While running a race, teenager Douglas Casa suffered from an exertional heat stroke (EHS) and collapsed. The immediate treatment he received preserved his life and propelled him toward a career of helping others who fall prey to this ailment.
Now, a professor in the Department of Kinesiology and the chief operating officer of the Korey Stringer Institute (KSI), Casa conducts research and educates athletics, the military and industry about preventing and treating EHS.
KSI bears the name of a former Minnesota Vikings football player, Korey Stringer. While attending a 2001 training camp, Stringer suffered from EHS and lost consciousness, but his situation was not as fortunate as Casa’s. Stringer died the next day. In 2010, Stringer’s widow worked with the National Football League and Casa to found the Institute. The Department of Kinesiology, which Casa calls “a hosting home for a lasting legacy,” houses KSI.
Casa gets satisfaction from EHS research and education because he knows from personal experience that it can be a matter of life and death. “As part of my efforts to maximize health and safety during intense exercise in the heat, I have helped save 185 people who were suffering EHS at events or practices in which I was providing clinical care,” Casa said.
Organizations and companies as diverse as Gatorade and General Electric partner with Casa and his fellow scientists to preserve life. Casa manages corporate donations to KSI that total over $1.2 million in the last five years. This is in addition to $1.5 million in research grants for the same period.
At risk for EHS. EHS can strike all kinds of people who exert themselves in high heat conditions. Those at risk include amateur and professional athletes of all ages and levels, soldiers in the military and industrial workers, such as those on construction sites.
The basis for an EHS diagnosis is a core body temperature of over 105 degrees with accompanying symptoms of central nervous system dysfunction, such as collapse or altered consciousness. Medical providers measure temperature with a rectal thermistor, a kind of thermometer that indicates minute changes in temperature, or an ingestible thermometer pill that sends data wirelessly for real-time monitoring purposes.
Recognizing the symptoms and immediately intervening with appropriate treatment that rapidly reduces body temperature within 30 minutes is crucial to assure survival. Based on his research, Casa advocates cooling the patient in an ice bath and then transporting him or her to a hospital. He once treated a competitive runner whose core temperature was 112 degrees. She survived EHS without complication.
Testing, research, education, policies, outreach According to Casa, the work of KSI has five main components: athlete testing, research, education, policy changes and mass media outreach.
Some thermoregulation, hydration and athlete performance testing takes place in a heat chamber lab in Gampel Pavilion. Other studies happen at athletic events. For example, 30 of Casa’s team members attended the New Balance Falmouth Road Race in August to conduct research and provide clinical care to approximately 10 to 15 runners that had EHS. The data gathered helps the researchers understand how fast the athletes cool down and what factors may have predisposed them to EHS.
KSI quickly disseminates research findings to make a difference in places where EHS is most likely to occur. The Institute has given Casa a platform to bring his educational message to decision makers at the top levels. He has advised elite athletes involved with the World Cup, Summer Olympics, Super Bowl and more.
“My most rewarding work is with the US military where I can influence the health and safety of an extremely large number of individuals,” he said. The Pentagon rewrote its heat stroke policies as a result of Casa’s efforts.
High school football is another area where policies are changing and athletic trainers and coaches have greater awareness of the risks. Currently, 14 U.S. states meet the Korey Stringer Institute minimum guidelines for heat acclimatization. KSI statistics show zero deaths from EHS in those states. This has saved more than 20 lives in the last four years, according to Casa’s estimates.
In Connecticut, as mandated by the Connecticut Association of Schools, all secondary schools adopted the KSI guidelines for heat acclimatization by August 2013. Since then, there are no reported deaths from EHS in Connecticut.
Another big component of the current KSI mission is reaching out to mass media. To get the word out, Casa does podcasts and webinars and appears as a guest expert. He enthusiastically spreads the message about the prevention of sudden death to anyone who will listen. TED-Ed heeds the call. USA Today, Sports Illustrated and the New York Times pay attention. ESPN, NBC and ABC know. As a result, Casa is one of the most quoted UConn researchers, according to Colin Poitras, a university relations associate in university communications.
It seems that EHS was and is a life and death matter to Casa, and it shows.