Page 60 - Athletic Health Handbook
P. 60
two hours before exercise to are standard components of
ensure hydration, and allow time commercial sports drinks.
for excretion of excess ingested 5. Clothing should be light-colored
fluid. Another 200–300 ml should and limited to one layer of
be consumed 30 minutes prior absorbent material to facilitate
to exercise. The recommended evaporation of sweat. Sweat-
fluid intake during exercise is saturated garments should be
200–300 ml of cold tap water replaced by dry garments if
or a flavored salted beverage every possible during competition.
20 minutes. An effective method
of monitoring fluid status is to Conclusion
weigh athletes before and after
practice. An athlete who loses With the increasing incidence of heat
more than 3 percent of body stroke, sports medicine physicians
weight during exercise is not need to be prepared to evaluate and
receiving adequate hydration. treat heat stroke victims. Effective
4. The type of fluid replacement is management requires prompt diagno-
dependent on the duration of the sis, which is aided by recognizing risk
event. Plain water is adequate for factors. Once the diagnosis is made,
events lasting less than 1 hour. rapid treatment is needed to stabilize
However, for events longer than the patient while cooling measures are
1 hour, the replacement fluid initiated to lower core body tempera-
should contain carbohydrates, ture. Prompt, effective treatment can
sodium, and potassium, which significantly lower the mortality
from heat stroke.

References

1. Sandor RP. Heat illness. The Physician and Sportsmedicine. 1997. 25:6. 60
2. Wexler RK. Evaluation and treatment of heat-related illnesses. American Family Physician. 2002. 65:11.
3. Sparling PB, Stafford MN. Keeping participants safe in hot weather. The Physician and Sportsmedicine. 1999. 27:7.
4. Hinton MA in DeLee JC, Drez D, Orthopaedic Sports Medicine, Second Edition. Philadelphia, PA: Saunders. 2003.
5. Noakes TD, Mayers LB. A guide to treating Ironman Triathletes at the finish line. The Physician and Sportsmedicine. 2000. 28:8.
6. Bouchama A, Knochel JP. Heat stroke. The New England Journal of Medicine. 2002. 346:25.
7. Convertino VA, Armstrong LE, Coyle EF, et al. American College of Sports Medicine position stand. Exercise and fluid

replacement. Medicine and Science in Sports and Exercise. 1996:28i–vii.
8. Blue JG, Pecci MA. The collapsed athlete. Orthopedic Clinics of North America. 2002. 33:3.
9. Inter-Association Task Force on Exertional Heat Illnesses. Exertional Heat Illnesses Consensus Statement. Available from

http://www.sportsmed.org/downloads/pdf/CS_heatillness.pdf. Last viewed on May 28, 2004.
10. Anderson SJ, et al. Climatic heat stress and the exercising child and adolescent. Pediatrics. 2000. 106:1.

© AMERICAN ORTHOPAEDIC SOCIETY FOR SPORTS MEDICINE, 2008, ALL RIGHTS RESERVED

ON-THE-FIELD MANAGEMENT OF HEAT STROKE
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