need to discontinue activity.
(iii)
No significant dysfunction of the central nervous system is present (e.g., seizure,
altered consciousness, persistent delirium)
(2)
If any central nervous system dysfunction develops, such as mild confusion, it re- solves
quickly with rest and cooling.
(3)
Patients with heat exhaustion may also manifest:
(i)
Tachycardia (very fast heart rate) and hypotension (low blood pressure)
(ii)
Extreme weakness
(iii)
Dehydration and electrolyte losses
(iv)
Ataxia (loss of muscle control) and coordination problems, syncope (passing out),
light-headedness
(v)
Profuse sweating, pallor (paleness), “prickly heat” sensations
(vi)
Headache
(vii)
Abdominal cramps, nausea, vomiting, diarrhea
(viii)
Persistent muscle cramps
(b)
Heat Stroke
(1)
The two main criteria for diagnosing exertional heat stroke:
(i)
Rectal temperature above 104°F (40°C), measured immediately following collapse
during strenuous activity.
(ii)
Central Nervous System dysfunction with possible symptoms and signs: disorienta-
tion, headache, irrational behavior, irritability, emotional instability, confusion, al
tered consciousness, coma, or seizure.
(2)
Most patients are tachycardic and hypotensive.
(3)
Patients with heat stroke may also exhibit:
(i)
Hyperventilation
(ii)
Dizziness
(iii)
Nausea
(iv)
Vomiting
(v)
Diarrhea
(vi)
Weakness
(vii)
Profuse sweating
(viii)
Dehydration
(ix)
Dry mouth
(x)
Thirst
(xi)
Muscle cramps
(xii)
Loss of muscle function
(xiii)
Ataxia
(4)
Absence of sweating with heat stroke is not typical and usually indicates additional medical
issues.
2.3.7
Management of Heat Illness
(a)
A primary goal of management of heat illness is to reduce core body temperature as quickly as pos-
sible. When exertional heat stroke is suspected, immediately initiate cooling, and then activate
emergency medical system. Remember “Cool First, Transport Second”.
(b)
Remove all equipment and excess clothing
(c)
If appropriate medical staff is present, assess athlete’s rectal temperature
(d)
Immerse the athlete in a tub of cold water (the colder the better). Water temperature should be
between 35 to 60°F (2 to 15˚C); ice water is ideal but even tepid water is helpful. Maintain
an appropriately cool water temperature. Stir the water vigorously during cooling.
(e)
Monitor vital signs (rectal temperature, heart rate, respiratory rate, blood pressure) and mental
status continually. Maintain patient safety.
(f)
Cease cooling when rectal temperature reaches 101 to 102°F (38.3 to 38.9°C)
(g)
If an immersion pool is unavailable or in cases of heat exhaustion, use these cooling methods:
(1)
Place icepacks at head, neck, axillae and groin.
(2)
Bathe face and trunk with iced or tepid water.
(3)
Fan athlete to help the cooling process.
(4)
Move athlete to a shaded or air conditioned area if available near the practice site.
2.3.8
CrashCourse Concussion Video Viewing Requirement - All coaches, athletes, and parents are required to
view the "CrashCourse" Concussion Video prior to participation in each season.
2.3.9
Cardiac Safety Program - All NCHSAA member schools must have a Cardiac Safety Program to include the
following components
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