goal: lower body temperature to <102°F in <30
minutes
 If untreated, in 30-60 minutes long-term effects
begin to set in, including organ failure
 If untreated> 60 minutes it can lead to death
 With full-body Cold Water Immersion (CWI), there is
a 1° drop in body temperature that occurs every
three minutes

Cool first, treat second!

HEAT ILLNESS: COACHES' TREATMENT

 If ATC is not present coaches' should do the

following:
 Remove athlete from practice into cool/ shaded area
 Call EMS
 Remove equipment and excess clothing
 Place athlete in cold water immersion
 Temperature drops ~ 1° F every 3 minutes
 Other forms of taking temperature are often inaccurate and not
recommended
 Consistently stir water and add ice as needed
 Cool FIRST, Transport SECOND
 Many emergency department do not have necessary equipment
to cool rapidly

Cool first, treat second!

COOLING PROTOCOLS
 Alert the AT that an athlete
is experiencing heat illness
 Activate EAP!
 Remove excess clothing and
equipment
 Immerse athlete in cold tub
up to their neck
 Cool victim until body
temperature is below 102°F
 When placed in an ice bath,
water must be stirred to
circulate coolness
 Ice should be added to a
water bath every six minutes
 Give athlete water or sports
drink to help with hydration
Cool first, treat second!
 PREVENTING EXERTIONAL HEAT ILLNESS
 Follow the SDHC Heat Stress Policy
 May require activity modifications
 Small changes can save an athlete’s life!
 Provide more frequent water breaks
 Longer rest breaks during activity
 Seek shelter/shade during activity breaks
 Use fans, dunk tubs, ice towels for cooling
 Wear loose fitting, lightweight, light-colored clothing
 Know your fitness level
 Allow the body to acclimate to the heat
 For ALL sports seasons

Cool first, treat second!

PREVENTING EXERTIONAL HEAT ILLNESS
 Restrict athlete from activity when sick
 More prone to heat illness
 Ex: COVID-19, fever, staph infections, MRSA
 Follow a balanced diet and stay hydrated all day
 The effects of heat stress are cumulative
 Utilize rest periods for recovery - don’t over-train!
 Good sleep habits – minimum 7 hours/night

Cool first, treat second!

PROPOSED ACTION STEPS
 Purchase of Wet Bulb Globe Thermometers (WBGTs)
for heat stress monitoring
 Implementation of SDHC Heat Stress Policy
 Cold Water Immersion (CWI) tubs available at all
high schools
 Cooling methods should be available at all practices
and games
 Display of signs and symptoms posters to be hung in
restroom stalls regarding Heat Illness
 Examples of appropriate clothing to wear during
training

Cool first, treat second!

YOUR BEST ACTION IS TO…
 Understand and follow SDHC Heat Stress
Policy.
 Prepare and practice the Emergency Action
Plan (EAP) to ensure that everyone knows
their role as a first responder in an
emergency.
 Know and properly execute an effective EAP
to ensure optimal response time in an
emergency.

Cool first, treat second!