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The full text of “Heatstroke Concerns for College Coaches” by Dr. Jack Hughes, from the Vol 2 — Fall 2018 issue.
Page 42By Dr. John H. Hughes The seriousness of heatstroke in young athletes has come to the attention of the public along with coaches, parents, administrators, and educators. Anyone Involved in the healthy development of young people appreciates the importance of prevention of harm and the coordination of efforts. Understanding the complex physiology of thermal regulation of the human body, at least in basic terms, is essential for any coach.
The concept of homeostasis of the body and the regulatory mechanisms that control body temperature are ones for which heat stress impacts exercise performance. This includes individual adaptations and fluid electrolyte imbalances. Maladaptation is serious and can be lethal. During exercise with associated heat stress, there is high skin blood flow and high sweating rates which can impose considerable cardiovascular strain and initiate a cascade of pathophysiological events leading to heat stroke.
There are many excellent reviews of this subject. Rowland is one that provides insights (1). Our Armed Forces have had extensive experience with this problem and have incorporated meaningful research in their guidelines for both prevention and care of heat-related illnesses.
In terms of review of this subject with the health team that supports sports there can be value in every coach utilizing https://www.youtube.com/watch?v=Ro4rjLEtDQg&feature=youtu.be and identifying risk factors that may be overlooked in integrating their sports program with the local Emergency Medical System. Early recognition and initiation of care can draw from guidelines suggested by Wassermann and Healy (2).
They describe “Heat exhaustion (as) characterized by elevated core body temperature associated with orthostatic hypotension, tachycardia, diaphoresis, and tachypnea.” They note that, “Heat stroke is defined as elevated core body temperature plus central nervous system involvement (delirium, decreased the level of consciousness, or ataxia).” Since conduction and evaporation are most effective in body cooling, “ice water immersion (is) the most effective and most rapid” mode of care.
It should be noted that regional and statewide data systems now examine the epidemiology of such events. For details, one might review the report of Mathes, Ito, Lane, and Matte (3). Heatstroke Concerns
Page 4343 for Football Coaches As both a mentor and guidance person, each coach usually recognizes that they are also important in the curriculum development of science, technology, engineering, and math. Should there be reader interest, this will be examined in a future article. References & Suggested Readings 1. Rowland T. Thermoregulation during exercise in the heat in children: Old concepts Revisited. Journal of Applied Physiology. 2008 Aug: 105 (2): 718-24.
Available from: h t t p s : / / w w w . p h y s i o l o g y. o r g / d o i / pdf/10.1152/applphysiol.01196.2007 2. Wasserman DD, Healy M. EMS, methods to cool a patient in the field. [Updated 2017 Oct 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih. gov/books/NBK459303/ 3. Mathes RW, Ito K, Lane K, Matte TD. Real-time surveillance of heat-related morbidity: Relation to excess mortality associated with extreme heat.
PLoS One 2017 09;12(9). Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184364 About the Author : Dr. John Hughes graduated from Yale and Cornell Medical School and did his surgical training at St. Luke’s Hospital in New York City. He has served in the academic, military and civilian sectors teaching surgery, emergency medicine and public health.
He is currently mentoring the Upward Bound Program at Pima Community College, providing research ideas in Health Science and Engineering at the University of Arizona, and serves as an Adjunct Professor of Surgery for the Uniformed Service University of the Health Sciences.
