NATA has released an executive summary  of a revised position statement on exertional heat illnesses to published in an upcoming issue of the Journal of Athletic Training, NATA's scientific publication.*
"Exertional heat illnesses are largely preventable within the confines of organized sports when appropriate protocols are put into place," said Douglas J. Casa, PhD, ATC, FACSM, FNATA, chief operating officer of the Korey Stringer Institute, director of Athletic Training Education, Department of Kinesiology at the University of Connecticut and chair of the position statement writing group. [Note: Casa is also a member of MomsTEAM Institute's Board of Advisors , which is developing best practice guidelines, including on exertional heat illness, as part of the Institute's SmartTeams Play Safe initiative .
"This includes heat acclimatization , body cooling, hydration , modifying of exercise based on environmental conditions , among other considerations. These guidelines are not just for athletes - they are also valuable for individuals exposed to warm weather environments such as those in the military or individuals whose work necessitates heat exposure."
Exertional heat stroke is one of the three leading causes of death in sport (and the leading cause in the summer). The period of 2005 to 2009 had more heat stroke deaths than any other five year period in the 35 years prior. There were 18 deaths from 2005 to 2009; from 2010 to 2014 (still being tracked) there are now an estimated 20 to 22 deaths.
Prevention of Exertional Heat Illnesses:
Recognition of Exertional Heat Illnesses:
Treatment of Exertional Heat Illnesses:
Specific recommendations for pre-season heat acclimatization protocol:
Recommendation of assessing rectal temperature if exertional heat stroke is suspected:
Best practices strongly advise the use of rectal temperature for the assessment of body temperature in a suspected exertional heat stroke patient. It is discouraged to use inaccurate devices such as oral, tympanic, etc.
Specific protocol for the treatment of exertional heat stroke:
The new guidelines suggest a specific step-by-step protocol for cold water immersion for the clinician to implement with an exertional heat stroke patient. This protocol is backed by research exhibiting a 100 percent survival rate when initiated quickly and properly.
Identification of approximate cooling rates for an exertional heat stroke patient:
While cooling rates may vary, the cooling rate for cold water immersion will be approximately 0.37°F/min. or about 1°F every three minutes when considering the entire immersion period for an exertional heat stroke patient. This provides an approximate treatment time for clinicians if rectal temperature monitoring is not possible during treatment.
Recommendation of "cool first, transport second":
Removal of hyponatremia as an exertional heat illness:
Hyponatremia  was removed from the current guidelines as this condition is not considered to be a true heat-related illness.
"Death from exertional heat stroke is 100 percent preventable when proper recognition and treatment protocols are implemented," concluded Casa. "Putting the right programs into place is essential to prevent and treat exertional heat illnesses and ensure appropriate care is in place."
* The updated position statement is now slated to be released in August/September 2015, according to Casa.
Source: National Athletic Trainers' Association
Updated July 22, 2015