Heat Illness Consensus Statement - NATA
Inter-Association Task Force on Exertional Heat Illnesses Consensus Statement
These guidelines were established to increase safety and performance for individuals engaged in physical activity, especially in warm and hot environments. The risks associated with exercise in the heat are well documented, but policies and procedures often do not reflect current state-of-the-art knowledge. Many cases of exertional heat illness are preventable and can be successfully treated if onsite personnel identify the condition and implement appropriate care in a timely manner.
Strategies to optimize proper care of dehydration, exertional heat stroke (EHS), heat exhaustion, heat cramps and exertional hyponatremia are presented here. This consensus statement was developed by medical/scientific experts experienced in the prevention, recognition and treatment of exertional heat illnesses.
Overall Strategies for the Prevention of Exertional Heat
and athlete's medical condition
Illnesses
? Lack of education and awareness of heat illnesses among
Every athletic organization should have a policy, procedure or coaches, athletes and medical staff
emergency plan established to address exertional heat illness- ? No emergency plan to identify and treat exertional heat
es. A thorough plan includes the key factors to prevent, identi- illnesses
fy and treat exertional heat illnesses.
? No access to shade during exercise or during rest breaks
? Duration and number of rest breaks is limited
Scientific evidence indicates the following factors may
? Minimal access to fluids before and during practice and rest
increase the risk associated with exercise in the heat.
breaks
Although some factors can be optimized (e.g., heat acclimati- ? Delay in recognition of early warning signs
zation), others cannot (e.g., health problems). Regardless, these
factors may help in developing a proactive approach to pre- General Considerations for Risk Reduction
venting exertional heat illnesses.
? Encourage proper education regarding heat illnesses (for
athletes, coaches, parents, medical staff, etc.). Education
Intrinsic factors include:
about risk factors should focus on hydration needs,
? History of exertional heat illnesses
acclimatization, work/rest ratio, signs and symptoms of
? Inadequate heat acclimatization
exertional heat illnesses, treatment, dietary supplements,
? Lower level of fitness status
nutritional issues and fitness status.
? Higher percent body fat
? Provide medical services onsite (e.g., certified athletic
? Dehydration or overhydration
trainer [ATC], emergency medical technician [EMT],
? Presence of a fever
physician).
? Presence of gastrointestinal illness
? Ensure pre-participation physical examination that includes
? Salt deficiency
specific questions regarding fluid intake, weight changes
? Skin condition (e.g., sunburn, skin rash, etc.)
during activity, medication and supplement use and history
? Ingestion of certain medications (e.g., antihista-
of cramping/heat illnesses has been completed.
mines, diuretics, etc.) or dietary supplements (e.g.,
? Assure that onsite medical staff has authority to alter
ephedra, etc.)
work/rest ratios, practice schedules, amount of equipment
? Motivation to push oneself/warrior mentality
and withdrawal of individuals from participation based on
? Reluctance to report problems, issues, illness, etc.
environment and/or athlete's medical condition.
? Pre-pubescence
DEHYDRATION
Extrinsic factors include:
Factors Contributing to Onset of Condition
? Intense or prolonged exercise with minimal breaks
When athletes do not replenish lost fluids, they become
? High temperature/humidity/sun exposure (Table 1
dehydrated. Mild dehydration ( ................
................
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