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Exertional Heat Illnesses (EHI) and Appropriate Hydration

EHI: Types, signs/symptoms, treatment 


 

Exercise-associated muscle cramps (EAMCs)

  • Painful, involuntary muscle contractions during or immediately after exercise
  • Stop activity, hydrate, stretch and massage the affected muscle, return to competition as tolerated

Heat Syncope

  • Inability to continue exercising due to heat stress and cardiovascular insufficiency
  • Remove excess clothing and take to shaded area
  • Cool immediately with wet/cold towels, ice bags to neck/axilla/groin, fans, ice water immersion if needed, begin rehydration

Heat Exhaustion

  • Inability to continue exercising due to heat stress and cardiovascular insufficiency
  • Remove excess clothing and take to shaded area
  • Cool immediately with wet/cold towels, ice bags to neck/axilla/groin, fans, ice water immersion if needed, begin rehydration

Exertional Heat Stroke (EHS)

  • Exercise-induced hyperthermia (core body temp > 104/105˚ F), significant central nervous system dysfunction
  • Typically seen in young athletes/military engaging in strenuous physical activity who can’t dissipate heat production
  • Seen most often in hot and humid environments (July through October)
  • Most commonly occurs in American football players and runners
  • Can be seen in cooler climates during heat wave due to lack of acclimatization
  • May be profusely sweating

Prevention of Exertional Heat Illnesses 


 

  • Ensure Athletic trainers (ATs) are on site during athletic activities
  • Adapt athletes to exercise in heat (acclimatization)
  • Follow appropriate work to rest guidelines
  • Drink when thirsty, drink to keep weight at baseline, drink to keep urine clear/light yellow
  • Avoid hottest/most humid part of the day
  • Follow a well-developed/well-rehearsed emergency action plan if emergency occurs

Pre-Hospital/Transport Care of Exertional Heat Stroke

  • Rapid recognition, rapid assessment, rapid cooling, rapid advanced care
  • Cold water immersion on-site
  • Cool First, Transport Second

Hydration Guidelines

  • Pre-exercise hydration – 350-500 mL 2-3 hours before exercise
  • Hydration during exercise – 200-300 mL every 20 minutes while exercising
  • Post-exercise hydration – replenish lost body fluids, carbohydrates, electrolytes and protein

Schedule an Appointment

352-273-7001

Contact us to schedule an appointment to be evaluated for a sports-related injury with one of our sports medicine providers.

UF Health Sports Medicine Providers

ProviderSpecialty
Kevin Farmer, MDUF Team Physician — Sports Medicine Surgeon
Joshua Reside, MDUF Team Physician — Sports Medicine Surgeon
Ryan Roach, MDUF Team Physician — Sports Medicine Surgeon
Ridhi Sachdev, MDUF Team Physician — Sports Medicine Surgeon
Joshua Altman, MDPrimary Care Sports Medicine
Manuel Britto, MDPrimary Care Sports Medicine
Sarah Chrabaszcz, MDPrimary Care Sports Medicine
Sara Gould, MDPrimary Care Sports Medicine
Ryan Mark, MDPrimary Care Sports Medicine
Alejandro Sanoja, MDPrimary Care Sports Medicine
Nicholas Smith, MDPrimary Care Sports Medicine
David Tran, MDPrimary Care Sports Medicine