I. Purpose of policy:

This policy describes the best practice procedures for the prevention, monitoring, and when necessary, the treatment of exertional heat illnesses for students/athletes, faculty, and staff of the School District. This policy applies to all staff members, including but not limited to athletic trainers, physicians, athletic administrators, coaches, strength and conditioning staff, and school administrators who are associated with activities where heat illness poses a risk, including but not limited to, outdoor and indoor activities where high temperature and specifically, high humidity environmental risks are present (e.g., athletics, intramurals, course instruction, marching band). Exertional heat illness includes exercise-associated muscle cramps, heat syncope, heat exhaustion, and exertional heat stroke (EHS)). Current best practice guidelines suggest that the risk of exertional heat injuries can be minimized with heat acclimatization and diligent attention to monitoring individuals participating in activities that place them at a higher risk for these types of injuries. In the event an athlete sustains a heat illness, immediate and proper treatment is necessary.

II. Definitions:

A. Acclimatization – The process of gradually increasing the intensity of activity in a progressive manner that improves the body’s ability to adapt to and tolerate exercise in the heat. The acclimatization period is defined as the first 14 calendar days of a student-athletes’ participation, beginning with the first allowable date of practice in the sport of the first day an athlete begins official practice, whichever is later.

B. Wet Bulb Globe Temperature – The WBGT is a measurement tool that uses ambient temperature, relative humidity, wind, and solar radiation from the sun to get a comprehensive measure that can be used to monitor environmental conditions during exercise. WBGT is different than heat index, as it is a more comprehensive measurement of environmental heat stress on the body.

C. Non-Practice Activities – Activities that include meetings, injury treatment, and film study.

D. Practice – The period of time that a student-athlete engages in coach- supervised, school approved sport or conditioning related-activity. Practice time includes from the time the players report to the field until they leave.

E. Walk Through – A period of time where players are reviewing positional strategy and rehearsing plays. Players do not experience contact and thus they do not wear equipment and the intensity of the activity is minimal often involving walking. This period of time shall last no more than one hour. It is not considered part of the practice time regulation. It may not involve conditioning or weight room activities. Players may not wear protective equipment during the walk through.

F. Recovery Time – This period of time is defined as non-activity time outside of practices or games. NO ACTIVITY, including non-practice activity, can occur during this time. When it is possible, proper recovery should occur in an air- conditioned facility for a minimum of 3 hours in duration.

G. Rest Breaks – This period of time occurs during practice and is a non-activity time that is in a ‘cool zone’ out of direct sunlight.

H. Exertional Heat Stroke (EHS)– Defined as having a rectal temperature over 104∞F-105∞F (40.5∞C), and central nervous system dysfunction (e.g. irrational behavior, confusion, irritability, emotional instability, altered consciousness, collapse, coma, dizzy, etc.).

I. Cooling Zone- An area out of direct sunlight with adequate air flow to assist in cooling. A cold-water or ice tub and ice towels should be available to immerse or soak a patient with suspected heat illness This may be outdoors or indoors depending on proximity to field.

J. Qualified Health Care Professional (QHP) - As defined by the American Medical Association (AMA), “is an individual who is qualified by education, training, licensure/regulation (when applicable), and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service.”

K. Hypohydration- (reduced hydration status) is a deficit of body water that is caused by acute or chronic dehydration.

L. Central Nervous System dysfunction- includes any sign or symptom that the central nervous system is not working properly, including: dizziness, drowsiness, irrational behavior, confusion, irritability, emotional instability, hysteria, apathy, aggressiveness, delirium, disorientation, staggering, seizures, loss of consciousness, coma, etc.

III. Monitoring Heat Stress - Schools must monitor heat stress. Heat stress is determined by measuring the ambient temperature, humidity, wind speed, sun angle and cloud cover at the site of the athletic activity. School are required to follow and adhere to the guidelines set forth by the FHSAA for heat stress readings.

A. A pre-participation history and physical exam is required. Individuals with risk factors will be identified and counseled on heat illness.

B. The athletic trainer or persons responsible will be notified of individuals with pre-existing conditions that place the individual at risk of exertional illness.

C. Coaches will be notified of individuals at higher risk as needed.

IV. Each athletic coach involving outdoor practices or events shall annually complete training in exertional heat illness identification, prevention, and response, including the effective administration of cooling zones.

V. Environmental Monitoring and Activity modification/Cancellation

A. Environmental monitoring will occur utilizing a WBGT device (insert school device here)

B. Environmental monitoring will occur any time it is warm outside (i.e. over 70°F)

C. Environmental monitoring and activity modifications may be necessary for certain types of indoor facilities.

D. Monitoring of WBGT will occur every 30 minutes beginning at the scheduled practice time.

E. All environmental monitoring will be recorded and stored either hard copy or electronically.

F. Modifications will be made in accordance with the best practice guidelines for our region. The School District is in the southern region and will follow the guidelines based on the Florida High School Athletic Association policy.

VI. Acclimatization protocols apply to all sports. Days 1 through 5 of the heat acclimatization period consists of the first 5 days of formal practice. During this time, athletes may not participate in more than one (1) practice per day. If a practice is interrupted by inclement weather or heat restrictions, the practice will recommence once conditions are deemed safe. Total practice time will not exceed 3 hours in a single day. A 1-hour maximum walk-through is permitted during days 1-5 of the heat acclimatization period. A 1-hour recovery period will take place between the practice and walk-through (or vice versa).

VII. Student-athletes who participate in activities that last for an extended amount of time or multiple activities in a day should be provided electrolytes to assist in rehydration. Rest breaks must involve unlimited hydration intake and rest without any activity involved.

VIII. Coaches are required to adopt a heat injury prevention philosophy by promoting unrestricted access to water at all times. A student-athlete should never be denied access to water.

IX. The school’s emergency action plan must include a procedure for onsite cooling using cold-water immersion or equivalent means before a student-athlete is transported to a hospital for exertional heatstroke.

X. Cooling zones must be available for each outdoor athletic contest, practice, workout, or conditioning session. Cooling zones must include the immediate availability of cold-water immersion tubs or equivalent and may also include ice sponges and towels or tarps that can be filled with ice and wrapped around individuals to rapidly cool internal body temperature. An employee or volunteer trained to administer cold-water immersion must be present.

©NEFEC
New: 07/27/20