2.  Heat Stress 1. The body will function normally as long as body temperature is maintained in a normal range. 2. Maintaining normal body temperature in a hot environment depends upon the body’s ability to dissipate heat.

3.  1.Notmal metabolic function in the body results in the production and radiation of heat; the higher the metabolic rate, the more heat produced.

5.  Heat Cramps A. Heat Cramps 1. Painful muscle spasms commonly in the calf and abdomen 2.Related to excessive loss of water and electrolytes (sodium, potassium, magnesium, and calcium)

6.  Immediate treatment is ingestion of large quantities of fluids- sports drinks

7.  Heat Exhaustion 1. Athlete becomes dehydrated to the point that he/she is unable to maintain adequate cardiac output.

8.  Signs and symptoms : pale skin, profuse sweating, stomach crams with nausea, vomiting or diarrhea, headache, persistent muscle cramps and dizziness/loss of coordination.

9.  Treatment: Immediately remove athlete from heat and start cooling.  Monitor heart rate, blood pressure and core temperature- may need to transport to emergency facility.

10. Life Threatening Emergency- Caused by severely elevated body temperature.

11.  Clinically characterized by sudden collapse with CNS dysfunction such as altered consciousness, seizures, confusion, emotional instability, irrational behavior or decreased mental acuity.

12.  Hot flushed skin with less sweating than seen in heat exhaustion, shallow breathing, rapid strong pulse, nausea, vomiting or diarrhea, headache, dizziness or weakness, decreased blood pressure and dehydration.

13.  The longer the body temp is above 104° the higher the mortality rate. Body temperature must be cooled immediately and immediate medical attention is necessary.  Must activate EMS

14.  Extertional Hyponatremia 1. Low level of sodium concentration in blood, caused by ingesting too much fluid. 2. Fluid intake should not exceed fluid losses.

15.  Symptoms: Headache, nausea, vomiting, swelling of hands and feet, lethargy, apathy or agitation, low blood sodium (<130 mmol/L)

16.  Dehydration A. Signs of dehydration: Thirst, dry mouth, headache, dizziness, irritability, lethargy, excessive fatigue, and possibly cramps. B. Physiological effects: reduced muscle strength and endurance, decreased blood volume, altered cardiac function, impaired thermoregulation, decreased kidney function, reduced glycogen stores and loss of electrolytes.

17.  Fluid and Electrolyte Replacement A. Average adult requires a minimum of 2.5 liters of water (10 glasses) a day. B. Normal sweat-loss rate during an hour of exercise ranges between 0.8 and 3 liters, with average 1.5 liters per hour. C. Body weight drops by 1-2%, you begin to feel thirsty- Do not rely on thirst as a signal to drink D. Athletes should be drinking enuogh so that their urine is clear. E. Most people only replace 50% of the water they lose through sweating.

18.  Using Sports Drinks A. Replacing lost fluids with sports drinks is better than with water- sports drinks replace both fluids and electrolytes and they taste better so athletes tend to drink them more than plain water. B. Sodium in sports drinks allows the body to hang on to the fluids longer than water does. C. Optimal Carbohydrate level is 14 grams per 8 ounces of water for quickest absorption.

19.  Gradual Acclimatization  Identifying Individuals More at Risk A. Athletes with large muscle mass and overweight individuals are prone to heat illness. B. Death from heatstroke increases at a ratio of 4:1 as body weight increases. C. Women are more physiologically efficient in body temperature regulation than men- women tend to sweat less and manifest a higher heart rate when working in heat. D. Other susceptible individuals include those with poor fitness levels or a history of heat illness.

20.  Selecting Appropriate Uniforms A. Uniforms should be selected on basis of temperature and humidity. B. Rubberized suits should never be worn.  Maintaining Weight Records A. Athletes should weigh in and out for the first two weeks of practice. B. A loss of 3-5% of body weight will reduce blood volume and could lead to a health threat.

21.  Monitoring the Heat Index A. Heat index is the combination of relative humidity and air temperature. The higher the heat index, the more precautions should be taken. 1. Modifications in practice should be made according to the Dry Bulb/Wet Bulb readings.  Guidelines for Athletes Who Intentionally Lose Weight A. NCAA and many state high school federations have recently established guidelines for weight loss and set policies for how and when a wrestler can officially weigh in. B. NCHSAA: allows wrestlers to only lose 1.5% per week.

22.  Combination of cold, wind, and dampness creates environment predisposing an athlete to hypothermia.  65% of heat produced by the body is lost through radiation- mostly through the head and neck.  20% of heat loss is through evaporation, two-thirds through the skin and one-third through respiratory tract.  Shivering ceases below a body temp of 85°-90°F (29.4°-32.2°C) Death is imminent if the core temp drops between 77 and 85°F (25°-29°C)

23.  Prevention A. Should dress in thin layers, that can be added or removed as the temperature decreases or increases B. When working or exercising in temps below 32°F (0°C), it is advisable to add a layer of protective clothing for every 5 mph. of wind. C. Athletes still need to replace fluids in cold weather, as they can still become dehydrated and that in turn will reduce blood volume, which means less fluid is available for warming the tissues.

24.  Frost Nip A. Involves ears, nose, cheeks, chin, fingers and toes. B. Commonly occurs when there is high wind, severe cold, or both. C. Skin appears firm, very cold, painless areas that may peel or blister in 24-72 hours. D. Treat with firm sustained pressure (without rubbing), gentle re-warming.

25.  Frostbite A. Chilblains: Skin redness, swelling, tingling and pain in the toes and fingers. B. Superficial Frostbite: Involves only the skin and subcutaneous tissue, skin appears pale, hard, cold and waxy. With re-warming will feel numb and then sting and burn. Later blisters will appear and will be painful for weeks.

26.  Deep Frostbite: Tissues are frozen- medical emergency and requires hospitalization. Tissue is hard, cold, pale or white and numb. Rapid rewarming is required and will appear blotchy red, swollen, and extremely painful, may become gangrenous (tissue death).

27.  Lightning is number 3 cause of death by weather related phenomena- 51 fatalities per year for past 20 years in the US  However only 26 in 2011  If you hear thunder or see lightning seek protective shelter indoors at once. If not available, an automobile is a safe alternative.

28.  Avoid standing near large trees, flagpoles, or light poles.  Choose an area not on a hill, see a ditch, ravine or valley.

29.  If you feel the hair stand on end and skin tingle- drop to the ground in a crouched position, do not lie flat to decrease body’s surface area in contact with the ground.  Avoid standing water, showers, telephones, and metal objects at all times (bleachers, umbrellas, etc.)

30.  “Flash-to-Bang” Method: To use, begin counting on the lightning flash and stop counting when the associated thunder is heard. Divide this number (in seconds) by 5 to determine the distance (in miles) to the lightning flash.  30 Minute “Return-to-Play” Rule: If a game, practice, or other activity is suspended or postponed due to lightning activity, it is important to wait at least 30 minutes after the last lightning flash or sound of thunder. Each time the lightning or thunder is seen or heard, the 30 minutes should be reset.

31.  Managing Victims of Lightning Strike 1. Survey the scene for safety 2. Carefully remove victim to safe area, if needed. 3. Evaluate and treat any breathing/circulation problems 4. Evaluate and treat for shock 5. Evaluate and treat for burns and fractures.  Because lightning-strike victims do not remain connected to a power source, they do not carry an electric charge and may be safely handled.

32.  Long-Term Effects on Skin A. Premature aging of the skin and skin cancer B. Skin cancer is most common malignant tumor found in humans, damage to DNA is suspected as the cause of skin cancer but exact cause is unknown.

33.  Using Sunscreens A. SPF (Sun Protection Factor): An SPF of 6 indicates that an athlete can be exposed to UV light six times longer than those without sunscreen. B. Sunscreens needed between March and November, but should be used year round, also should be used between 10 A.M. and 4 P.M. and should be applied 15-30 minutes prior to sun exposure. C. Clothing can provide some protection but are not a substitute for sunscreen, a typical white T-Shirt provides an SPF of 5.

34.  Slip Slap Slop: Slip on a shirt, slop on sunscreen, and slap on a hat!  Apply a sunscreen with SPF 30 or higher.  Reapply sunscreen every 2 hours  Wear a hat that shades your face and neck

35.  Stay in the shade when possible  Avoid unnecessary exposure to radiation from sunlamps and tanning beds  Wear lip balm to protect your lips from drying/cracking  Wear sunglasses to protect your eyes.