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Cumberland University

Heat Policy

HEAT POLICY

Exertional Heat Illness
This statement provides recommendations for Cumberland University athletic trainers and coaches to (1) identify and implement preventive strategies that can reduce heat-related illnesses in sports, (2) characterize factors associated with the early detection of heat illnesses, (3) provide on-site fi rst aid and emergency management of athletes with heat illnesses, (4) determine appropriate return-to-play procedures, (5) understand thermoregulation and physiologic responses to heat, and (6) recognize groups with special concerns related to heat exposure.1
 
Condition Sign or Symptom
 
  1. Exercise-associated muscle (heat) cramps
  2. Dehydration
  3. Thirst
  4. Sweating
  5. Transient muscle cramps
  6. Fatigue
  7. Heat syncope
  8. Dehydration
  9. Fatigue
  10. Tunnel vision
  11. Pale or sweaty skin
  12. Decreased pulse rate
  13. Dizziness
  14. Lightheadedness
  15. Fainting
  16. Exercise (heat) exhaustion
  17. Normal or elevated body-core temperature
  18. Dehydration
  19. Dizziness
  20. Lightheadedness
  21. Syncope
  22. Headache
  23. Nausea
  24. Anorexia
  25. Diarrhea
  26. Decreased urine output
  27. Persistent muscle cramps
  28. Pallor
  29. Profuse sweating
  30. Chills
  31. Cool, clammy skin
  32. Intestinal cramps
  33. Urge to defecate
  34. Weakness
  35. Hyperventilation
  36. Exertional heat stroke
  37. High body-core temperature (>40oC [104oF])
  38. Central Nervous system changes
  39. Dizziness
  40. Drowsiness
iii. Irrational behavior
  1. Confusion
  2. Irritability
  3. Emotional instability
vii. Hysteria
viii. Apathy
  1. Aggressiveness
  2. Delirium
  3. Disorientation
xii. Staggering
xiii. Seizures
xiv. Loss of consciousness
  1. coma
  2. Dehydration
  3. Weakness
  4. Hot and wet or dry skin
  5. Tachycardia (100 to 120 beats per minute)
  6. Hypotension
  7. Hyperventilation
  8. Vomiting
  9. Exertional hyponatremia
  10. Body-core temperature <40oc>
  11. Nausea
  12. Vomiting
  13. Extremity (hands and feet) swelling
  14. Low blood-sodium level
  15. Progressive headache
  16. Confusion
  17. Significant mental compromise
  18. Lethargy
  19. Altered consciousness
  20. Apathy
  21. Pulmonary edema
  22. Cerebral edema
  23. Seizures
  24. Coma
 
PREVENTION CHECKLIST
 
  1. Pre-event preparation
  • ____ Am I challenging unsafe rules (eg, ability receives fluids, modify game and practice times)?
  • ____ Am I encouraging athletes to drink before the onset of thirst and to be well hydrated at the start of activity?
  • ____ Am I familiar with which athletes have a history of heat illness?
  • ____ Am I discouraging alcohol, caffeine, and drug use?
  • ____ Am I encouraging proper conditioning and acclimatization procedures?
  1. Checking hydration status
  • ____ Do I know the pre-exercise weight of the athletes (especially those at high risk) with whom I work, particularly during hot and humid conditions?
  • ____ Are the athletes familiar with how to assess urine color? Is a urine color chart accessible?
  • ____ Do the athletes know their seat rates and, therefore, know how much to drink during exercise?
  • ____ Is a refractometer or urine color chart present to provide additional information regarding hydration status in high-risk athletes when baseline body weights are checked?
  1. Environment assessment
  • ____ Am I regularly checking the wet-bulb globe temperature or temperature and humidity during the day?
  • ____ Am I knowledgeable about the risk categories of a heat illness based on the environmental conditions?
  • ____ Are alternate plans made in case risky conditions force rescheduling of events or practices?
  1. Coaches’ and Athletes’ responsibilities
  • ____ Are coaches and athletes educated about the signs and symptoms of heat illnesses?
  • ____ Am I double checking to make sure coaches are allowing ample rest and rehydration breaks?
  • ____ Are modifications being made to reduce risk in the heat (eg, decrease intensity, change practice times, allow more frequent breaks, eliminate double sessions, reduce or change equipment or clothing requirements, etc)?
  • ____ Are rapid weight-loss practices in weight-class sports adamantly disallowed?
  1. Event management
  • ____ Have I checked to make sure proper amounts of fluids will be available and accessible?
  • ____ Are carbohydrate-electrolyte drinks available at events and practices (especially during a twice-a-day practices and those that last longer than 50 to 60 minutes or are extremely intense in nature)?
  • ____ Am I aware of the factors that may increase the likelihood of a heat illness?
  • ____ Am I promptly rehydrating athletes to pre-exercise weight after an exercise session?
  • ____ Are shaded or indoor areas used for practices or breaks when possible to minimize thermal strain?
  1. Treatment Considerations
  • ____ Am I familiar with the most common early signs and symptoms of heat illness?
  • ____ Do I have the proper field equipment and skills to assess a heat illness?
  • ____ Is an emergency plan in place in case an immediate evacuation is needed?
  • ____ Is a kiddy pool available in situations of high risk to initiate immediate cold-water immersion of heat-stroke patients?
  • ____ Are ice bags available for immediate cooling when cold-water immersion is not possible?
  • ____ Have shaded, air-conditioned, and cool areas been identified to use when athletes need to cool down, recover, or receive treatment?
  • ____ Are fans available to assist evaporation when cooling?
  • ____ Am I properly equipped to assess high core temperature (ie, rectal thermometer)?
  1. Other situation-specific considerations
 
Wet-Bulb Globe Temperature Risk Chart 1
WBGT Flag Color Level of Risk Comments
<18oc><> Green Low Risk low but still exist on the basis of risk factors
18-23oC (65-73oF) Yellow Moderate Risk level increases as event progresses through the day
23-28oC (73-82oF) Red High Everyone should be aware of injury potential; individuals at risk should not complete
>28oC (82oF) Black Extreme or Hazardous Consider rescheduling or delaying the event until safer conditions prevail; if the event must take place, be on high alert
HEAT ACCLIMATIZATION RECOMMENDATION
 
Universal WBGT Index:
 
Heat Category WBGT * F
Easy Work
Moderate Work
Hard Work
Work/Rest*
 Water/Hour Work/Rest Water/Hour Work/Rest* Water/Hour
1 78-81.9 No Limit ½ qt No Limit ¾ qt 40/20 min ¾ qt
2 82-84.9 No Limit ½ qt 50/10 min ¾ qt 30/30 min 1 qt
3 85-87.9 No Limit ¾ qt 40/20 min ¾ qt 30/30 min 1 qt
4 88-89.9 No Limit ¾ qt 30/30 min ¾ qt 20/40 min 1 qt
* Rest means minimal physical activity (sitting or standing) and should be accomplished in the shade if possible.
5
 >90 50/10 min 1 qt 20/40 min 1 qt 10/50 min 1 qt
 
Football (5-Day) Acclimatization Period:  
  • Includes – freshmen, transfers, and returners
  • 1 (3 hour) practice per day
    • 1 (1 hour) agility/speed practice – 1 (2 hour) practice per day
  • Must provide 3 hours of continuous rest between practices
    • Can’t include meetings, weights, testing, walkthroughs, etc.
    • Can include meals and medical treatments
  • Walkthroughs don’t count towards acclimatization, but they do count towards practice days
  • Athletes can’t practice separately
  • First (2 days) helmets only
  • Third and Fourth day helmets and shoulder pads
  • Fifth day and thereafter full pads
  • Sunday practice is counted as acclimatization day
  • Students who arrive late must undergo (5 day) acclimatization period
 
Preseason after (5-Day) Acclimatization Period: 
  • Full pads can’t be worn consecutive multiple practice days
  • No more than (3 hour) practices on 1 practice days
  • Must provide 3 hours of continuous rest between practices
    • Can’t include meetings, weights, testing, walkthroughs, etc.
    • Can include meals and medical treatments
  • Walkthroughs aren’t considered on field practices (activities) as long as equipment is not used or worn
    • Counts as a day
    • Can’t exceed (2 hours) on 1 practice days
    • Can’t exceed (1 hour) on 2 practice days
  • No more than (5 hours) of on field practice during multiple practice days
  • (6 days) prior to first competition must be single practices
 
NCAA guidelines for preventing heat:
  • Obtain athletes’ medical histories of previous heat illnesses.
  • Allow a period of seven to ten days for acclimatization.
  • Instruct athletes to wear appropriate clothing during the acclimatization period.
  • Take regular measurements of the WBGT index.
  • Encourage athletes to adequately replace fluids.
  • Record body weight of athletes before and after practice.
  • Identify susceptible athletes.
  • Constantly monitor athletes for signs of heat illness.
 
Wrestling Weight Management:
  • Prohibited Practices
    • The use of laxatives, emetics, excessive food and fluid restriction, self-induced vomiting, hot rooms, hot boxes, saunas, and steam rooms is prohibited for any purpose.  The use of diuretics at any time is prohibited by NCAA legislation for all sports.  Regardless or purpose, the use of vapor-impermeable suits (e.g., rubber or rubberized nylon) or any similar devices used solely for dehydration is prohibited.  Artificial means of rehydration (i.e., intravenous hydration) are also prohibited.
  • Practice-Room Temperature
    • The wrestling practice facility must be kept at a temperature not to exceed 80 degrees Fahrenheit at the start of practice.  It is understood that some practice facilities cannot maintain this exact temperature due to physical plant deficiencies.  It is within the spirit of the rule that every effort shall be made to maintain the 80-degree temperature throughout the practice.
  • Nutritionist
    • To help the athlete maintain proper eating habits while cutting weight.
    • Design individual dietary plan for each individual athlete.
    • Be available to answer any question concerning weight-management and dietary issues.
 
Recommendations for fluid replacement:
  • Athletes should begin all exercise session well hydrated.
  • Establish a hydration protocol for fluid replacement.
  • To ensure proper hydration, the athlete should consume seventeen to twenty ounces of water or a sports drink two to three hours before exercise and then seven to ten ounces twenty minutes before exercise.
  • Fluid replacement beverages should be easily accessible during activity and should be consumed at a minimal rate seven to ten ounces every ten to twenty minutes.
  • During activity, the athlete should consume the maximal amount of fluid that can be tolerated, but not to exceed the amount lost in sweat.
  • A cool, flavored beverage at refrigerator temperature is recommended.
  • The addition of proper amounts of carbohydrates and electrolytes to a fluid replacement solution is recommended for exercise events that last longer than forty-five to fifty minutes or are intense.
  • For vigorous exercise lasting less than one hour, the addition of carbohydrates and electrolytes does enhance physical performance.
  • A 6 percent carbohydrate solution appears to be optimal (fourteen grams of carbohydrate per eight-ounce serving).  A concentration greater than 8 percent slows gastric emptying.
Adding a modest amount of sodium (0.3 to 0.7 grams per liter) is acceptable to stimulate thirst and increase fluid intake