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High Schools Struggle to Adopt Evidence Based Practices for the Management of Exertional Heat Stroke
CONCLUSIONS: ATs in the HS setting appear to be struggling to adopt a comprehensive EHS strategy, with rectal temperature continuing to appear as the biggest undertaking. Tailored strategies based on health behavior, facilitators and barriers may aid in changing this paradigm.PMID:33626130 | DOI:10.4085/361-20
Source: Journal of Athletic Training - February 24, 2021 Category: Sports Medicine Authors: S E Scarneo-Miller R M Lopez K C Miller W M Adams Z Y Kerr D J Casa Source Type: research

Roundtable on Preseason Heat Safety in Secondary School Athletics: Prehospital Care of Patients With Exertional Heat Stroke.
CONCLUSIONS: Exertional heat stroke continues to be a leading cause of sudden death in young athletes and the physically active. This may be partly due to the numerous barriers and misconceptions about the best practice for diagnosing and treating patients with EHS. Exertional heat stroke is survivable if it is recognized early and appropriate measures are taken before patients are transported to hospitals for advanced medical care. Specifically, best practice for EHS evaluation and treatment includes early recognition of athletes with potential EHS, a rectal temperature measurement to confirm EHS, and cold-water immersion...
Source: Journal of Athletic Training - December 9, 2020 Category: Sports Medicine Tags: J Athl Train Source Type: research

Age- and Sex-Based Differences in Exertional Heat Stroke Incidence in a 7-Mile Road Race.
CONCLUSIONS: In this unique investigation of EHS incidence in a road race, we found a 29% decreased EHS risk in females compared with males. However, when sex was considered with age and WBGT, only younger age accounted for an increased incidence of EHS. These results suggest that road race medical organizers should consider participant demographics when organizing the personnel and resources needed to treat patients with EHS. Specifically, organizers of events with greater numbers of young runners (aged 19 to 39 years) and males should prioritize ensuring that medical personnel are adequately prepared to handle patients w...
Source: Journal of Athletic Training - November 12, 2020 Category: Sports Medicine Tags: J Athl Train Source Type: research

Probability of Heat Intolerance: Standardized Interpretation of Heat-Tolerance Testing Results Versus Specialist Judgment.
CONCLUSIONS:   The PHT has the potential to be substituted for manual interpretation of the HTT and to serve in a variety of clinical and research applications. PMID: 29775421 [PubMed - in process]
Source: Journal of Athletic Training - May 20, 2018 Category: Sports Medicine Tags: J Athl Train Source Type: research

Fatal Exertional Heat Stroke and American Football Players: The Need for Regional Heat-Safety Guidelines.
CONCLUSIONS:   The combination of lower exposure WBGTs and frequent extreme climatic values in milder climates during fatal EHSs indicates the need for regional activity-modification guidelines with lower, climatically appropriate weather-based thresholds. Established activity-modification guidelines, such as those from the American College of Sports Medicine, work well in the hotter climates, such as the southern United States, where hot and humid weather conditions are common. PMID: 29332471 [PubMed - as supplied by publisher]
Source: Journal of Athletic Training - January 16, 2018 Category: Sports Medicine Tags: J Athl Train Source Type: research

Round Table on Malignant Hyperthermia in Physically Active Populations: Meeting Proceedings.
CONCLUSIONS:   Clinicians should consider an MH-like syndrome when a diagnosis of EHS or ER cannot be fully explained by clinical signs and symptoms presented by a patient or when recurrent episodes of EHS or ER (or both) are unexplained. Further research is required to elucidate the genetic and pathophysiological links among MH, EHS, and ER. PMID: 28430550 [PubMed - in process]
Source: Journal of Athletic Training - April 23, 2017 Category: Sports Medicine Tags: J Athl Train Source Type: research

Validity of Core Temperature Measurements at 3 Rectal Depths During Rest, Exercise, Cold-Water Immersion, and Recovery.
CONCLUSIONS:  When EHS is suspected, clinicians should insert the flexible rectal thermistor to 15 cm (6 in) because it is the most valid depth. The low level of bias during exercise suggests Trec is valid for diagnosing hyperthermia. Rectal temperature is a better indicator of pelvic organ temperature during cold-water immersion than is Teso. PMID: 28207294 [PubMed - as supplied by publisher]
Source: Journal of Athletic Training - February 18, 2017 Category: Sports Medicine Tags: J Athl Train Source Type: research

Cooling Effectiveness of a Modified Cold-Water Immersion Method After Exercise-Induced Hyperthermia.
CONCLUSIONS:  The TACO treatment provided faster cooling than did the CON treatment. When location, monetary, or spatial restrictions are present, TACO represents an effective alternative to traditional CWI in the emergency treatment of patients with exertional hyperthermia. PMID: 27874299 [PubMed - as supplied by publisher]
Source: Journal of Athletic Training - November 23, 2016 Category: Sports Medicine Tags: J Athl Train Source Type: research

Physiologic and Perceptual Responses to Cold-Shower Cooling After Exercise-Induced Hyperthermia.
CONCLUSIONS:  Although the CS facilitated cooling rates faster than no treatment, clinicians should continue to advocate for accepted cooling modalities and use CS only if no other validated means of cooling are available. PMID: 26942657 [PubMed - as supplied by publisher]
Source: Journal of Athletic Training - March 6, 2016 Category: Sports Medicine Tags: J Athl Train Source Type: research

Necessity of Removing American Football Uniforms From Humans With Hyperthermia Before Cold-Water Immersion.
CONCLUSIONS:   Whereas participants cooled faster in NOpads, we still considered the PADS cooling rate to be acceptable (ie, >0.16°C/min). Therefore, if clinicians experience difficulty removing PADS or CWI treatment is delayed, they may immerse fully equipped hyperthermic football players in CWI and maintain acceptable Trec cooling rates. Otherwise, PADS should be removed preimmersion to ensure faster body core temperature cooling. PMID: 26678288 [PubMed - as supplied by publisher]
Source: Journal of Athletic Training - December 19, 2015 Category: Sports Medicine Tags: J Athl Train Source Type: research

National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.
Authors: Casa DJ, DeMartini JK, Bergeron MF, Csillan D, Eichner ER, Lopez RM, Ferrara MS, Miller KC, O'Connor F, Sawka MN, Yeargin SW Abstract OBJECTIVE: To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation. BACKGROUND: Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of t...
Source: Journal of Athletic Training - September 20, 2015 Category: Sports Medicine Tags: J Athl Train Source Type: research

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