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Coaches Follow Guidelines for Heat Illness and Prevention: Heat index readings and mandatory water breaks are recommended

In the wake of a number of heated-related fatalities suffered by high school athletes in Kentucky, the Kentucky High School Athletic Association (KHSAA) implemented several measures to protect the health and safety of student athletes.

Exertional heat stroke (EHS) is a frequent cause of exercise-related death. Following recommendations from the Kentucky Medical Association Committee on Physical Education and Medical Aspects of Sports, the KHSAA established a Heat Illness and Prevention Policy, which includes guidelines for conducting practices and other sports activities, both contact and non-contact. Indoor sports, played in facilities where air conditioning may not be available, are also included in the testing.

“I think it’s helping,” said Bill Letton, head football coach at Lexington Catholic High School. “I know we’ve had some tragic occurrences in the state of Kentucky over the last four or five years and that’s something certainly that none of us as coaches want to ever go through.”

KHSSAA member schools and their teams and coaches must determine the heat index at a practice or competition site and follow the requirements for preventing heat-related illness. On-site devices such as digital sling psychrometers measure temperature and relative humidty, and the reading dictates whether the practice or competition should continue or be halted.

Thirty minutes before the activity starts, temperature and humidity readings are to be taken at the site. The readings are recorded on a form that the school is required to submit to the KHSAA. A heat index reading above 95 degrees would require that the activity be limited. Additional readings at 30-minute intervals are used to determine if the activity should be eliminated or resumed.

When the heat index reading is below 95 degrees, athletes should hydrate as much as possible during optional 10-minute water breaks taken every 30 minutes. The KHSAA recommends having towels filled with ice to cool off the athletes. The coaches and trainers should monitor their players closely.

If the heat index reading is at 99 degrees, the water breaks become mandatory. Helmets and other equipment should be removed when the athletes are not directly competing, drilling or practicing. It may be advisable to postpone practice until later in the day.

A heat index reading of 100 to 104 degrees encompasses the previous hydration recommendations and also suggests letting the athletes change to dry clothing at defined intervals. Coaches should also consider reducing the time of outside activity or postponing it. If helmets or other protective equipment are required to be worn by rule or normal practice, the practice or competition should be suspended immediately.

When the heat index is about 104 degrees, all practices and competitions must be halted.

Schools should ideally have a certified athletic trainer on staff to develop and implement the guidelines. Athletes should always have access to water and be provided with shade, fans and other cooling devices, including frozen towels and ice. Much of the work of preventing EHS can occur off the playing field.

“We try to educate our kids about proper eating, proper hydration, making sure the trainer is aware if there are any medications that they’re on,” Letton said. “We keep water readily available and take water breaks every 30 minutes.” If worse comes to worse, the football team is prepared.

“We have a big trough we fill with ice and water in case a kid does start to get hot so we can get that temperature down as soon as possible,” Letton said.

The KHSAA has several programs in place that educate coaches and trainers about the warning signs and dangers of heat exhaustion. For more information, visit http://www.khsaa.org.

By Tanya J. Tyler, Associate Editor

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