Heat Stroke Prevention

How do you prevent heat stroke?

For more detailed information on steps to prevent exertional heat stroke, please see Ariel’s Checklist, a tool developed for hikers. The concepts apply to nearly all individuals exercising in the heat.

  • Ensure hydration

    • To ensure hydration, athletes can observe the color of your urine, which should be a straw yellow or the color of lemonade, or compare to a urine color chart. Your urine should be a color 3 or less.

    • Measure the athletes’ weight before and after each practice to ensure they do not lose more than 2% of their pre-workout weight, assuming they started in a hydrated state. Use the equation: (Pre-exercise weight minus post-exercise weight divided by pre-exercise weight) x 100. By the time next practice begins, athletes should ingest fluids and weigh the original weight. This equation assumes that they do not eat, drink or go to the bathroom during practice.

    • Encourage drinking throughout practice, in the shade if possible, and throughout the day, especially when having multiple practices.

    • As they become used to exercising in the heat they will sweat more and therefore need to replace a greater amount of fluids during the course of the workout.

    • Learn how to calculate your sweat rate here.

  • Wear loose-fitting, absorbent or moisture wicking clothing

    • During hot or humid conditions minimize the amount of equipment and clothing worn.

  • Minimize warm-up time, and practice in the shade when feasible.

  • Sleep at least 6–8 hours and eat a well-balanced diet.

  • Practice and perform conditioning drills at appropriate times during the day, avoiding the hottest part of the day (10am–5pm).

  • Work with coaches and administration to follow acclimation guidelines.

  • Slowly progress the amount of time and intensity of conditioning and practices throughout the season.

  • Ensure that proper medical coverage is provided and familiar with exertional heat illness (EHI) policies.

  • Include EHI questions on pre-participation exam to identify high-risk individuals.

  • Make sure your emergency action plan (EAP) is consistent with the most recent guidelines for preseason heat acclimatization; adapt individuals to heat gradually over 10–14 day period.

  • Educate other medical staff, athletes, coaches, emergency personnel, and parents about EHI and proper hydration.

  • Ensure proper body cooling methods are available, including a cold water immersion tub, ice towels, access to water, ice, etc. and that this equipment is prepared before practices begin.

  • Establish hydration policies: rest/work ratios, weigh-ins before and after activity, encourage drinking both water and fluids containing sodium.

  • Establish guidelines for hot, humid weather including; Wet Bulb Globe Temperature (WBGT) readings, time of activity, intensity/duration, equipment issues, rest/water breaks.

  • Be aware of the intrinsic factors (mostly in your control/items you can adjust) and extrinsic factors (mostly outside your control) that cause EHS