After a Heat Emergency: What Your Program Should Do in the Days That Follow

It isn't legal or medical advice. Your school, district or league may have its own reporting steps, and those come first. Use this as a checklist to make sure nothing falls through the cracks.

First, look after the people

• The athlete and family. Someone the family trusts, usually the head coach or athletic director, should check in. Keep it personal and simple. Medical updates come from the family and the athlete's doctors, not from the team.
• The teammates. Players who saw a teammate go down may be scared, or may be quietly worried about themselves. Talk with them as a group, answer what you can, and tell them again that speaking up about feeling sick will never cost them playing time.
• The staff and volunteers. The people who called 911 and did the cooling had a hard day. Thank them by name, in private, and ask how they're doing.

Write down what happened while it's fresh

Within a day or two, have the people who were there write down what they saw and did, each in their own words. Keep it factual.

• What time the athlete showed signs, and what those signs were.
• What time 911 was called and what time cooling started.
• How the athlete was cooled, and for how long before transport.
• When the ambulance arrived, which gate it used, and who met it.
• The conditions that day: time of practice, heat, what the team was doing.

Follow your program's rules on where these notes go and who sees them. Keep the athlete's health information private.

Hold a short staff review

Within the first week, sit down with everyone who had a role. The goal is to fix the plan, not to blame a person. Go through the emergency order and ask, step by step, whether it happened the way the plan says it should:

1. Did someone call 911 while others started cooling at the same time?
2. Did cooling start within 10 minutes?
3. Was the athlete in cold water with ice agitation, and kept there until cooled? The goal is about 102°F within 30 minutes. At 104°F the body loses its ability to regulate its own temperature.
4. Did the team cool first and transport second?
5. Was gear handled the right way? Remove anything you can quickly but don't delay cooling because of gear removal.

Exertional heat stroke is 100% survivable when the athlete is cooled fast, on site. Any step that ran slow is the first thing to fix.

Questions that usually turn up the gaps

• Was the tub filled and the ice there, or did someone have to go get it?
• Did everyone know who was in charge, or did people wait for direction?
• Did the 911 caller know the right address and gate?
• Was the athletic trainer or medical lead on site, and if not, did the coaches know the plan without them?
• Were there warning signs earlier in practice that nobody acted on?
• Did the day's heat rules get followed, and were they the right rules for that day?

Update the plan and practice it again

Change the written emergency action plan to fix what the review found, then make sure every coach and volunteer gets the new version. If your program doesn't have a written plan for each venue, the free National Stay Cool Day EAP builder walks you through one. Then run a full drill with the updated plan. National Stay Cool Day's heat stroke drill guide shows how. Walk the site again with the preseason venue walkthrough checklist.

Bringing the athlete back

An athlete who had exertional heat stroke should come back only with a doctor's clearance and a gradual return. The team doesn't set that timeline. National Stay Cool Day has a guide to return to play after heat stroke that families and staff can read together.

A close call counts too

If an athlete got sick and recovered on the sideline, or a step in the plan almost failed, run the same review. A close call is the cheapest lesson your program will ever get.

Where to go next

Athletic directors can use the athletic directors page to check the rest of the program. Coaches can use the coaches page for the daily heat routine. For questions about the Council, contact us.