Heat Stroke Prevention

How do you prevent exertional heat stroke (EHS)?

  • Ensure hydration
    • To ensure hydration, athletes can observe the color of your urine, which should be a light 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.
    • Encourage drinking both water and fluids containing sodium.
      • 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.
    • 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 policies and procedures are consistent with the best practice 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 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

    This page was last modified August 5, 2019