Heat Related Illness

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Heat Related Illness

• Diane King, MS, RD, CSSD, ATC

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What is Heat Illness?

• It is an accumulation of body heat that results
  when the bodys ability to cool itself is
  overwhelming.
  
• Body heat increases during exercise naturally and
  can cool itself through sweat evaporation.

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Why is Heat Illness a Problem in the South?

• The risk of developing heat illness significantly
  increases in hot, humid environmental conditions
  because the evaporation of sweat is hindered.
  
• Exercise in our conditions can cause dehydration
  in as little as 30 minutes.

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Three Levels of Heat Illness

• Heat Cramps
• Heat Exhaustion
• Heat Stroke

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What are Heat Cramps?

• Painful, involuntary muscle spasms that occur
  during heavy exercise in hot environments.
  Inadequate fluid intake is often the cause.
  
• Muscles most often affected are your calves,
  quads, arms, abdomen and back.

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Heat Cramps First Aid

• Rest and cool down in the shade.
• Drink water or sports drinks. Sip!
• Massage and stretch affected area.
• If cramps do not go away in one hour, call a
  doctor.

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Heat Cramps

• Recognition at this point is critical to prevent
  further illness.

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What is Heat Exhaustion?

• This is what develops after heat cramps have been
  left untreated.
  
• Symptoms include
• Extreme thirst
• Feeling faint
• Nausea
• Heavy sweating
• Ashen or grey appearance
• Rapid, weak heart beat
• Low blood pressure
• Cool, moist skin
• Low-grade fever

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Heat Exhaustion First Aid

• Get the student out of the sun and into a shady
  or air conditioned location.
  
• Lay the student down with feet up.
• Remove excessive clothing or equipment.
• Drink small amounts of water, often.
• Cool the student by spraying or sponging them off
  with cool water.
  
• Monitor carefully!! Heat exhaustion can
  quickly become Heat stroke, when in doubt, call
  911.

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What is Heatstroke?

• Like heat cramps and heat exhaustion, Heatstroke
  is often caused from heavy work in hot, humid
  environments, usually from inadequate fluid
  intake.
• The difference is thermoregulatory capacity is
  exceeded, and extreme metabolic stresses produce
  tissue damage, and physiological dysfunction that
  can result in death.

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Heatstroke Symptoms

• Dry, hot, red skin
• Rapid heart beat, shallow breathing
• Dizziness, nausea
• Loss of coordination
• Irritability, belligerence
• Seizures
• Coma
• Remember, your heart is a muscle.

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Heatstroke First aid

• CALL 911!!
• While waiting on EMS
• Get the student in a cool place or shade.
• Remove unnecessary clothing and shoes.
• Rapid cooling such as ice towels or ice packs on
  neck, groin and head.
  
• Monitor ABCs
• airway
• breathing
• circulation

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How To Adjust For The Heat Index

• Modifying practice sessions for exercising
  adolescents
  
• WBGT
  Restraints on Activities
  
• F C ________________________________
  ____
  
• be alert for signs and symptoms of
  heat-related illness in prolonged events
  
• 75.0 - 78.6 24.0 -25.9 Longer rest
  periods in the shade enforce drinking
  every 15 minutes
  
• 79.0 84.0 26.0 29.0 Stop activity of
  unacclimatized persons and high-risk
  persons limit activities of all others
  (disallow long distance races, cut the
  duration of other activities)
• 85.0 29.0 Cancel all athletic
  activities

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Prevention is the key

• Stress to your students they have to come to PE
  already hydrated.
  
• Have water available within arms reach.
• Drink every 15 minutes.
• Take frequent breaks.
• Dress for the weather.
• Coaches- Allow for acclimation.

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Such A Lovely Sight When Its Hot, Cool Em Down
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After exercise

• Fluid replacement
• 20oz. of fluid per pound of weight loss within 2
  hours of exercise.
  
• (Coaches- weigh athletes before and after
  practices, when the temperature is above 90
  degrees)
  
• Encourage students to drink water, or sports
  drinks, when they are at home and not soft drinks
  or tea.

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Water vs. Sports drinks

• Water
• Hydrates, but some believe it washes out
  electrolytes.
  
• Hyponatremia
• Sports Drinks
• Hydrates, but some believe they have too much
  sugar that can cause nausea and diarrhea.
  
• Fast electrolyte replacement.
• Use both!!!

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Early Quick Fixes

• Bananas
• Salty foods
• Sports drinks (not energy drinks)
• Yellow mustard
• Salt or salt substitute
• ALWAYS follow quick fixes with proper
  hydration.
  

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What About MRSA?

• To answer the question what are the symptoms of
  MRSA, it is important to understand that most
  MRSA symptoms are identical to traditional staph
  infection symptoms MRSA is simply a sub-category
  of staph infection
• Only a professional bacterial culture or
  bacterial DNA test can confirm if you have an
  MRSA or staph infection.
  
• MRSA and staph infection are often diagnosed as
  causing one of several conditions.

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What About MRSA?

• Staph infection symptoms and signs of MRSA
  infection can show up any place on your body but
  are more common in the following specific areas
  
• Areas of clothing friction and irritation, such
  as the legs, buttocks and shaving areas and
  places where football pads touch the skin
  
• Sweaty areas like armpits, neck, face, groin and
  feet
  
• Deeper infections like cellulitis are most common
  on the arms, hands, lower legs and face.
  

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Images

• Cellulitis

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Staph

• Clusters

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MRSA

• Hand
• Knee

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What Does MRSA Look Like?

• The most common visible MRSA symptoms are bumps,
  pimple-like lumps, or blisters on the skin (these
  are also the symptoms of staph aureus infection
  in general).
• Lumps on the skin are often accompanied by
  swelling and reddening of the surrounding skin
  area.
  
• The center of the lump often has a white or
  yellow pus filled head, which sometimes drains on
  its own.

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What Does MRSA Look Like?

• The lumps are often tender, itchy and warm to the
  touch and can become deep sores with increasing
  pain and swelling if left unchecked.
  
• The color of the surrounding skin area is often
  red to purple and may begin to spread as the
  infection progresses.
  
• Available on-line at http//www.cdc.gov/ncidod/hi
  p/aresist/ca_mrsa_public.htm

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Is It Really A Big Deal?

• Most MRSA and staph infections are limited to the
  skin. However, staph can also enter your
  bloodstream and spread to internal organs. More
  serious staph infections symptoms that can result
  from an internal infection are
• Fever
• Chills
• Weakness or fatigue
• Shortness of breath
• Rashes
• Headache
• Muscle aches
• Nausea
• Acute pain

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Conclusion

• Prevention
• Education
• Early recognition
• Quick response
• Have necessary tools readily available.

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Conclusion

• Questions???
• Resources
• www.nata.org/statements/index.htm
• www.nata.org/youthsports/index.htm
• www.ghsa.net/sportsmedicine
• www.gssiweb.org

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NutritionFueling Your Performance

• Diane King, MS, RD, CSSD, ATC

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Know Your Limits For Giving Advice

• Recommendations should be Basic
• Teach them to Avoid Skipping Meals or Snacks
• Fluids Are Important
• Eat Every 3-4 Hours
• When Possible

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Secret To Optimal Performance

• The real secret of effective training is
  conditioning your brain to recognize what kind of
  foods
  
• your body
• needs.

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Energy Requirements

• Another Estimate for Active, Male Athletes
• (your body weight x 21) activity
  calories/day
  
• A 200-pound male practicing soccer for 2 hours
  can use approximately
  
• 630 calories a 150-pound athlete can burn about
  475 calories

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Myth Buster

• I need extra protein because Im trying to build
  muscle
  
• Theres no such
• thing as to much
• muscle

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Pre-Practice Snack Ideas

• CRUNCHY Pretzels, Popcorn, Animal Crackers,
  Trail Mix, Granola Bars, Baked Chips
  
• CHEWY Raisins, Dried Fruit, Bagels, Breakfast
  Bars, Rice Krispie Treats
  
• CREAMY Pudding, Yogurt, Peanut Butter,
  Milkshakes
  
• Juicy Fresh Fruits, Applesauce, Juice Packs,
  Jello

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Fast Food

• Plan Ahead For The Days When You Know You Need To
  Stop.
  
• Portion Control and Balanced
• Food Choices Can Be The Key.
• Skip The Empty Calories.

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Recovery Nutrition

• Within the FIRST 30 minutes of
• completing practice.
• Quantity is based on the age
• and size of child.
• Fluids are okay,
• but dont get too full.
• Should include Carbs
• plus Protein

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Recovery Fluids

• Sports Drinks, like Gatorade
• Accelerade
• Chocolate Milk
• Fruit Smoothies
• Fruit Juice
• NOT ENERGY DRINKS
• NOT DILUTED FRUIT JUICES
• NOT SODA

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Recommended Intakes for Kids

• Timing Amount
• 2 hours before 2 cups
• 10-15 minutes before 2 2 ½ cups
• Every 15-20 minutes during ½ - 1 cup
• After Activity 2 cups for every pound
• lost

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Color Scale

• Pale like Lemonade
• Not Dark Like Apple Juice

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Game Day Nutrition

• 2 to 3 hours before event
• Meal should include
• 2/3 high-carbohydrate options for quick energy
• 1/3 lean protein to build and help repair muscle
• Food should be salted to replace sodium lost
  through sweating
  
• Game Day Meal Ideas

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Game Day Nutrition

• If Schedule Does Not Permit Going Home Between
  School and Game, Pack Foods Like
  
• Sports drinks
• Energy bars
• Sub sandwiches
• Snack pack cans of tuna/chicken
• Dried fruit
• Whole fruit
• Crackers and Bagels

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Half-Time Snacks Wont Fix Otherwise Poor Eating
Habits.

• Pure Nutrition?
• Not Always Cool

• Pure Evil?
• Pure Fun

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Food is Fuel - Summary

• Strategies To Help Maintain Fuel Tanks
• Encourage Athletes to Eat Breakfast Even If It Is
  Small.
  
• Focus On Grab Go Foods.
• Focus on Foods With Protein and Carbohydrate.