At the National Athletic Trainers Association (NATA) 65th annual symposia and expo, new guidelines for treating heat related illness were announced and they are causing a stir.
The controversial part of the guidelines: “Cool first, transport second.”
Athletes die every year in the USA from heat stroke. In fact, the National Center for Catastrophic Sports Injury (NCCSI) at the University of North Carolina reports that such deaths have more than doubled since 1975, and that these deaths are 100% preventable. Permanent brain and other organ damage can also result from heat related illness.
Conventional wisdom and practice is to transport victims of heat stroke and other serious medical conditions to the hospital immediately. NATA recommendations are to first treat the athlete on site by getting their core body temperature down to safe levels before sending them to hospital. Even if an ambulance is on site ready to go, they advise to remain on site and get the body temperature down first. The advise is based on observations that the window of time is very short to prevent organ damage or death due to elevated core body temperature.
Their preferred modality for achieving this is cold water immersion.
Doug Casa of the Korey Stringer Institute go so far as describing this change in emergency treatment advice as “a complete paradigm shift in medicine.”
The complete statement and guidelines is expected to be published in the next issue of the Journal of Athletic Training.
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