Exertional Heat Illness

 

Practice or competition in hot and/or humid conditions presents particular problems for athletes. In these situations, heat illness as a result of heat stress, is a major concern of the sports medicine staff. Education and consistent monitoring are necessary to prevent heat-related problems. Death from heat illness is rare but certainly possible. The following guidelines should be followed:

 

1. A complete medical history, including past history of heat illness, should be obtained prior to practice/competition.

2. Acclimatization over a period of 1-2 weeks should be encouraged. Athletes need this time to gradually increase aerobic activity and give their body an opportunity to acclimatize. The term acclimatization is not simply referring to an athlete “getting used to” practice/competition in hot/humid conditions. Acclimatization refers to the actual physiologic changes that occur within the human body to accommodate increasing levels of activity and hot/humid conditions. Acclimatization also occurs during changes in altitude. Each exposure should reflect a gradual increase in duration and intensity of activity over the 1-2 weeks until an exposure is approximately equal to the expected time of a practice/competition.

3. When heat & humidity conditions are extreme, consider moving practice/competition to another time of day that is cooler.

4. Heavy clothing, protective equipment, pads, and helmets impede upon the body’s cooling mechanism by restricting methods of heat loss and sweating. Therefore, this equipment should be avoided, when possible, during times of extreme heat/humidity. Frequent rest periods are encouraged for the purpose of loosening equipment/clothing and allowing heat loss. Dark colored clothing should be avoided because it absorbs more solar energy than lighter colored clothing.

5. Athletes should be encouraged to avoid substances that contain diuretics and/or stimulants.

6. The following conditions should be taken into consideration as they make an athlete more susceptible to heat illness: inadequate aerobic fitness, a history of heat illness, inadequate re-hydration, heart conditions, excess body fat, and inadequate acclimatization.

7. At all times during practice, training, competition, and especially during acclimatization; hydration should be maintained and encouraged.

8. The following are signs and symptoms of heat illness: weakness, cramping, excessive sweating, fatigue, rapid and/or weak pulse, flushed or pale skin, nausea, lack of coordination/balance, incoherency, and cessation of sweating. Any problems should be immediately reported to the Certified Athletic Trainer.

9. The athletic training staff and coaching staff are responsible for monitoring environmental conditions for possible heat/humidity extremes. Measurements should be taken to assess the likelihood of extreme conditions. These measurements include: wet bulb temperature and dry-bulb temperature to find relative humidity. Final decisions on the postponement or cancellation of a practice/competition will be made by the on-site Athletic Trainer.

 

Heat Cramps

 

Definition: Heat cramps are caused by sweating a lot during strenuous activity. This sweating depletes the body's salt and moisture. The low salt level in the muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion.

Signs and Symptoms: • Abdominal Cramps • Muscle Spasms • Leg Cramps First Aid:

1. Move victim to a cool location

2. Give victim water slowly, 1/2 a glass of water every 15 minutes, over next 30 minutes to an hour

 

Heat Exhaustion

 

Definition: Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids. Heat exhaustion is caused by fluid loss which, in turn, causes blood flow to decrease to vital organs, resulting in a form of shock. As a result of dehydration, victims often complain of flu-like symptoms hours after exposure.

Signs and Symptoms: • Cool, Moist, Pale Skin • Headache • Dizziness and/or Weakness • Nausea • Skin may feel warm • Excessive Sweating

First Aid:

1. Call 911

2. Move victim to a cool location

3. Give victim water slowly, 1/2 a glass of water every 15 minutes

4. Do not give liquids with alcohol or caffeine in them, as they may make the condition worse

5. Loosen or remove tight or bulky clothing

6. Apply cool, wet towels

 

Heat Stroke

 

Definition: Heat stroke occurs when the body's heat regulating mechanisms fail. Body temperature rises so high that brain damage and death may result unless the body is cooled quickly

Signs and Symptoms: • Skin may be hot, red and dry • Weak, rapid pulse • Rapid, shallow breathing • Vomiting • Decreased level of consciousness

First Aid:

1. Call 911 - Heat Stroke is a life-threatening condition

2. Move victim to a cool location

3. Place victim in a cool tub of water and/or apply wet rags, towels or sheets

4. Use ice packs if available in the armpits, neck, wrists, and ankles to cool the major blood vessels

5. Do not give any fluid by mouth

• Immediately ensure classroom doors are locked and barricade interior classroom doors.
• All persons move out of sight in locked rooms. Turn off lights if visibility is possible from interior windows and doors.
• Remain silent and place all phones in silent mode.
• School officials should also get into lockdown position.

Tornado Watch and Warning

 

Sheltering during a storm if inside a building

• Go to the basement or to an inside hallway at the lowest level of the building.
• Take your personal belongings if time permits (laptops, purses, book bags, etc.).
• Secure your work computer if time permits (log off and shut down to minimize damage and potential loss of data).
• Lock offices and secure sensitive or confidential items (grade books, financial records, etc.) if time permits.
• Avoid places with wide-span roofs such as auditoriums, theater-style rooms, cafeterias, large hallways, or gymnasiums.
• Stay away from exterior windows and doors as well as display cases, shelving or wall-mounted audio-visual equipment that could collapse on top of you.
• Get under a piece of sturdy furniture (if available) such as a workbench, heavy table, or desk, and hold on to it.
• Use your arms to protect your head and neck.

 

Sheltering during a storm, if outdoors, in a vehicle, or on a school bus

• Get inside a building, if possible.
• Follow the instructions of your bus driver if you are riding on a school bus.
• Lie in a low-lying area, or crouch near a strong building if shelter is not available or if there is no time to get indoors.
• Be aware of the potential for flash flooding.
• Use your arms to protect your head and neck.

 

Post-storm suggestions

• Help injured, trapped, or people with disabilities or special needs.
• Give first aid when appropriate. Do not try to move the seriously injured unless they are in immediate danger of further injury. Call APSPD dispatch at (404) 802-2000 for help.
• Watch out for downed power lines and other damaged utilities when evacuating.
• Turn on a radio or television to get the latest emergency information.
• Stay out of damaged buildings. Return only when public safety officials deem the building(s) to be safe.
• Use telephones for emergency calls only after severe weather.
• Avoid spilled medicines, bleaches, gasoline or other flammable liquids. Do not attempt to clean up spills without proper equipment.
• Leave the buildings if you smell gas or chemical fumes and notify APSPD dispatch at (404) 802-2000.

 

Winter Storm

• The major dangers of winter storms are intense cold, power outages and breakdown of transportation because of poor visibility and road conditions.
• One of three announcements will be made:
  
  • “Atlanta Public Schools are open and operating on a regular schedule”
  • “Atlanta Public Schools are closed”
  • “Atlanta Public Schools will delay opening or specific events until a specific time”

Announcements will be distributed in the following ways:

• Posting to the Atlanta Public Schools district home page
• Announcement through local media
• District Emergency Mass Notification System

• If There Is a Fire or Visible Smoke:
• Notify the occupants of the school or building, by pulling the nearest fire alarm (pull station) and from a safe distance outside the building, call the APSPD at (404) 802-2000 or 911 to provide details of the situation.
• If you have been trained in the use of a portable fire extinguisher and are able to safely extinguish the fire, do so. Be sure you have a safe exit from the area and leave if the extinguisher does not put out the fire.
• Evacuate the building as soon as the alarm sounds.
• On your way out, warn others nearby.
• Move away from fire and smoke. Close doors and windows if time permits.
• Feel closed doors with the top-side/back of your hand to feel for heat. Do not open doors if you feel heat.
• Use stairs only. Do not use elevators.
• Move a minimum of 300 feet away from the building.
• Do not re-enter the building or work area until you have been instructed to do so by the emergency responders.

• Stay calm. Do not rush and do not panic.
• Stop your work or teaching.
• Gather your personal belongings if it is safe to do so. (Reminder: take prescription medication with you if possible. It may be hours before you are allowed back into the building.)
• If safe, close your office door and window, but do not lock them.
• Use the nearest safe stairs and proceed to the nearest exit. Do not use the elevator.
• Follow instructions from emergency responders.
• Do not re-enter the building until you have been instructed to do so by the emergency responders.
• Move to the established assembly area and ensure accountability of building personnel is conducted in a timely manner.
• Report any known or suspected missing persons.

• Building occupants should be invited to volunteer ahead of time to assist people with disabilities in an emergency. If a volunteer is not available, designate someone to help.
• DO NOT evacuate people with disabilities in their wheelchairs.
• Always ASK someone with a disability how you can help BEFORE attempting any rescue technique or giving assistance. Ask how they can best be helped or moved, and whether there are any special considerations or items that need to come with them.
• If someone cannot evacuate, the individual(s) should wait in the stairwell and notate the floor and which stairwell.  Then give this information to the responding agencies.
• If the situation is life-threatening, call APSPD at (404) 802-2000.

• Report utility failures during regular school hours (Monday – Friday 8 a.m. – 5 p.m.) to Facilities
• Report data network and telephone system interruptions to the district IT department.
• Report utility failures after regular work hours, on weekends, and on holidays to the APSPD dispatch (404) 802-2000.

 

Gas Leaks (Indoor):

• Evacuate the area immediately.
• Call Facilities at (404) 802-3700 and APSPD dispatch (404) 802-2000 to report the problem.
• Do not switch on lights or any other electrical equipment. Do not smoke in the area.
• Account for all building personnel once outside and wait for further instructions from the police and/or the Atlanta Fire Rescue Department.

 

Gas Leaks (Outdoor):

• Evacuate the area immediately.
• Do not attempt to shut off gas or manipulate valves.
• Call Facilities at (404) 802-3700 and APSPD dispatch at (404) 802-2000 to report the problem.
• Prevent vehicular traffic and pedestrians from entering the area until the police arrive to set up a perimeter.
• Do not smoke in the area or move any vehicles that are parked near the broken gas line.
• Follow the instructions of APSPD and the Atlanta Fire Rescue Department.

 

Power Outage:

• Report the outage to Facilities (404) 802-3700 and APSPD dispatch at (404) 802-2000.
• Help co-workers in darkened areas move to safer locations.
• Secure experimental work and keep refrigerators and freezers closed.
• Unplug personal computers, appliances and non-essential electrical equipment.
• Open windows for additional light and ventilation.

If you witness a hazardous material spill, evacuate the spill site and warn others to stay away. Call APSPD at (404) 802-2000 if you believe the spill may be life-threatening. If you can determine the spill is not life-threatening, follow the procedures outlined below.

If You Spill Hazardous Material(s):

1. Leave the area of the spill first and proceed to a safe location nearby. Then assess if you have the proper training and protective gear to clean up the spill.
2. If you are able to clean up the spill, follow proper cleanup procedures and use proper personal protection. Manage the generated waste as appropriate. Consult your supervisor if necessary.
3. Isolate the spill area to keep everyone away, and post signs as necessary.
4. Call APSPD dispatch at (404) 802-2000.

If you suspect or witness a release of a hazardous material to the environment (air, water, ground), call APSPD dispatch at (404) 802-2000.  APSPD will contact Atlanta Fire Rescue. Appropriate agencies will be notified if the situation cannot be handled with internal capabilities or if the situation poses a threat to life safety.

• Take cover immediately.
• Direct others to get under a desk, chair or table for shelter.
• Seek shelter between seating rows in a lecture hall or against a corridor wall if in a hallway.
• If outside, move to an open area, away from buildings.
• Report injuries to Atlanta Public Schools Police at (404) 802-2000.
• Examine your area for damage and report damages to APS Facilities at (404) 802-3700.
• Be alert for aftershocks. Do not use elevators and evacuate in a calm and orderly manner.
• Await instructions from first responders and do not re-enter buildings until they are examined by trained officials