Constantly provide cold water and schedule frequent rest periods where students are encouraged to drink 2-3 glasses of water.
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1 HEAT RELATED GUIDLELINES- All PE teachers, athletic directors, and physical education teachers should be give a hard copy for quick reference. (ifolder) Our heat guidelines are designed to protect students from incurring heat related illnesses or problems. This is a guide for personnel to use and refer to when making decisions or modifying and/or suspending outdoor activities. The best defense against heat-related conditions is Prevention. On an annual basis the staff will train on precautions to take to ensure student safety during high heat. Staff focus will be on "constant surveillance" of students during high heat to ensure student health. Should symptoms arise, they will be addressed immediately by using Quick Care guidelines and Basic First Aid as needed. The following guidelines are to be used as appropriate to ensure student safety during high heat. Implementation may vary depending on the activity. Quick Care Guidelines for Staff Reduce the intensity and duration of physical activity initially and gradually increase exposure to allow students to grow accustomed to heat levels. Fully hydrate students prior to strenuous physical activity. Avoid caffeine, alcohol and high sugar, carbonated drinks. Constantly provide cold water and schedule frequent rest periods where students are encouraged to drink 2-3 glasses of water. Plan strenuous outdoor activity for early morning or late in the day. Be aware of student s chronic health issues and medications of students Heighten surveillance of students with special needs. Be aware of students with certain conditions that are at a greater risk to heat stress. Included in these (but not limited to) are: cystic fibrosis, vomiting, diarrhea, fever, obesity, diabetes, chronic heart failure, caloric malnutrition, anorexia nervosa, sweating insufficiency syndrome. Check to see if student's medication has specific precautions regarding heat, sunlight, etc. Use a "buddy system" where students are educated regarding symptoms and monitor each other.
2 Implement extra precautions when playing on concrete or asphalt. Provide water on long, non-air-conditioned bus trips or encourage students to bring their own. Decrease the intensity of activities that last 30 minutes or more whenever relative humidity and air temperature (Heat Index) are above critical levels (HI of 90 or above). The higher the humidity, the more dangerous high air temperature is because of decreased evaporation of body sweat. Note that full sun exposure can increase the Heat Index by as much as 15 degrees F. Check the Heat Index at or an approved measuring device. Student Guidelines Inform your teacher/instructor of any medications recently taken. Wear lightweight, loose, cool, reflective clothing. Wear hats or sun visors when participating in direct sun. Wear sun glasses or protective eyewear. Avoid caffeine and high-sugar, carbonated drinks. Bring water to drink throughout activity. Inform instructor if recently ill. Avoid eating heavy, protein-rich foods prior to exercise. Basic First Aid Guidelines Remove from the heat to a cool shaded area. Provide cold water/electrolyte drinks to replenish body fluids. Remove excessive clothing (shoulder pads, shoes, long socks, etc.) Place ice packs or ice towels on the following areas to cool the student s body core temperature: Neck Arm Pits Sides Abdomen Groin
3 IN case of heat exhaustion, submerge the student in an ice bath until EMS arrives. CALL 911 anytime during heightened heat exhaustion. There are four main heat-related reactions to excess heat: Heat syncope - fainting or near fainting due to overheating; pale, cool, moist skin. Heat cramps - muscle cramps occurring during intense, prolonged activity in the heat. Heat exhaustion - body temperature of ; paleness, dizziness, disorientation, nausea, cramps. Heat stroke - body temperature of ; disorientation, seizures, hot and dry skin, coma. Guidelines for Student Athletic Activities (to include recess) The following guidelines and procedures have been adopted by Jackson County Public Schools regarding practices and competitions conducted during times of extremely high heat and/or humidity. These guidelines have been established to carry out and support the practice and policies for heat and humidity set by the Georgia High School Athletics Association: 1. BY-LAW 2.67 Practice Policy for Heat and Humidity Schools must follow the statewide policy for conducting practices and voluntary conditioning workouts in all sports during times of extremely high heat and/or humidity that will be signed by each head coach at the beginning of each season and distributed to all players and their parents or guardians. The policy shall follow modified guidelines of the American College of Sports Medicine in regard to: 1. The scheduling of practices at various heat/humidity levels 2. The ratio of workout time to time allotted for rest and hydration at various heat/humidity levels 3. The heat/humidity level that will result in practice being terminated A scientifically approved instrument that measures Wet Bulb Globe Temperature (WBGT) reading must be utilized at each practice to ensure that the written policy is being followed properly. WBGT READING ACTIVITY GUIDELINES & REST BREAK GUIDELINES UNDER 82.0 Normal activities --Provide at least three separate rest breaks each hour of minimum duration of 3 minutes each during workout Use discretion for intense or prolonged exercise; watch at-risk
4 players carefully; Provide at least three separate rest breaks each hour of a minimum of four minutes duration each Maximum practice time is two hours. For Football: players restricted to helmet, shoulder pads, and shorts during practice. All protective equipment must be removed for conditioning activities. For all sports: Provide at least four separate rest breaks each hour of a minimum of four minutes each Maximum length of practice is one hour, no protective equipment may be worn during practice and there may be no conditioning activities. There must be 20 minutes of rest breaks provided during the hour of practice. OVER 92 No outdoor workouts; Cancel exercise; delay practices until a cooler WBGT reading occurs GUIDELINES FOR HYDRATION AND REST BREAKS 1. Rest time should involve both unlimited hydration intake (water or electrolyte drinks) and rest without any activity involved 2. For football, helmets should be removed during rest time 3. The site of the rest time should be a cooling zone and not in direct sunlight. 4. When the WBGT reading is over 86: a. ice towels and spray bottles filled with ice water should be available at the cooling zone to aid the cooling process. b. Cold immersion tubs must be available for practices for the benefit of any player showing early signs of heat illness. DEFINITIONS 1. PRACTICE: the period of time that a participant engages in a coachsupervised, school-approved sport or conditioning-related activity. Practices are timed from the time the players report to the field until they leave. 2. WALK THROUGH: this period of time shall last no more than one hour, is not considered to be a part of the practice time regulation, and may not involve conditioning or weight-room activities. Players may not wear protective equipment. PENALTIES: Schools violating the heat policy shall be fined a minimum of $ and a maximum of $1, Jackson County Guidelines: 1. All sports: All sports that condition, practice or play in conditions of high heat/humidity must monitor and follow these guidelines as prescribed by GHSA.
5 Football Only: When conditions warrant football is required to measure and document the Wet Bulb Globe Temperature prior to practice and at 30 minute intervals throughout practice. This should be done by s responsible party: The certified athletic trainer will be responsible for recording this reading and keeping these records on file. They will report to the Athletic Director. In event the recording cannot be taken by the certified athletic trainer, the school athletic administrator or football coach will take and record the reading. These records are to be kept on file. 2. During summer and early fall and late spring, high temperatures and high humidity are present. If extreme heat/ humidity is present practices and games should be held early in the morning to avoid times when environmental conditions are generally more severe. 3. An unlimited supply of cold water shall be available to participants during practices and games. a. Coaches/Supervisors shall inform all students participating that cold water is always available or accessible and they will be given permission anytime he/she asks for water. It is also recommended that coaches constantly teach our students about proper hydration throughout each day. b. Hydration and fluid replacement is a daily process. Students should hydrate themselves before, during, and after practice. Meals should include an appropriate amount of fluid intake in addition to a healthy diet. c. It is important that student-athletes be allowed to carry water with them during the day and hydrate themselves, especially on days of practice and games, while the weather has the possibility of reaching critical levels in relation to the heat and humidity. 4. Give adequate rest periods. Remove appropriate equipment or clothing when possible. Exposed skin cools more efficiently. a. Football players shall be allowed to remove helmets. b. Shoulder pads should be removed if conditions warrant. 5. For football and other sports when warranted the athletes should weigh in before practice and weigh out to monitor water loss to identify those who may become dehydrated. 6. Participants should wear clothes that are light in weight and color. 7. Students who need careful monitoring include: a. Overweight students b. Weight control problems (fluctuation) c. Those taking over-the-counter and prescription medication d. Students who have done absolutely no exercise at all 8. Be familiar with all heat related symptoms and corresponding treatments. 9. Be familiar with any emergency and 911 procedures. 10. Be familiar with the WBGT Chart and utilize guidelines determining length of practice and rest. 11. Any directives from the Central Office must be strictly followed.
6 Treatment Strategies for Exertional Heat Illnesses: ( As recommended by the National Athletic Trainers Association, July 2006 ) DEHYDRATION When athletes do not replenish lost fluids, they become dehydrated. Dry mouth Thirst Being irritable or cranky Headache Seeming bored or disinterested Dizziness Cramps Excessive fatigue Not able to run as fast or play as well as usual Treatment: Move athlete to a cool environment and rehydrate. Maintain normal hydration (as indicated by baseline body weight). Begin exercise sessions properly hydrated. Any fluid deficits should be replaced within 1 to 2 hours after exercise is complete. Hydrate with a sports drink like Gatorade, which contains carbohydrates and electrolytes (sodium and potassium) before and during exercise is optimal to replace losses and provide energy. Hydrate throughout sports practice to minimize dehydration and maximize performance. Seek medical attention to replace fluids via an intravenous line if athlete is nauseated or vomiting. If degree of dehydration is minor and the athlete is symptom free, continued participation is acceptable EXERTIONAL HEAT STROKE A severe illness characterized by central nervous system (CNS) abnormalities and potentially tissue damage resulting from elevated body temperatures induced by strenuous physical exercise and increased environmental heat stress. Increase in core body temperature, usually above 104 F/40 C (rectal temperature) when athlete falls ill Central nervous system dysfunction, such as altered consciousness, seizures, confusion, emotional instability, irrational behavior or decreased mental acuity Nausea, vomiting or diarrhea Headache, dizziness or weakness Hot and wet or dry skin
7 Increased heart rate, decreased blood pressure or fast breathing Dehydration Combativeness Treatment Aggressive and immediate whole-body cooling is the key to optimizing treatment. The duration and degree of hyperthermia may determine adverse outcomes. If untreated, hyperthermia-induced physiological changes resulting in fatal consequences may occur within vital organ systems (muscle, heart, brain, etc.). Due to superior cooling rates, immediate whole-body cooling (cold water immersion), is the best treatment for EHS and should be initiated within minutes post-incident. It is recommended to cool first and transport second if onsite rapid cooling and adequate medical supervision are available. The athlete s physician should devise a careful return-to-play strategy that can be implemented with the assistance of a qualified health care professional. HEAT EXHAUSTION Heat exhaustion is a moderate illness characterized by the inability to sustain adequate cardiac output, resulting from strenuous physical exercise and environmental heat stress. Athlete finds it hard or impossible to keep playing Loss of coordination, dizziness or fainting Dehydration Profuse sweating or pale skin Headache, nausea, vomiting or diarrhea Stomach/intestinal cramps or persistent muscle cramps Treatment: Remove athlete from play and immediately move to shaded or air-conditioned area. Remove excess clothing and equipment. Cool athlete until rectal temperature is approximately 101 F (38.3 C) Have athlete lie comfortably with legs propped above heart level. If athlete is not nauseated, vomiting or experiencing any CNS dysfunction, rehydrate orally with chilled water or sports drink. If athlete is unable to take oral fluids, implement intravenous infusion of normal saline. Monitor heart rate, blood pressure, respiratory rate, core temperature and CNS status. Transport to an emergency facility if rapid improvement is not noted with prescribed treatment. Athlete should be symptom free and fully hydrated; recommend physician clearance; rule out underlying condition that predisposed him/her for continue problems; and avoid intense practice in heat until at least the next day. HEAT CRAMPS Muscle cramps are not well understood. Heat cramps are often present in athletes who perform strenuous exercise in the heat. Conversely, cramps also occur in the absence of warm or hot conditions, which is common in ice hockey players. Intense pain (not associated with pulling or straining a muscle)
8 Persistent muscle contractions that continue during and after exercise Treatment: Reestablish normal hydration status and replace some sodium losses with a sports drink or water Some additional sodium may be needed (especially in those with a history of heat cramps) earlier in the activity. Light stretching, relaxation and massage of the involved muscle may help acute pain of a muscle cramp. Athletes should be assessed to determine if they can perform at the level needed for successful participation. EXERTIONAL HYPONATREMIA When an athlete s blood sodium levels decrease, either due to overhydration or inadequate sodium intake, or both, medical complications can result in cerebral and/or pulmonary edema. This tends to occur during warm/hot weather activities. Hyponatremia may be completely avoided if fluid consumption during activity does not exceed fluid losses. Excessive fluid consumption before, during and after exercising (weight gain during activity) Increasing headache Nausea, vomiting (often repetitive) Swelling of extremities (hands and feet) Treatment: If blood sodium levels cannot be determined onsite, hold off on rehydrating athlete (may worsen condition) and transport immediately to a medical facility. The delivery of sodium, certain diuretics or intravenous solutions may be necessary. All will be monitored in the emergency department to ensure no complications develop. Physician clearance is strongly recommended in all cases. It is recommended that all guidelines be followed in such a way that the safety and best interests of our students be made our number one priority.
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