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Ten Steps To Preventing Heat Stroke


When I was chairman of the Sports Injury Advisory Group to the Governor of Michigan, I helped develop some guidelines on preventing heat stroke among football players, guidelines that are applicable to every sport and recreational activity.

Our recommendations included:

  1. Acclimatize to heat gradually. Practices for the first week to 10 days should be shorter and less intense, as should practices on abnormally hot or humid days. In addition athletes should be encouraged to initiate their own conditioning program several months prior to the beginning of the season. During the hottest weather practice sessions should be scheduled in cooler parts of the day.

  2. Account for heat and humidity. Both the temperature and relative humidity should be taken into account in determining the length of practice sessions. It has been suggested that if the sum of the temperature and relative humidity are greater than or equal to 160, special precautions must be taken. If the sum is greater than 180, practice and or games should be cancelled.

  3. Provide for frequent breaks. Adjust the activity level and provide frequent rest periods during hot weather (at least 15 minutes per hour of practice). Athletes should rest in shaded areas; helmets should be removed, and jerseys should be loosened or removed.

  4. Rehydrate. Cold water or sports drinks should be available in unlimited quantities to players. Scheduled water breaks should be strictly enforced.

  5. No salt tablets. Salt should be replaced through salting of food, not salt tablets.

  6. Weigh athletes before and after practice. Athletes should be weighed before and after each practice to monitor water loss. Weight loss greater than 3% indicates a substantial risk and 5% a significant danger to the student athlete.

  7. No heavy or wet clothing. During practice athletes should wear cooling clothing such as shorts and fish net jerseys. Sweat saturated t-shirts should be changed often because they retain heat. Helmets should only be used sparingly in hot weather.

  8. Parent monitoring. Parents should monitor all practices and games, with the responsibility shared on a rotating basis among all parents of student athletes. If a parent observes an unsafe situation developing, he or she should immediately bring it to the attention of the coach.

  9. Identify athletes at greater risk. Some athletes are more susceptible to heat illness than others. Identify and observe closely those at greatest risk of heat illness, including those who are poorly conditioned, overweight, have an acute illness, or have cystic fibrosis, diabetes, or mental retardation. Student athletes with a previous history of heat illness should bewatched closely during practices and hot weather.

  10. Learn the warning signs. It is imperative that all coaches, parents, and players are on the lookout for signs of dehydration or heat illness, such as fatigue, lethargy, inattention, stupor, and/or awkwardness. An athlete exhibiting any of these signs should be immediately removed from participation, cooled down and placed in a shaded environment.

Parent Involvement Is Key

If all parents, coaches and athletes learned and followed these ten steps, I believe the number of heat-related deaths of student-athletes could be reduced to zero. But it will only happen if parents become much more actively involved by attending their child's practices and games to ensure that they don't become tragic statistics like the players in Indiana, Florida, and Minnesota.



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