Blog Post

NFL Webinar on Heat Stroke with Dr. Doug Casa (Registration)

On Tuesday, August 3, at 8:00 p.m. ET, NFL Chief Medical Officer Dr. Allen Sills will host Dr. Douglas J. Casa, CEO of the Korey Stringer Institute (KSI) and Professor of Kinesiology at the University of Connecticut, for an ‘NFL Presents’ webinar to discuss best practices to prevent, identify, assess and treat exertional heat stroke. Dr. Casa, who is a foremost expert in this field, has long been a partner of the NFL, creating educational material for NFL clubs about heat stroke and advising across the league on this important topic.


Registration can be found here:

America’s No. 1 Weather Killer Is Not Tornadoes, Flooding, Lightning or Hurricanes

America’s No. 1 Weather Killer Is Not Tornadoes, Flooding, Lightning or Hurricanes

At a Glance

  • Excessive heat claims over 100 lives in an average year in the U.S.
  • It’s particularly dangerous for the elderly living in large cities without air conditioning.
  • One heat wave in the 1990s claimed over 1,000 lives.

Extreme heat is responsible for more weather-related deaths in the U.S. in an average year than any other hazard.

Excessive heat claimed an average of 138 lives per year in the U.S. from 1990 through 2019, according to NOAA. That’s higher than the average annual death tolls from flooding (88), tornadoes (65), hurricanes or tropical storms (45) and lightning (41) in that 30-year period.

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Heat is killing more people than ever. Scientists are looking for ways to lower the risk (Science)

Heat is killing more people than ever. Scientists are looking for ways to lower the risk

“It’s 5 a.m. and still dark at the Carlton Complex fire camp in central Washington, except for the fire’s orange glow on a distant ridgeline. Wildlands firefighter Bre Orcasitas, two colleagues, and three volunteers suit up: heavy duty fire-resistant pants, shirt, jacket, and helmet. Their boots weigh 2 kilograms; the backpacks they will haul to the fire—loaded with 6 liters of water, food for a 16-hour shift, safety gear, and hand tools—can weigh 30 kilograms. Sometimes the burden includes a 12-kilogram chain saw.

On this day in August 2014, the crew is not just fighting flames, but also taking part in research. Orcasitas outfits each person with a chest harness and sensors that will record their heart rate, elevation gain, distance traveled, carbon monoxide intake, and skin temperature. Each swallows an ingestible radio thermometer that relays deep body temperature to the chest monitor every 15 seconds via Bluetooth. Orcasitas and her two colleagues will record each firefighter’s activities, be it cutting down trees, digging a fire break, or burning vegetation to keep a larger fire away. It’s all part of a study to assess heat exposure in wildlands firefighters—the biggest ever to do so. From 2013 through 2016, more than 300 firefighters participated.

High body temperatures are inevitable in firefighting: A study in 2013 uncovered about 50 heat-related injuries across the United States during that fire season. But other data from their project have surprised Orcasitas and her colleagues. Warmth from the firefighters’ physical exertion, not heat from the fires, was the greatest danger, the researchers found. Another surprise: “The assumption across the fire community was that if somebody went down, it was because they just didn’t drink enough water,” Orcasitas says. But the team found otherwise. “You can’t drink yourself out of a heat-related injury,” explains project leader Joseph Domitrovich, an exercise physiologist at the U.S. Forest Service’s National Technology and Development Program. “It’s not the magic bullet that people thought.” …  article continued at:


CIAC Distributes Cold Water Immersion Tubs to 74 Schools (CIAC Sports)

CIAC Distributes Cold Water Immersion Tubs to 74 Schools

The Connecticut Interscholastic Athletic Conference announced today the distribution of cold water immersion tubs to 74 CIAC member schools throughout Connecticut. The tubs will be used by school athletic departments as a means of emergency treatment for athletes who incur heat illness brought on through participation in sports.

New emergency medical guidance requires that victims of heat illness are cooled as soon as possible in order to prevent serious consequences which could be life threatening. Nearly all other serious emergencies and injuries require stabilization and rapid transport to the hospital. Schools contract with local EMT services for that transportation. The revised guidelines still require calling 911 immediately, however the new regulations stipulate that for heat illness the victim’s body temperature must be lowered before transportation.

“The best way to lower body temperature for a victim of heat illness is to submerge the athlete in a cold water tub filled with ice,” said Marc Aceto, athletic trainer at East Haven High School. “Having a cold water immersion tub in proximity to athletic practices and contest venues is an essential part of all high school athletic emergency action plans.”

“We at the CIAC make student safety our first priority,” said CIAC Executive Director Glenn Lungarini. “We are glad to purchase and distribute these tubs to our schools that need them in order to help them keep kids safe during an emergency.”

The CIAC surveyed schools about their needs to fulfill an emergency action plan at each school. Athletic directors indicated that there was a need to acquire new tubs as the guidelines had changed. For those schools who didn’t have a tub, the CIAC provided one. The CIAC purchased the tubs with support from H.W. Hine Hardware in Cheshire, an ACE Hardware affiliate.

Aceto, who serves as the liaison to the Connecticut Athletic Trainers Association (CATA) for the CIAC, along with Samantha Scarneo-Miller, from the Korey Stringer Institute advised the CIAC in preparing a new Medical Handbook. The handbook was distributed to all CIAC schools last summer and includes a sample Emergency Action Plan with up-to-date guidelines for treating athletes suffering from heat illness.

CATA president Perry Siegel who serves on the CIAC Sports Medical Committee along with other members of the CATA offered to distribute the tubs to schools who were not able to pick them up at H.W. Hine, an undertaking that began on November 5th.

Lungarini was quick to recognize the collaborative effort; “CATA, The Korey Stringer Institute and the CIAC Staff all worked together to provide current information and support to our member school athletic departments. We want all of our schools to have the most up-to-date training and to be prepared for all athletic emergencies.”

Article here: CIAC Sports

NFL Partner Korey Stringer Institute Drives Progress in Safety (Player Health)

Published: October 16, 2020

“In September 2017, the Korey Stringer Institute (KSI) published a report providing a snapshot of state-level policies concerning sudden death and catastrophic injuries in high school sports. Since this initial landscape analysis and a robust effort to strengthen these policies across the country, 38 states have adopted legislative or State High School Athletic Association changes improving on that baseline. This remarkable progress was chronicled in KSI’s most recent policy evaluation report, released in August 2020.

It’s no coincidence that three-quarters of states have adopted changes in just three years. This nationwide movement towards stronger safety rules has been driven by the work of Team Up for Sports Safety (TUFSS), a KSI-led initiative aiming to propel the adoption of high school athletic policies proven to reduce the incidence of catastrophic sports injuries. The rapid, widespread success of TUFSS has been fueled by robust support from the National Football League Foundation and the National Athletic Trainers’ Association along with numerous private donors.

As part of the TUFSS initiative, KSI hosts meetings within states and invites local high school sports leaders and policy makers to engage in conversation aimed as fueling the adoption of health and safety policies that enhance the wellbeing of high school student athletes. Through the implementation of TUFSS-recommended policies and procedures, schools can be well prepared in the unfortunate event of a catastrophic injury, helping to reduce risk of athlete fatality from sudden cardiac arrest, traumatic head injuries, exertional heat stroke, and exertional sickling.

Research, Advocacy and Education

The Korey Stringer Institute draws its name and inspiration from Korey Stringer, a Minnesota Vikings offensive lineman who passed away from exertional heat stroke in 2001. In an effort to prevent additional exertional heat stroke deaths, Stringer’s widow, Kelci, joined forces with exertional heat stroke expert Dr. Douglas Casa at the University of Connecticut to form KSI, which launched in April 2010. KSI’s mission is to provide research, education, advocacy and consultation to maximize performance, optimize safety and prevent sudden death for the athlete, warfighter and laborer”

The entirety of article can be found here: Player Health & Safety Article October 2020

Korey Stringer Institute: Progress Made in High School Sports Safety Policies (UCONN Today)


“In the three years since UConn’s Korey Stringer Institute published its initial report examining health and safety policies for high school athletes, 38 states have adopted legislative or State High School Athletic Association changes that make high school athletes safer in their respective states, according to its latest findings.

The update, released this month, reflects the notable progress states have made in the past year (August 2019-August 2020) in adopting important new policies to protect student athletes. States adopting policy changes that went into effect this year include Alabama, Arkansas, Colorado, Delaware, District of Columbia, Florida, Hawaii, Illinois, Iowa, Louisiana, Missouri, New Jersey, New Mexico, New York, Oklahoma, Tennessee, Texas, and Vermont.

These changes come as the NFL Foundation and the National Athletic Trainers’ Association, along with countless private donors, have announced their support of Team Up for Sports Safety (TUFSS), a KSI-led initiative with a goal to help propel the adoption of policies proven to reduce the incidence of catastrophic sports injuries.

As part of the TUFSS initiative, KSI hosts state meetings and invites local high school sports leaders and state legislatures to engage in conversation and help encourage the adoption of health and safety policies that benefit the wellbeing of high school student athletes. In the coming years, KSI will visit all 50 states, the District of Columbia, and Puerto Rico.

“One of the most important projects in the history of the Korey Stringer Institute is TUFSS,” KSI Chief Executive Officer and professor of kinesiology at UConn Douglas Casa says. “The project deeply reflects our core mission and provides an unbelievable opportunity to effect positive change that will influence so many youth athletes. Working with the state level policy leaders has been rewarding, but seeing the change in policies from the collective efforts of so many is truly inspirational- knowing that we are doing things that will literally allow more kids to arrive home for dinner instead of at a hospital or a morgue.”

Following KSI’s visit to Louisiana, a sweeping student athlete safety bill was signed into law by Gov. John Bel Edwards on June 15, 2020. It mandates emergency action plans, requires heat acclimatization and the use of wet bulb globe temperature (WBGT) to monitor environmental conditions.

“The Louisiana Project was a cooperative endeavor bringing the LA High School Coaches Association, LA Football Coaches Association, LA High School Athletic Association, LA High School Athletic Directors Association, LA Association of School Executives, and the LA Athletic Trainers’ Association together with one goal,” says Scott Arceneaux, Director of Athletic Training at St. Amant High School and President-elect of the Louisiana Athletic Trainers’ Association. “The goal…was to improve the health and safety of the student athletes in our great state. This was the key factor in Louisiana passing ACT 259 in the 2020 legislative session. Without the guidance and resources of the TUFSS program, this would not have been possible.”

Florida was another state visited by KSI that made legislative policy changes this year. The Zachary Martin Act requires Florida High School Athletic Association member schools to modify athletic activities based on heat stress guidelines and require emergency action plans to include procedures for onsite cooling before transporting a student for exertional heat stroke. Zachary Martin was a 16-year-old offensive lineman who collapsed during a hot summer football practice. His core temperature was 107°F, and he was taken off life support 11 days after his collapse. Zachary’s mother, Laurie Giordano, was instrumental in the passage of this bill.

“Sharing this tragedy with a room full of strangers was difficult, but I was encouraged by the heartfelt concern of Florida legislators and their commitment to ensuring the safety of our high school athletes,” she says. “KSI was instrumental in motivating lawmakers to address exertional heat illness safety through a state survey of high schools that included KSI’s High School Sports Safety Policy Review data for Florida. This survey highlighted inconsistent safety policies and revealed a shocking number of exertional heat illnesses along with a lack of Emergency Action Plans and heat safety equipment. As I spoke to each committee about losing Zach to exertional heat stroke, KSI’s recommendations became a clear path to athlete safety in Florida high schools. I am grateful for KSI’s influence in Florida and I am both humbled and proud that this law is named in honor of Zach.”

The new Florida law also requires Florida High School Athletic Association member schools to make automated external defibrillators available on school grounds in clearly marked, public locations. The Zachary Martin Act was signed by Gov. Ron DeSantis and went into effect July 1, 2020.

“We initially expected to have our policy changes enacted through our state high school athletic association but that did not occur,” said Dr. Michael Seth Smith, Clinical Associate Professor at the University of Florida Department of Orthopedics and Rehabilitation. “Ultimately, through the continued efforts of family members of athletes who have been affected by exertional heat stroke, like Laurie Giordano of the Zach Martin Memorial Foundation, athletic trainers like Bob Sefcik of the Jacksonville Sports Medicine Program, the Florida Alliance for Sports Medicine, the state of Florida Sports Medicine Advisory Committee, and countless other sports medicine professionals, administrators, and coaches along with the support of KSI, the Zachary Martin Act was signed into law on June 23, 2020. It is a great honor to see HB 7011 approved in the FL legislature, which hopefully ensures that our secondary school athletes can continue to participate in sports in a safer manner than in the past in regard to exertion heat illness, sudden cardiac death, and other sports medicine emergencies. I would encourage other state sports medicine groups, who are interested in policy changes, to explore the quickest way to get policy changes approved but not to be afraid to pivot to different paths if the initial one is obstructing their ability to approve mandatory policy changes to keep our young athletes safer while participating in sports.”

In New Jersey, two bills were signed by Gov. Phil Murphy on January 9, 2020, which mandate the use of accepted best practices in the state. The first requires the use of WBGT to monitor environmental conditions, and the second requires the establishment and implementation of emergency action plans. The KSI and TUFSS team has worked closely with New Jersey high school sports leaders over the last three years assisting in this policy change process.

“Both bills are the Athletic Trainers’ Society of New Jersey’s (ATSNJ) product of many years striving to keep New Jersey’s secondary school student athletes safe,” says David Csillan, MS, LAT, ATC, member of the NJSIAA Sports Medicine Advisory Committee. “S2443 mandates all New Jersey secondary schools to follow the New Jersey State Interscholastic Athletic Association’s (NJSIAA) Heat Participation Policy. The policy utilizes WBGT to access environmental conditions and, if safe, allows for activity to continue with the appropriate modifications of increased water breaks, removal of equipment and decreased intensity of activity. S2494 requires school districts to have an emergency action plan at the ready, should a serious or potentially life-threatening sports-related injury occur. According to the 2018/19 participation data from the National Federation of State High School Associations (NFHS), New Jersey had approximately 280,000 secondary school athletes participating in interscholastic sports and we have a responsibility to keep them safe while under our watch.”

More information about the current review from KSI’s high school sport safety study and details regarding each state’s assessment can be found online here. “



Returning To Training During A Pandemic (ThreeCycleStrength)

Cycle For Strength: Dr. Douglas Casa – Returning To Training Safely During A Pandemic – Episode 10

“The Korey Stringer Institute (KSI), with the help of several other experts in the field of sports medicine and athletic performance, has published a critical document with recommendations on how to return to sports and exercise safely during the current pandemic. In this episode, Dr. Douglas Casa, the CEO at KSI, shares his perspective on this document and the unique challenges COVID-19 presents.”

Cycle For Strength: Episode 10 Link