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Carol Forsloff - A football player is reported to have had a stroke during practice, but this can
happen to other active folks, so experts advise what to do about and how to prevent exertional stroke.
happen to other active folks, so experts advise what to do about and how to prevent exertional stroke.
Summer is the time people want to get in shape. That means outdoor exercise, practice football, mowing the lawn and also a time for heat stroke. But exertional stroke can occur any time of the year; it is just more prevalent in July and August.
The Journal of Strength and Conditioning Research (JSCR), official research journal of the National Strength and Conditioning Association takes a look at these issues, because many people don't
understand the risks of working and playing when the weather is hot.
understand the risks of working and playing when the weather is hot.
Experts like Kelly D. Pagnotta, A.T.C., P.E.S., and colleagues of University of
Connecticut, Storrs, highlight the critical role certified athletic trainers (ATs) play in diagnosing and treating exertional heat stroke.
Connecticut, Storrs, highlight the critical role certified athletic trainers (ATs) play in diagnosing and treating exertional heat stroke.
They write, "A trained medical provider, particularly an AT, needs to make an accurate diagnosis to provide the most appropriate care, which can be very different based on the clinical diagnosis to prevent death."
Without prompt recognition and treatment, EHS can be rapidly fatal. In 2008 alone, there were 12 deaths from EHS in high-school football players (plus
another two deaths in youth football players and two in soccer players) in the United States.
another two deaths in youth football players and two in soccer players) in the United States.
Although it is more likely to occur in hot, humid conditions, EHS can occur under in any type of weather, including cooler environments. Some risk factors
for EHS are unique to the athlete and potentially under his or her control. Other potential contributors are out of the athlete's control, including the environmental conditions, the pace of practice, and pressure from coaches. What are these specific conditions?
for EHS are unique to the athlete and potentially under his or her control. Other potential contributors are out of the athlete's control, including the environmental conditions, the pace of practice, and pressure from coaches. What are these specific conditions?
"These extrinsic factors can be influenced by altering practice times or increasing rest breaks," Pagnotta and co-authors write.
Even for health professionals, EHS can be difficult to recognize. When an athlete collapses, the two main symptoms of EHS are a core body temperature over
105° F and the presence of central nervous system changes (such as disorientation or unconsciousness). The authors emphasize that the body temperature must be taken rectally, by a health professional-oral thermometers or other measures are unreliable.
105° F and the presence of central nervous system changes (such as disorientation or unconsciousness). The authors emphasize that the body temperature must be taken rectally, by a health professional-oral thermometers or other measures are unreliable.
However, athletes with EHS may have other symptoms, such as vomiting or hyperventilation. Furthermore, other serious conditions are possible,
including head injury, cardiac arrest, or asthma. Because of this complexity, Pagnotta and colleagues write, "[A] trained medical professional, such as an AT, should be the one assessing an athlete who collapses, not a coach or strength and conditioning coach."
including head injury, cardiac arrest, or asthma. Because of this complexity, Pagnotta and colleagues write, "[A] trained medical professional, such as an AT, should be the one assessing an athlete who collapses, not a coach or strength and conditioning coach."
Once EHS is recognized, proper treatment consists of rapid cooling by cold water immersion. The longer the body temperature remains above 105°, the
greater the risk of death; the faster the cooling, the better the chance of survival. A cold shower or cold, wet towels can be used until a cold
tub is ready. Other cooling measures-like ice bags, misting fans, and shade-have been proven ineffective.
greater the risk of death; the faster the cooling, the better the chance of survival. A cold shower or cold, wet towels can be used until a cold
tub is ready. Other cooling measures-like ice bags, misting fans, and shade-have been proven ineffective.
Once the body temperature has been lowered to 102°, the athlete should be transported to the closest medical facility. "It is important to remember that EHS
has been 100% survivable with proper assessment and rapid treatment,"Pagnotta and co-authors write.
has been 100% survivable with proper assessment and rapid treatment,"Pagnotta and co-authors write.
Consistent with the recommendations of the National Athletic Trainers Association, the authors urge high schools to have a school physician and an on-site AT
to provide appropriate medical care. They conclude, "Trained medical professionals should be available on-site and ready to treat any medical
emergency that arises to have the optimal outcome."
to provide appropriate medical care. They conclude, "Trained medical professionals should be available on-site and ready to treat any medical
emergency that arises to have the optimal outcome."
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