Exertional Heat-Stroke Management Practices and Intentions Among Secondary School Football Athletic Trainers

Aliza K Nedimyer; Avinash Chandran; Rebecca M Hirschhorn; William M Adams; Riana R Pryor; Douglas J Casa; Johna K Register-Mihalik; Zachary Y Kerr

doi:10.4085/1062-6050-474-19

Exertional Heat-Stroke Management Practices and Intentions Among Secondary School Football Athletic Trainers

J Athl Train. 2020 Oct 1;55(10):1081-1088. doi: 10.4085/1062-6050-474-19.

Authors

Aliza K Nedimyer^{1

2}, Avinash Chandran^{1

3}, Rebecca M Hirschhorn⁴, William M Adams⁵, Riana R Pryor⁶, Douglas J Casa⁷, Johna K Register-Mihalik¹, Zachary Y Kerr¹

Affiliations

¹ Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.
² Human Movement Science Curriculum, University of North Carolina at Chapel Hill.
³ Datalys Center for Sports Injury Research and Prevention, Inc, Indianapolis, IN.
⁴ Department of Exercise Science, University of South Carolina, Columbia.
⁵ Department of Kinesiology, University of North Carolina at Greensboro.
⁶ Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, State University of New York.
⁷ Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs.

Abstract

Context: Athletic trainers (ATs) are educated and trained in appropriate exertional heat-stroke (EHS) management strategies, yet disparities may exist between intended and actual uses in clinical practice.

Objective: To examine the intended and actual uses of EHS management strategies among those who did and those who did not treat patients with suspected cases of EHS during the 2017 high school (HS) American football preseason.

Design: Cross-sectional study.

Setting: Online questionnaire.

Patients or other participants: A total of 1016 ATs who oversaw patient care during the 2017 HS American football preseason.

Main outcome measure(s): Responding HS ATs recorded whether they had or had not managed patients with suspected EHS events during the 2017 HS American football preseason. Those who had managed patients with suspected cases of EHS reported the management strategies used; those who had not managed such patients described their intended management strategies. For each management strategy, z tests compared the proportions of actual use among ATs who managed patients with suspected EHS with the proportions of intended use among ATs who did not manage such patients.

Results: Overall, 124 (12.2%) ATs treated patients with suspected EHS cases during the 2017 HS American football preseason. Generally, the proportions of intended use of management strategies among ATs who did not treat patients with suspected EHS were higher than the actual use of those strategies among ATs who did. For example, ATs who did treat patients with suspected EHS were more likely than those who did not treat such patients to intend to take rectal temperature (19.6% versus 3.2%, P < .001) and immerse the athlete in ice water (90.1% versus 51.6%, P < .001).

Conclusions: Inconsistencies occurred between intended and actual use of EHS management strategies. The standard of care for managing patients with suspected cases of EHS was not consistently used in clinical practice, although ATs who did not treat EHS stated they intended to use these management strategies more frequently. Future researchers should identify factors that preclude ATs from using the standard of care when treating patients with suspected cases of EHS.

Keywords: emergency care; exertional heat illness; high school sports.

Publication types

Multicenter Study

MeSH terms

Adult
Athletes / statistics & numerical data*
Cross-Sectional Studies
Female
Football / education*
Heat Stroke / prevention & control*
Hot Temperature / adverse effects*
Humans
Intention*
Male
Middle Aged
Schools*
Surveys and Questionnaires