For School Nurses: Your Part in the Sports Heat Plan

This page is for school nurses and health office staff at schools with sports teams, marching band, PE or other outdoor activities in the heat. It is also for the athletic directors and coaches who want the nurse in the room when the heat plan gets written.

Why the nurse belongs in the heat plan

You already know things the coaching staff may not: which students have health plans on file, who takes medication, who has been sick this week, and how to reach families fast. That knowledge belongs in the written emergency plan, not just in your office.

• Ask to review the athletics emergency plan before the first hot practice. If there isn't one, the free National Stay Cool Day EAP builder walks a school through one, and the finished plan carries the school's name.
• Check that every practice site has its own entry. The main field, the practice field, the gym and any off-campus site each need a street address, an ambulance entrance and a cooling setup.
• Make sure the plan names people, not just titles. "Coach" isn't an owner. Who calls 911, who starts cooling and who meets the ambulance should all be written down by name for each team.

Know the plan works when you're not there

A heat plan that depends on the nurse fails at 5:30 PM on a Thursday. Help the people who will be there:

• Coaches and team adults should know the emergency order by heart, where the cooling tub sits and where the closest AED is after hours.
• The front office and custodial staff should know who unlocks gates and buildings in the evening and on weekends.
• Athletic trainers, where the school has one, should share notes with you on athletes who had heat illness symptoms at practice.

Offer a short heat refresher at a preseason coaches meeting. The coaches page and the athletic directors page cover their side of the same plan.

The emergency order every adult should know

Exertional heat stroke is 100% survivable when the athlete is cooled fast, on site. Teach the same order to everyone on the plan:

1. Call 911 and start cooling at the same time. One person calls. Everyone else works on cooling.
2. Get the athlete into cold water. Cold-water immersion with ice agitation is the standard. Cooling should start within 10 minutes.
3. Keep cooling. The goal is about 102°F within 30 minutes. At 104°F the body loses its ability to regulate its own temperature, so it can't cool itself down.
4. Cool first, transport second. Cooling happens before the athlete is moved.
5. Remove anything you can quickly but don't delay cooling because of gear removal.

Heat stroke can look like something milder at first. National Stay Cool Day's guide on heat exhaustion vs heat stroke explains the difference in plain language.

During the school day

Heat isn't only an after-school problem. PE classes, recess, field days and band rehearsals happen while you're in the building.

• Know where ice and a tub or other cooling setup can be reached during school hours, not only at the athletic field.
• Ask PE teachers and band directors to send a student to you early if they look off: confused, stumbling, unusually tired or acting strangely.
• Keep the heat-day schedule changes from your athletic director or principal on file, so you know when outdoor activity moves or ends.

Working with families

Families tell the nurse things they may not tell a coach. Use that.

• Remind families early in the season to tell the school about illness, new medications or a past heat illness.
• Share the parents page so families know what a prepared program already has in place.
• After any heat illness at school or practice, follow your school's own policy on notifying families and on return to activity. This page doesn't set medical or return-to-play rules.

After a heat emergency

• Sit down with the athletic director and coaches and write down what slowed the response.
• Fix it in the written plan, then walk the venue again with the preseason venue walkthrough.
• Restock ice and make sure the tub is back where the plan says it is.

Where to go next

Build or refresh your school's plan with the free EAP builder. Coaches use the coaches page and athletic directors the athletic directors page. Families can start with the parents page. For questions about the Council, contact us.