States are not do­ing enough to keep heat stroke at bay.

Austin American-Statesman - - SPORTS - By Barry Wil­ner

A high school sports study con­ducted by the Korey Stringer In­sti­tute shows that many in­di­vid­ual states are not fully im­ple­ment­ing key safety guide­lines to pro­tect ath­letes from po­ten­tially life-threat­en­ing con­di­tions, in­clud­ing heat stroke.

More than 7.8 mil­lion high school stu­dents par­tic­i­pate in sanc­tioned sports an­nu­ally. KSI an­nounced the re­sults Tues­day at a news con­fer­ence at NFL head­quar­ters. The league par­tially spon­sors the in­sti­tute.

The state-by-state sur­vey of all sports played in high school showed North Carolina with the most com­pre­hen­sive health and safety poli­cies at 79 per­cent, fol­lowed by Ken­tucky at 71 per­cent. At the bot­tom were Colorado (23 per­cent) and Cal­i­for­nia (26 per­cent). Those scores were based on a state meeting best prac­tice guide­lines ad­dress­ing the four ma­jor causes of sud­den death for that age group: car­diac ar­rest, trau­matic head in­juries, ex­er­tional heat stroke and ex­er­tional sick­ling oc­cur­ring in ath­letes with sickle cell trait.

“The bot­tom line is that many sim­ple pol­icy changes can have a mas­sive im­pact when a life is saved,” says Dr. Dou­glas Casa of KSI. “That is the goal of KSI in re­leas­ing th­ese rank­ings, to pre­vent need­less deaths in high school sports. We have had count­less con­ver­sa­tions with loved ones who have lost a child/sib­ling/ grand­child/ath­lete. If th­ese rank­ings can get more kids home for din­ner in­stead of to a hos­pi­tal or morgue, then we have suc­ceeded.”

The in­sti­tute is a sports safety re­search and ad­vo­cacy or­ga­ni­za­tion lo­cated at the Univer­sity of Con­necti­cut and named af­ter the for­mer Vik­ings star who died from ex­er­tional heat stroke in 2001.

Sud­den car­diac ar­rest is the lead­ing cause of death for the age range.

Casa notes that progress is slow be­cause most states only make a change af­ter a tragedy. But he stresses that the poli­cies KSI pro­motes are not dif­fi­cult to adopt.

“At least one state has adopted each in­di­vid­ual item, and for many items, more than half of the states have the pol­icy in place,” he said. “So this tells us it is fea­si­ble (to max­i­mize pro­tec­tion). Now we need to col­lec­tively get states to learn from their col­leagues and adapt th­ese (pro­grams) in their own state. Our top state is at about 80 per­cent, show­ing that, with ef­fort, th­ese poli­cies can be im­ple­mented.”

Bob Gfeller lost his son, Matthew, at age 15 in 2008, af­ter a trau­matic brain in­jury while play­ing in his first high school foot­ball game.

Gfeller is an ex­ec­u­tive vice pres­i­dent at Wake For­est Bap­tist Med­i­cal Cen­ter and the ex­ec­u­tive di­rec­tor of the Chil­dress In­sti­tute for Pe­di­atric Trauma. He found the wide range of re­sults by state “en­light­en­ing.”

Asked what can be done to get states to adopt more of the guide­lines to pro­tect high school ath­letes, Gfeller says: “Shar­ing of best prac­tices amongst the state high school pro­fes­sion­als. For each state to study where they are gap­ping and what other states who are scor­ing high are do­ing, so then to be able to de­ter­mine how to close their gap.”

In his field of ex­per­tise, ex­er­tional heat stroke, Casa notes that states that have adapted sig­nif­i­cant changes to heat ac­clima­ti­za­tion poli­cies have not had such a death when the poli­cies have been fol­lowed.

“Keep in mind th­ese poli­cies are for the phas­ing in of ini­tial prac­tices in Au­gust,” Casa says. “Some of th­ese states have still had ex­er­tional heat stroke deaths dur­ing sum­mer con­di­tion­ing in June/July or other times of the year, be­cause they lack poli­cies that gov­ern th­ese other cir­cum­stances.”

To pre­vent death from EHS, it comes down to three things:

■ Pre­ven­tion — heat ac­clima­ti­za­tion, mod­i­fy­ing work/ rest ra­tios based on en­vi­ron­men­tal con­di­tions, hy­dra­tion, body cool­ing, etc.;

■ Recog­ni­tion — be­ing aware, act­ing quickly, rec­tal tem­per­a­ture;

■ Treat­ment — cold-water im­mer­sion, cool first/trans­port sec­ond.

Casa adds that the cost of reach­ing the de­sired pre­ven­tive mea­sures is not high.

“To be hon­est, you could get to 90 per­cent im­ple­men­ta­tion with very lit­tle cost and ef­fort,” he says. “Spend­ing prob­a­bly less than $5,000 per school could get you close to 90 (per­cent). You also would prob­a­bly need a two-day meeting with the key state as­so­ci­a­tion of­fi­cials to re­fine the de­tails of the changes.

“It is mat­ter of con­vinc­ing peo­ple that th­ese is­sues are im­por­tant and that they need at­ten­tion.”


A high school foot­ball player in Ok­la­homa cools off dur­ing a break at prac­tice Mon­day. Doc­tors say stay­ing hy­drated is a key to avoid­ing heat stroke.

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