A.S. was a healthy young athlete who collapsed while engaging in football practice in the late afternoon. There were no reports that he had complained of being overheated or was suffering from signs or symptoms of heat related illnesses. The outdoor temperature was in the 80’s with moderate humidity. He was admitted to a local hospital with a body temperature of 108 degrees and died two days later.

Heat related illnesses claimed 7000 lives from 2006-2011. Six high school football players died in 2011 alone. Heat related illnesses are caused by the loss of our ability to control our internal body temperature.

Usually our bodies do a good job keeping our temperature around 96 degrees by the distribution of blood flow and by means of sweating. It is primarily the evaporation of sweat that enables us to withstand the heat. Most incidences of heat related illnesses involve outdoor workers and sports activities but many involve people particularly susceptible to such illness. These include the elderly, the young, those suffering from heart disease, diabetes, chronic illnesses, obesity, mental illnesses or a previous episode of a heat related illness. . Patients taking  medications such as diuretics, antihypertensives,  and tranquilizers, are particularly sensitive to heat.

Heat related illnesses are a spectrum of symptoms that range from:

•cramping (heat cramps) to

•nausea, vomiting, headaches, tunnel vision, extreme weakness (heat exhaustion) to

•confusion, delirium, and collapse (heat stroke)

Heat stroke occurs when the body temperature rises quickly causing multiple organ failure and death. The tragedy is that these illnesses are all preventable.

How can we prevent heat related illnesses?  Whether you are an athlete, a construction worker, or even an elderly person taking a walk in the heat it is imperative to plan ahead.

•Drink 10 ounces of water or sports drinks with minimal sugar once an hour and more if thirsty. It’s very important to know that if you wait until you are thirsty to replenish fluids, you’re too late.

•Wear bright colored loose fitting clothing.

•Plan to take regular breaks from the heat regardless of how you feel.

•Avoid alcohol and excessive caffeine.

•Never, ever leave a child, elderly person or pet in a car. Ambient temperature in a non-ventilated car rises 20 degrees in 15 minutes and 45 degrees in one hour. Cracks in windows are not effective. What should you do when overheated or helping someone else who is overheated:

•First get the person to a cool, ventilated area out of the sun. Use fans if available.

•Apply cool water soaked towels to the skin and the armpits.

•Give water or sports drinks.

•If the patient has signs of heat exhaustion, bring the patient to a climate controlled area and care for the patient until symptoms have improved. Be aggressive with cooling maneuvers such as cool baths or showers. If the person has not improved in one hour, take him or her to the hospital.

•If the person is confused, acting irrationally or can not be aroused, call an ambulance immediately,

The football player died from Exertional Heat Related Illness. These athletes, or anyone who is engaged in strenuous activities that, by the intensity of the exercise raise body temperature, tend to get ill very quickly when practicing in the heat. This can happen in moderate temperatures and humidity that are not ordinarily associated with illness. Awareness of this phenomenon is most important. Overweight athletes are of particular concern. Coaching associations are becoming more involved in the awareness and prevention of Exertional Heat related Illness, but everyone must have their own plans to stay healthy and safe in the heat especially athletes:

•Use the same plans as listed above and begin and end the day hydrated.

•Advise your athlete children  not to wait for thirst to drink fluids and to drink enough to keep their urine clear yellow.

•Stop practice immediately for any signs of illness,

•Weigh your children at the end of the day. If they have lost weight, they are probably not drinking enough fluids.

•Know your child’s coaching staff’s heat prevention plans

•If the athletes have suffered heat exhaustion, they should probably stop for the day.

Awareness of what heat related illnesses are and how they happen is key to good planning to be safe and healthy in hot weather.

By Dr. Jim Aiken. Jim is chief of medical operations and administrative director of emergency services at Pearl River County Hospital in Poplarville.