“ BRINGINGTO WATER” University of Maryland Department of Intercollegiate Athletics Heat Illness Prevention & Management Program

 Developed by the University of Maryland Sports Medicine Department in consultation with University of Maryland Team Physicians “BRINGINGTO WATER”

 Personnel (Team Physicians)- Dr. Craig Bennett MD  Team Physician / Orthopedist Dr. Yvette Rooks, MD  Team Physician / Family Practice Dr. Michael Yorio, MD  Team Physician / Sports Medicine Dr. Tom Maino, MD  UMMS Family Practice / Sports Medicine Fellow “BRINGINGTO WATER”

 Personnel (Physicians)- Dr. Sacared Bodison, MD  Physician- University Health Center Dr. Stephen Fahey, MD  Physician- University Health Center Dr. Yulanda Swindell, MD  Physician- University Health Center “BRINGINGTO WATER”

 Personnel (Athletic Trainers)- Darryl Conway (Football) Sandra Worth (Football) JJ Bush (Volleyball / Comcast Center) Matt Charvat (Football) Deanna Bennett (Field Hockey) Terrence Gee (Men’s Soccer) Andrea Roth (Women’s Soccer) “BRINGINGTO WATER”

 Personnel (Athletic Trainers)- Mary Anderson (Men’s Soccer / Cross- Country) Theresa Doherty (Field Hockey) Chris Duncan (Women’s Soccer) Erin Field (Football) Niki McElroy (Volleyball) Jason Olszewski (Football) “BRINGINGTO WATER”

 Temperature Regulation- Air temperature Wind Humidity Clothing Activity intensity Fluid intake Adaptability of the body “BRINGINGTO WATER”

 Susceptibility- Prior history Medical conditions Poorly conditioned / un-acclimatized Overweight / high BMI Low body fat / low BMI Low “heat tolerance” Ill athletes “BRINGINGTO WATER”

 Susceptibility- Taking medications Supplements Poor diet / nutrition High core temperatures > 3% body weight loss Restricted / low-salt diets Heavy sweaters (“Salty Sweaters”) “BRINGINGTO WATER”

 Prevention (Pre-Season)- Medical history / physical exam Strength & conditioning Acclimatization Education (coaching staff) Education (student-athletes) Education (athletic trainers) “BRINGINGTO WATER”

 Prevention (Pre-Season)- Facility prep Emergency planning Team meetings “BRINGINGTO WATER”

 Supplements- Notify your athletic trainer what supplements you are taking  Supplement Notification Form STOP taking all supplements

 Prevention (Pre-Practice)- Heat Index (HI) / weather radar Communicate with SA Communicate with coaches Weight charts Field Prep Charts-  Urine Color Chart  How Much Water To Drink “BRINGINGTO WATER”

“BRINGING TO WATER!” 1 If your urine matches the colors 1, 2, or 3, you are properly 2 hydrated. Continue to consume fluids at the recommended 3 amounts. 4 If your urine color is below the RED line, you are 5 DEHYDRATED and at risk for cramping / a heat illness! 6 YOU NEED TO DRINK MORE WATER / GATORADE! 7 8

“BRINGING TO WATER!”  Hydration oz of cold water / Gatorade every minutes pre-practice 12 oz of cold water / Gatorade every minutes throughout practice 24oz of cold water / Gatorade for every one (1) pound lost during practice

 Prevention (During Practice)- Athletic trainer presence during practice Monitor HI Sports Medicine Staff communication Communicate with coaching staff Communicate with student-athletes On-site physicians Tent / “Cool Area” “BRINGINGTO WATER”

 Prevention (During Practice)- Ice / water / Gatorade / ice towels Gatorlyte / Heat Guard / Magonate IVs Cold tubs “BRINGINGTO WATER”

 Prevention (Post-Practice)- Weight Charts Urine Color Chart How Much Water To Drink Chart Diet / Nutrition REST Heat Guard / Magonate / MediLyte “BRINGINGTO WATER”

 Prevention (Post-Practice)- Cold Tubs Communicate with coaching staff Team Physician availability IVs “BRINGINGTO WATER”

“BRINGING TO WATER!”  Hydration- Fulfill thirst  eat a good, nutritious meal  DRINK! 24oz of cold water / Gatorade for every one (1) pound lost during practice

“BRINGING TO WATER!”  Meals- Low-fat, high carbohydrate, moderate protein Fruits & vegetables Foods high in sodium & potassium  (e.g. ham & cheese, tomatoes / tomato sauce, pickles, bananas, etc.) No fast food No caffeine or alcohol Lightly salt foods to taste No supplements

“BRINGING TO WATER!”  Meetings- DRINK!!  Water bottles Cool clothing

 Heat Cramps-  Heat Exhaustion-  Heat Stroke- “BRINGINGTO WATER”

 Heat Index- “BRINGINGTO WATER”

 Heat Index Practice Recommendations- Below 80- monitor 80 – 85- additional breaks 85 – 90- additional breaks; monitor closely; ?? modify uniform > 90- additional breaks; monitor closely; modify uniform; ?? shorten practice time “BRINGINGTO WATER”

 Modification of Athletic Activities- Chain of Command Criteria-  Monitor HI  Communicate with coaching staff  Recommendations “BRINGINGTO WATER”

 Supplement Notification Form- “BRINGINGTO WATER”

“BRINGING TO WATER!” 1 If your urine matches the colors 1, 2, or 3, you are properly 2 hydrated. Continue to consume fluids at the recommended 3 amounts. 4 If your urine color is below the RED line, you are 5 DEHYDRATED and at risk for cramping / a heat illness! 6 YOU NEED TO DRINK MORE WATER / GATORADE! 7 8

“BRINGING TO WATER!”  How Much Water To Drink Chart oz of cold water / Gatorade every minutes pre-practice 12 oz of cold water / Gatorade every minutes throughout practice 24oz of cold water / Gatorade for every one (1) pound lost during practice

 3% Weight Loss Chart- “BRINGINGTO WATER”

 Heat Illness Warning- “BRINGINGTO WATER”

“BRINGING TO WATER!”  Miscellaneous- Communicate Be prepared Encourage & PRACTICE good fluid replacement & dietary habits Recognize heat illnesses & follow the established emergency plan Get REST!

“BRINGING TO WATER!”  Questions???

“BRINGING TO WATER!” THANK YOU!