This years excessive heat continues to cause problems across the country. Dr. Douglas Casa from the University of Connecticut states that this last week was "the worst week in the last 35 years in terms of athlete deaths."

The American Academy of Pediatrics (AAP) has reissued and updated policy recommendations associated with adolescent athletes, particularly those participating in outdoor sports in hot humid conditions (http://www.aap.org/advocacy/releases/aug811studies.htm#heatillness). Of particular note, is a change that suggests that children can tolerate and adapt to exercise in heat as well as similarly fit adults when adequate hydration is observed. The previous AAP policy, issued in 2000, indicated that children were less able to tolerate and adapt to heat stress compared to adults, but more recent research has found children and adults have similar physiological responses when exercising under the same conditions.

Regardless of the physiologic capacity it is important that coaches, players, parents, and administrators ensure that common sense measures are taken to avoid unnecessary tragedy.

Among the recommendations:

• Providing risk-reduction training for coaches, trainers and other adults.
• Ensuring trained staff are available on-site to monitor for and promptly treat heat illness.
• Educating children about preparing for the heat to improve safety and reduce the risk for heat illness.
• Allowing athletes to gradually adapt to physical activity in the heat.
• Offering time for and encouraging sufficient fluid intake before, during, and after exercise.
• Modifying activity as needed given the heat and limitations of individual athletes. Practices and games may need to be canceled or rescheduled to cooler times.
• Providing rest periods of at least 2 hours between same-day contests in warm to hot weather.
• Limiting participation of children who have had a recent illness or have other risk factors that would reduce exercise-heat tolerance.
• Encourage athletes to weigh before and after practice. Loss of more than 3% would indicate dehydration, more than 5% indicates that heat related illness has begun.
• Developing and having in place an emergency action plan.

According to Dr. Casa heat stroke is mostly survivable if coaches and players immerse the athlete in cold water (i.e. tub, pool, hose, etc.) Anything that helps get the core body temperature down will reduce the complications. Unfortunately for many this is an afterthought, as most people would call 911 and fail to think of what to do while they wait.

As recent events have shown, quick action can mean the difference between life and death.

Play hard, but play smart.