Is it heat stroke or sudden cardiac arrest?

Since many sports begin practicing in the hot summer weather weeks before school begins, it is important that athletes and coaches are aware of your school's PAD program and know how to implement it. While heat stroke is different than sudden cardiac arrest, both require dialing 911, retrieval of the AED and possible CPR. Heat stroke can cause death, particularly if treatment is delayed more than two hours.

Heat illness occurs when the body generates heat faster than it can be expelled and always is associated with dehydration and electrolyte loss. Body temperatures can range from 100 to 106 degrees Fahrenheit. Taken to the extreme, body temperatures can exceed 106 degrees and organ damage can occur. This is often referred to as heat stroke.

Heat stroke causes a change in consciousness, which can result in fainting. Other symptoms of heat illness often are non-specific and difficult to recognize initially. The person may become fatigued, nauseated or light-headed and experience headaches or muscle cramps. He or she may appear flushed and be perspiring profusely or have sweat-drenched clothing. The person may have very warm, dry skin and the inside of the mouth may be dry. As the hyperthermia progresses to heat stroke the victim may exhibit bizarre behaviors, become irritable or have hallucinations. He or she may pass out and experience seizure-like stiffening.

If an athlete is completely unconscious from heat stroke and you do not feel a pulse, it is important to dial 911, begin CPR and request the AED. If the person is not in an abnormal heart rhythm, the AED will not recommend a shock. If the person is awake, an AED is not required, however, activating 911 is still important. For milder heat exhaustion without mental status changes, the person should be removed immediately from the warm environment, have their temperature taken and their pulse checked. If either pulse or temperature is abnormal, quick medical attention is important. Under no circumstances should a person experiencing heat exhaustion be allowed to resume vigorous physical activities that same day. A physician should be consulted if there are signs of dark urine or blood in the urine later in the day.

Several things contribute to heat illness other than hot summer weather and dehydration. These include high humidity, lack of air conditioning, high ultraviolet sun exposure for long periods and the duration of exposure and intensity of physical exertion. Personal factors also can contribute such as taking certain medications and having or recovering from illness.

Fainting spells can occur under much different circumstances than heat exhaustion, and most children recover quickly from unconsciousness. However, the person still requires medical attention, and the athlete should not return to the sporting event without physician clearance.

For more information about Project ADAM, call (414) 266-3889 or e-mail projectadam@chw.org.