Lightning is the most consistent and significant weather hazard that athletes encounter. According to the National Severe Storms Laboratory (NSSL), there are approximately 100 fatalities and between 400 and 500 injuries resulting from lightning strikes each year in the United States. Even though the probability of being struck is extremely low, the danger increases when a storm is in the area and proper safety precautions are not followed.
The National Collegiate Athletic Association (NCAA) has developed guidelines for lightning safety. The following Connecticut College procedures are based on those guidelines, and should be followed whenever there is a risk of lightning.
- Coaches and athletic trainers should obtain up-to-date weather information prior to all practices and games.
- Coaches and trainers should be aware of the nearest safe structure to their practice and game sites. For activities on Harkness, Freeman, Knowlton, and Chapel fields, and for the south tennis courts, shelter would be the surrounding buildings. For Silfen and Dawley fields, shelter would be the athletic center. If lightning occurs unexpectedly, and there is insufficient time to reach shelter, especially at Silfen and Dawley fields, automobiles may be used if available. Waterfront shelter would be the rowing boathouse. Do not shelter under trees. You are not safe anywhere outside!
- The NCAA recommends the National Severe Storms Laboratory (NSSL) "Flash-to-Bang" method of calculating the proximity of lightning. Coaches and trainers should use this method to determine when a practice or game should be interrupted, directing players and spectators to shelter:
- Lightning awareness should be increased with the first flash of lightning or the first clap of thunder, no matter how far away.
- Activities in the Natatorium should be halted and swimmers removed from the pool.
- Events should not be resumed until 30 minutes after the last flash of lightning is seen, or the last clap of thunder is heard. Lightning can strike as much as 10 miles away from where rain is falling. So it's important to understand that the absence of rain, or even cloudy skies, does not eliminate the risk of lightning strikes.
- If your skin tingles or your hair stands on the end, a lightning strike may be about to happen. Crouch down on the balls of your feet with your feet close together. Keep your hands on your knees and lower your head. Get as low as possible without touching your hands or knees to the ground. DO NOT LIE DOWN!
- Once indoors, stay OFF corded phones. Cell or cordless phones, not connected to the building's wiring, are safe to use. Don't touch electrical equipment or cords. Avoid plumbing. Do not wash your hands or take a shower. Stay away from windows and doors. Do not lie on concrete floors, and do not lean against metal or concrete walls. Stay at least a few feet away from open windows, sinks, toilets, tubs, showers, electrical outlets and appliances. Do not shower during a thunder or lightning storm.
From 1979-2003, excessive heat exposure caused 8,015 deaths in the United States. During this period, more people in this country died from extreme heat than from hurricanes, lightning, tornadoes, floods and earthquakes combined. In 2001, 300 deaths were caused by excessive heat exposure.
Individuals suffer heat-related illness when their bodies are unable to compensate and properly cool themselves. The body normally cools itself by sweating. But under some conditions, sweating just isn't enough. In such cases, a person's body temperature rises rapidly. Very high body temperatures may damage the brain or other vital organs. Under conditions of high heat and humidity, even well-conditioned athletes are at risk of heat-related illness:
- Heat Cramps - Painful cramps involving abdominal muscles and extremities caused by intense, prolonged exercise in the heat and depletion of salt and water due to sweating.
- Heat Syncope - Weakness, fatigue and fainting due to loss of salt and water in sweat and exercise in the heat. Predisposes to heatstroke.
- Heat Exhaustion - OBTAIN MEDICAL CARE AT ONCE. Cool body as you would for heat stroke while waiting for transfer to hospital. Give fluids if athlete is able to swallow and is conscious.
Heat Exhaustion (Water Depletion) - Excessive weight loss, reduced sweating, elevated skin and core body temperature, excessive thirst, weakness, headache and sometimes unconsciousness. Symptoms may include increased or reduced sweating, elevated skin and core body temperature, exhaustion, nausea, vomiting, muscle cramps, and dizziness.
- Heat Stroke - THIS IS A MEDICAL EMERGENCY. DELAY COULD BE FATAL. Immediately cool the body while waiting for transfer to a hospital. Remove clothing and place ice bags on the patient’s neck, in the axilla (armpit), and on the groin area. An increasing number of medical personnel are now using a treatment for heat illness that involves applying either alcohol or cool water to the victim's skin and vigorously fanning the body. The fanning causes evaporation and cooling. Symptoms include nausea, seizures and disorientation, with a very high body temperature (>105ºF) and hot dry skin. It may occur suddenly without being preceded by any other clinical signs. The individual can rapidly lapse into unconscious or coma.
It's important to know both the temperature and humidity when performing strenuous activities. The greater the humidity, the more difficult it is for the body to cool itself. Coaches and trainers should check the Heat Index Map at http://www.weather.com to determine the recommended duration of strenuous athletic activity before resting. Below is a chart from the National Weather Service that illustrates the relationship between temperature and humidity as it relates to heat illnesses:
All heat related illnesses are preventable. Following are steps Athletic Department staff can take that can reduce the likelihood of heat related illnesses:
- Lack of physical fitness impairs the performance of an athlete who participates in high temperatures. Coaches should know the physical condition of their athletes, and set practice schedules accordingly.
- Along with physical conditioning, acclimatization to heat conditions is important. Acclimatization is the process of becoming adjusted to heat and it is essential to provide for gradual acclimatization to hot weather. A graduated physical conditioning program should be used when training in hot and/or humid weather, with the body becoming acclimated in seven to ten days. Final stages of acclimatization to heat conditions are marked by increased sweating and reduced salt concentration in the sweat.
- Water must be readily available to athletes in unlimited quantities at all times. It is recommended that a minimum of ten minutes be scheduled for a water break every half hour of heavy exercise in the heat. Coaches should check to make sure athletes are drinking plenty of fluids. Cold water is preferable. Drinking ample water before practice or games has also been found to aid performance in the heat. Avoid caffeinated or alcoholic beverages.
- Adequate salt levels in the body are also important in preventing heat related illnesses, and need to be replenished. Experts agree that normal salting of foods during meals is usually sufficient for this purpose. Gatorade™ or other commercial sports drinks are specially formulated to replace lost electrolytes, and are useful in maintaining proper hydration and sodium levels. Use of salt tablets is NOT recommended.
Methicillin Resistant Staphylococcus Aureus (MRSA)
MRSA is a type of infection caused by Staph bacteria that is resistant to some common antibiotics such as penicillin. While most cases have involved athletes, cases involving non-athletes have also occurred. Skin infections such as abscesses and boils are the most common form of this infection. The infected area usually starts out as a small bump resembling a pimple, which becomes redder and often develops pus drainage. Staphylococcus bacteria (or Staph) are commonly carried on the skin or in the nose of healthy individuals. Staph and MRSA are spread by close contact either through direct physical contact with an infected individual or by touching objects (e.g. towels, sheets, wound dressings, clothes, or sports equipment) contaminated with the bacteria.
In most cases, MRSA infections are mild and can be treated successfully with proper hygiene and the appropriate antibiotics. If left untreated, MRSA can progress to a life threatening infection and become difficult to treat because there are fewer effective antibiotics available at this stage of the illness.
Here are a few guidelines to help prevent and control the spread of MRSA:
- Wash hands frequently with soap and water.
- Avoid sharing personal items (e.g., towels, washcloths, razors, clothing, or uniforms). An individual who becomes infected should wash all bed linens and clothes in hot water and laundry detergent frequently until the infection has cleared.
- Report any suspicious skin sore or boil to your healthcare provider (including the school nurse) immediately.
- If you participate in sports involving close personal contact (e.g. wrestling and football), shower with soap immediately after each practice, game, or match.
- Non-washable gear (i.e. head protectors), should be wiped down with alcohol after each use.
- Athletic equipment such as wrestling or gymnastics mats should be wiped down regularly with an anti-bacterial solution (i.e. Hibiclens).
- Athletes should receive a total body check prior to any game, match, or tournament. Individuals with an infection involving drainage (i.e. pus drainage) should be excluded from participation in sporting events and practices until all signs of pus drainage have resolved, the infected site can be adequately covered with a bandage and clothing, and a physician’s release has been obtained.
- Any cut or break in the skin should be washed with soap and water and a clean dressing applied on a daily basis.
More information regarding MRSA is available on the CDC’s website at: http://www.cdc.gov/ncidod/dhqp/ar_MRSA_AthletesFAQ.html