ROP Sports Medicine: Heat Injuries

Body Temperature can be affected by 5 factors: Metabolic Heat Production: Metabolism always causes an increase in body heat that depends on the intensity of the physical activity. The higher the metabolic rate, the more heat produced.

Body Temperature can be affected by 5 factors: Conductive Heat Exchange: Physical contact with other objects can result in either a heat loss or heat gain. e.g. Football players competing on artificial turf on a sunny afternoon will experience an increase in body temperature simply by standing on the turf.

Body Temperature can be affected by 5 factors: Convective Heat Exchange: Body heat can be lost or gained depending on the temperature of the circulating medium (e.g. air or water). (Think hot tub!)

Body Temperature can be affected by 5 factors: Radiant Heat Exchange: Radiant heat from sunshine increases body temperature.

Body Temperature can be affected by 5 factors: Evaporative Heat Loss: Sweat glands in the skin allow water to be transported to the surface, where it evaporates, taking large quantities of heat with it. When the temperature and radiant heat of the environment become higher than the body temperature, the loss of body heat becomes highly dependent on the process of sweat evaporation.

Body Temperature can be affected by 5 factors: Evaporative Heat Loss: A normal person can sweat about 1 quart of water per hr. for about 2 hrs. Sweating does not cause heat loss. It’s the evaporation of the water that dissipates the heat.

1. Heat Rash a.k.a. prickly heat Cause: Usually occurs when the skin is continuously wet with unevaporated sweat; commonly located on areas of the body that are covered with clothing. Symptoms: Benign condition, associated with a red, raised rash, accompanied by sensations of prickling and tingling during sweating. Treatment: The athlete should wash the area and replace their clothing with dry clothing. Hydrocortisone may be applied to relieve itching if needed.

2. Heat Syncope a.k.a. Heat Collapse Cause: Standing in heat for long periods or by not being accustomed to exercising in the heat. Peripheral vasodilation of superficial vessels results in hypotension (low B.P.), or pooling of blood in the extremities. Symptoms: dizziness, fainting, nausea Treatment: Laying down in a cool environment and replacing lost fluids.

3. Heat Cramps Usually related to painful muscle spasms that occur most often in the calf and abdomen (although any muscle can be involved). Excessive sweating causes loss of large amounts of water, and small quantities of sodium, potassium, magnesium, and calcium  causes an imbalance in concentration of these elements in the body  results in painful muscle contractions and cramps.

3. Heat Cramps Person most likely to get heat cramps = someone in good condition, but has overexerted themselves in heat.

3. Heat Cramps Prevention: adequate replacement of electrolytes, slightly increasing level of salt in the diet (DO NOT use salt tablets), eat bananas (potassium), drink milk and eat dairy products (calcium). Treatment: ingestion of large quantities of water or preferably Gatorade, mild, prolonged stretching with ice massage of the muscle in spasm.

3. Heat Cramps Should an athlete who is experiencing heat cramps be allowed to return to play? No! Why or why not? Because of the risk of reoccurrence of cramping.

4. Heat Exhaustion Cause: from inadequate replacement of fluids lost through sweating Clinical Symptoms: the victim will collapse and have profuse sweating, pale skin, mildly elevated temperature (<102 degrees F), dizziness, hyperventilation, and a rapid pulse.

4. Heat Exhaustion Person most likely to get heat exhaustion = person in poor physical condition who attempts to exercise in the heat. Treatment: most importantly, immediate ingestion and eventually IV replacement of large quantities of water, and placement in a cool environment is helpful as well.

5. Heatstroke A serious, life-threatening EMERGENCY! Cause: The specific cause is UNKNOWN. Clinical Symptoms: sudden collapse with usual loss of consciousness, flushed, hot skin, sweating about 75% of the time (some cases may have less sweating than seen with heat exhaustion), shallow breathing, and a rapid, strong pulse.

5. Heatstroke Most important sign = Core Temp. of 104 degrees or higher **Can occur suddenly, without warning. Possibility of death can be reduced if the body temperature can be lowered to normal within 45 mins.

5. Heatstroke Treatment = get the athlete into a cool environment, remove clothing and immerse the athlete in a cold water bath, or sponge him/her with cold water and fan with a towel. Replacement of fluids is not as critical as lowering the core temperature. CALL 9-1-1 and/or get the person to the hospital A.S.A.P.!!!