GHSA Heat Guidelines. Jeff Hopp, ATC, LAT Head Athletic Trainer, Marietta High School May 30, 2013

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GHSA Heat Guidelines Jeff Hopp, ATC, LAT Head Athletic Trainer, Marietta High School May 30, 2013

Exertional Heat Illnesses Heat Cramps muscle cramping, fatigued, sweating Heat Syncope pale, lightheaded, dizzy, slow pulse, fainting, sweating Heat Exhaustion lightheaded, dizzy, headache, nausea, muscle cramps, chills, abdominal cramping, sweating Exertional Heat Stroke elevated core temp > 104 0 F, dizziness, drowsy, irrational behavior, disorientation, seizures, loss of consciousness, rapid pulse, vomiting, not sweating Exertional Hyponatremia (extremely rare) elevated core temp > 104 0 F, low sodium levels in the blood, lethargic, seizures, nausea, vomiting, muscle cramping, confusion

Background to GHSA Heat Guidelines 3 year UGA heat study (2009, 2010, 2011) 25 high schools across Georgia Data collected by Certified Athletic Trainers daily Monitor heat and record all Exertional Heat Illnesses (EHI) EHI s: Heat Stroke, Heat Exhaustion, Heat Syncope, Cramps Record type of practice and equipment worn EHI Summit at UGA January 26-27, 2012 UGA, Korey Stringer Institute, GATA, GHSA, and various other experts in heat GHSA voted to approve new guidelines on March 19, 2012 UGA is continuing the study through 2014 EHI Summit at UGA January 29, 2013

Findings from the UGA study Highest rate of EHI s during the first week, especially the first 3 days Injury rate increased in the 87-90 WBGT range EHI s happened earlier in practice during acclimatization stage (Week 1 2 hours, Week 2 2.5 hours) Injury rates were essentially the same no matter what time of the day Full acclimatization occurs in 10 14 days

There is no ONE Answer! Environment Acclimatization Previous History of EHI Time of Day Fitness Level EHI Nutrition Duration of Practice Equipment Worn Intensity of Practice Session Number of Sessions in a day Number and duration of rest breaks in a session Previous days practice session

Heat Index Developed to measure indoor conditions Lots of assumptions Shade 5 7, 147 lbs Long pants and short sleeve shirt Walking at 3 mph (not for activity) Not representative of football practice conditions!

Wet Bulb Globe Temperature WBGT = 0.7 WB + 0.2 GT + 0.1 DB Wet Bulb Temperature how effectively evaporation can lower temperatures Black Globe Temperature Solar Heat (sunny vs. cloudy day) Dry Bulb Temperature - ambient air temperature

GHSA Practice Policy for Heat and Humidity 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 Under 82.0 Activity Guidelines & Rest Break Guidelines Normal activities Provide at least three separate rest breaks each hour of minimum duration 3 minutes each during workout. 82.0 86.9 87.0 89.9 90.0 92.0 Over 92.0 Use discretion for intense or prolonged exercise; watch at-risk 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 s and shoulder pads/shorts or no shoulder pads/full pants 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. No outdoor workouts; Cancel exercise; delay practices until a cooler WBGT reading occurs.

GHSA Practice Policy for Heat and Humidity (cont) 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 coach-supervised, school-approved sport or conditioning-related activity. Practices are timed from the time the players report to the field until they leave. Weight training is included in practice time 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 $500.00 and a maximum of $1,000.00.

GHSA Football Practice Guidelines Football practice may begin five consecutive weekdays prior to August 1st (July 25th). 1. In the first five days of practice for any student, the practice shall not last longer than 2 hours, and the student shall not wear more than shorts, helmet, mouthpiece, and shoes. (NOTE: The time for a session shall be measured from the time the players report to the field until they leave the field.) 2. Beginning August 1st, any student may practice in full pads and may practice two times in single calendar day under the following stipulations: a. A student must have participated in five conditioning practices wearing shorts and helmet before being allowed to practice in full pads b. If multiple workouts are held in a single day: i. No single session may last longer than 3 hours ii. The total amount of time in the two practices shall not exceed 5 hours. iii. There must be at least a 3-hour time of rest between sessions iv. There may not be consecutive days of two-a-day practices. All double session days must be followed by a single-session day or a day off. c. These procedures are derived from recommendations created by the Inter- Association Task Force for Preseason Secondary School Athletics Participants in the research paper Preseason Heat-Acclimatization Guidelines for Secondary School Athletics.

What do you need? WBGT device Record your readings Over 86 WBGT Ice Tubs Rest Time Cooling Zone Ice Towels/Sponges Spray bottles/misters with ice water Not in direct sunlight

Questions Jeff Hopp, ATC, LAT Office - 770-428-2631 ext 2508 Cell - 404-788-7888 Email jhopp@marietta-city.k12.ga.us