Pediatric Blogs
Every year there are heat-related deaths on the sports field. This happens particularly in August when the heat is at its worst and fall related sports are getting into full swing. How does this keep happening you ask? Well … state high school sports associations have been slow to adopt rules to make practices safe in extreme heat (although things are dramatically better than they used to be). And of course, kids sports prior to high school age are often not legislated at all in terms of rules regarding practicing/playing in the heat.
So when does it become unsafe to practice outside? And what precautions should be taken? Generally, when the heat index (which takes into account relative humidity) climbs above 100, practicing and playing outside assumes a much larger risk of dehydration, heat illness, and heat stroke. When the heat index is 90-100, ample water should be provided, and athletes should have unrestricted access to it (for example, there shouldn’t only be one water break per practice). And the heat index should be re-checked one or more times during a practice or game if the heat index is approaching 100.
If the heat index is 100-104, you should begin to think about canceling outdoor activities. Water breaks should be mandatory every 30 minutes, and toweling down with ice cold towels should be encouraged. And when the heat index is 105 or above, play or practice should be stopped and moved inside. Two-a-day practices (common practice in fall sports like football) should be reconsidered when the heat becomes an issue, and certainly, practicing when it is cooler earlier in the morning is a smart idea.
What are the consequences or the heat and how do athletes get in trouble? Severity of heat related medical problems ranges from dehydration, to muscle cramps, to heat exhaustion, to heat stroke. With each step, an athlete gets progressively sicker and important attention needs to be paid to an athlete progressing towards heat stroke. The biggest indicator that an athlete is headed toward trouble is if he or she starts acting abnormal (aka altered mental status). They may become combative, aggressive, and clearly not act like themselves. If medical personnel are available at that point, the athletes temperature should be taken and they should be immediate immersed in an ice bath if possible. And call 911!
The heat shouldn’t be ignored when your child is playing a sport outside. As a parent, you definitely have a role if you think limits are being pushed in play or practice!
Rachel Brewer, MD
Originally Posted on Pediatricians for Parents
