With the summer’s constant rain and intermittent hot and humid weather, the risk of heat illness is a big concern as we approach preseason training. Acclimatization is key to preventing heat stroke.
Parents and coaches should watch out for a continuum of warning signs, from cramping to utter confusion, follow state guidelines for acclimatization and include frequent water-breaks to better protect kids.
This week, I visited in studio and spoke with 1590 WAKR morning show host Ray Horner about heat illness and those kids that may be at greater risk.
Below is an audio file and transcript of our discussion.
And boy, Joe, we had some real hot days over the weekend. I know the kids were real sweaty and it’s gonna continue. Great days, love the summertime season, but also we’ve got the fall sports practices kicking in, starting next week and I know you want to send out some word of caution in this regard.
DR. CONGENI: Yeah, caution, caution, Ray. You know, we’ve been doing this and … really been carrying on the tradition of, uh, the guy known down at Ohio State, “Dr. Bob,” Dr. Bob Murphy down there.
He was the first one in the ’50s and ’60s that started to talk about, hey, heat illness is preventable. These 10 to 12 to 15 kids a year that used to die in the bad old days of the ’50s and ’60s when the heat was out there [could have been saved]. We still get some kids who, uh, die of heat stroke in this country.
And so, its okay to make sure we educate parents, educate athletes, educate coaches and the training staffs that are out there because in the next few weeks this is when people are at risk.
I’m a little worried this year because we haven’t had that really hot, humid stretch yet and so that has me a little bit concerned, Ray.
HORNER: Well, I know the coaches have done real well in adjusting. At least when you and I played, Joe, I remember 3-a-days and pads and everything all day long.
Now, a lot of the coaches will either go real early, they’ll go in the afternoon. At least they’re more educated now than they were way back then.
DR. CONGENI: Definitely more educated and that’s helpful, and there are rules changes that protect kids and that’s helpful. But remember, heat illness is kind of a continuum, too, like a lot of other things.
So, it starts as maybe cramping and the person you can tell is not handling heat well. Then, we get into heat exhaustion, where they’re tired and maybe a little bit confused, and [have a] headache. [Lastly], we get to the point of heat stroke, where we start getting into issues where they’re really confused and kids are out of it.
Don’t wait too long. If you’ve got somebody that’s going from heat exhaustion to heat stroke you definitely have to put that kid in the shade. Get them cooled in a hurry. Call 9-1-1. Don’t wait on these kids. That’s one thing is knowing that this thing is a continuum and, uh, kids can go down hill pretty quickly.
HORNER: Give me the warning signs there from stage to stage to stage, Joe.
DR. CONGENI: So, the biggest thing in the stages is that … their temperature rises, but most coaches and things don’t have a thermometer with them. So, what you’ll see is these kids become out of it.
They’re confused … it seems almost like somebody with a head injury. They are not able to answer simple questions and things, and in those types of situations, we need to move them out of the heat. A lot of the teams have these baby pools filled with ice water. Get them cooled in a hurry.
Remember, prevention also has a lot to do with who is at risk, and who is at risk are the kids that are not in very good shape. The kids that despite what we’ve been saying all summer … haven’t acclimatized. Remember, the kids that are overweight and out of shape are really at risk.
There are rules out there for them, too. … Remember, the first few days have to be without full equipment because that’s when kids are at risk.
HORNER: … And this is certainly talking to the kids starting the fall sports, [such as] cross-country. If you’re a parent, have the kid run and train for cross-country early in the morning, or go at 7:30 maybe at night to get them out of the heat.
Also, you know, sports medicine, Joe, talk about the average golfer that likes to walk the course. There’s some risk here, too, of getting overheated while you’re walking the course.
So, it’s real important to pay attention. Towels on the neck certainly don’t hurt. Keep yourself hydrated and cool.
DR. CONGENI: No question, and you know the one problem is in most situations — our body does a fantastic job buffering this — thirst doesn’t keep up.
DR. CONGENI: So, a lot of people say, well … we’ll drink enough. Hydration is just so important and water-breaks are so important. That’s where Dr. Bob Murphy [made a difference]. He really pushed for the regular water-breaks every half hour. Make sure that you’re staying hydrated.
A couple ways you’ll know is by your urine output. If you’re not urinating as much, or your urine is really concentrated, that dark yellow that you can see, you know you’re starting to get dehydrated.
It’s a cumulative effect. We weigh the kids every day and you’ll start to see kids lose 2 pounds, then 3, then 5. At the end of the week, they’ve lost 7, 8, 9, 10 pounds. That’s water weight. They’re getting dehydrated. So, that’s where trainers and athletes and parents and coaches need to be aware of those things.
One other thing [to consider], Ray, is if a kid is sick; if a kid has diarrhea or is throwing up … they could get dehydrated. If they’re on medicines, that can dehydrate kids.
A lot of our kids are on stimulants. A lot of our kids are on cold medicines and other things that can, uh, be stimulants that can dehydrate kids. They’re on the, uh, protein supplements and other things like that that dehydrate kids. Many times they take anti-inflammatories ’cause the muscles are sore. That can lead to dehydration.
So, be aware of all those things. Get on those things early when they’re starting to show early signs of heat illness with heat cramps and maybe be coming into heat exhaustion a little. Don’t let it progress to the point of heat stroke, where you’re urgently calling 9-1-1.
But, if somebody is slipping into that heat stroke area, don’t be afraid to do that and cool them rapidly.
HORNER: Water and the sports drinks. Not the energy drinks.
DR. CONGENI: Water and sports drinks. Sports drinks are okay. … We talked about, uh, if somebody’s practicing for more than an hour and they’re starting to lose electrolytes a little bit, using the, uh, fluids with electrolytes in them is okay. But, water does a fine job.
And, like you said, all the preparation, all the prevention [is important]. Practice early in the day. Practice late at night. Know the kids that are at risk.
You should know on your team who’s at risk. Who are kids that are out of shape? Who are kids that are overweight? Who are kids that maybe are not well; they’re ill? Pull those kids aside. Don’t take the chance.
Don’t take a risk here. The next 2 or 3 weeks are when our kids are at most risk, and I think the new state rules will be a benefit because 5 days is a pretty good acclimatization period.
If people really follow those rules, 4 or 5 days before they put the pads on, acclimatization should take a lot of kids out of that risk zone.
HORNER: Alright, Joe, great information. Thanks for coming in again.
DR. CONGENI: Gotta do this every year, Ray, thanks. … In this situation perhaps, [we can] even save a life.
HORNER: There you go. Dr. Joe Congeni, Sports Medicine Center, Akron Children’s Hospital, joining us live in the studio.