Loudoun County Public Schools Approves EHS Protocol

Paul A. Peterson MA, LAT, ATC

Athletic Trainer, Woodgrove High School

(May 17, 2018 Virginia)-  We are proud to announce that Loudoun County Public Schools has approved an exertional heat stroke (EHS) protocol that includes the use of rectal thermometry.  We hope this decision will encourage other secondary school districts in the state of Virginia and throughout the United States, who are having difficulties convincing their administrators the vital importance of rectal thermometry, to continue their pursuit.

In the past, our school district administration was adamantly opposed to approving rectal thermometry.  They denied our athletic trainers, on numerous requests, permission to purchase and use rectal thermistors.  Ironically, this past fall, one of our student-athlete cross-country runners suffered EHS during a championship meet.  The athletic trainers and EMS volunteers immediately assessed the student-athlete’s internal body temperature at 107.7°F via rectal thermometry, placed him in an ice water immersion tub and didn’t transport him to the ER until his internal body temperature dropped to 102°F.  Fortunately, the student-athlete was released from the ER later that night with no organ damage and made a full recovery.

By following best practice guidelines in the treatment of EHS, the athletic trainers and EMS volunteers, almost certainly prevented a catastrophic outcome.  This incident, once again, brought the need for our school district administration to approve the use of rectal thermometry in the treatment of EHS to the forefront.  After an eight-month process to help educate the administration on the vital importance of rectal thermometry, we finally received consent and this policy is now officially part of our EHS protocol.

This policy implementation would not have been possible without the support of several individuals. First and foremost, we had the support of our Athletics Supervisor. Second, we received support and the go ahead from our Health Services’ Supervisors and Director.  Third, we received support and further go ahead from our Risk Management Supervisor.  Then finally, we received approval from our School Administration Director to include our EHS protocol in the LCPS policies and procedures section of the student-athlete handbook.

The key to our success was a team effort approach.  With help and support from many individuals most notably, the LCPS athletic trainers, the orthopedic physicians and staff from The National Sports Medicine Institute (NSMI), the researchers at the Korey Stringer Institute (KSI), Dr. Kevin Miller at Central Michigan University, and Darryl Conway at The University of Michigan, we were finally able to convince our administration to allow the medical professionals in the school system to make the medical decisions and act within published best practices.

With patience and perseverance, the LCPS athletic trainers were able to accomplish the goal of getting an appropriate EHS protocol approved to ensure the future health and safety of LCPS student-athletes who may suffer from EHS.