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Medicine & Science in Sports & Exercise:
doi: 10.1249/MSS.0b013e3182a11f45
Applied Sciences

Implementing Exertional Heat Illness Prevention Strategies in US High School Football

Kerr, Zachary Y.1,2; Marshall, Stephen W.1,2,3; Comstock, R. Dawn4,5; Casa, Douglas J.6

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Abstract

Purpose: Approximately 6500 high school football athletes are treated annually for exertional heat illness (EHI). In 2009, the National Athletic Trainers Association (NATA)–led Inter-Association Task Force (NATA-IATF) released preseason heat acclimatization guidelines to help athletes become accustomed to environmental factors contributing to EHI. This study examines compliance with NATA-IATF guidelines and related EHI prevention strategies.

Methods: The study used a cross-sectional survey completed by 1142 certified athletic trainers (AT), which captured compliance with 17 NATA-IATF guidelines and EHI prevention strategies in high school football during the 2011 preseason.

Results: On average, AT reported football programs complying with 10.4 NATA-IATF guidelines (SD = 3.2); 29 AT (2.5%) reported compliance with all 17. Guidelines with the lowest compliance were as follows: “Single-practice days consisted of practice no more than three hours in length” (39.7%); and “During days 3–5 of acclimatization, only helmets and shoulder pads should be worn” (39.0%). An average of 7.6 EHI prevention strategies (SD = 2.5) were used. Common EHI prevention strategies were as follows: having ice bags/cooler available (98.5%) and having a policy with written instructions for initiating emergency medical service response (87.8%). Programs in states with mandated guidelines had higher levels of compliance with guidelines and greater prevalence of EHI prevention strategies.

Conclusion: A low proportion of surveyed high school football programs fully complied with all 17 NATA-IATF guidelines. However, many EHI prevention strategies were voluntarily implemented. State-level mandated EHI prevention guidelines may increase compliance with recognized best practices recommendations. Ongoing longitudinal monitoring of compliance is also recommended.

© 2014 American College of Sports Medicine

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