Thermoregulation and heat expert Brendon McDermott visited with law enforcement officers, school officials and more on heat safety during a presentation June 20 at the Conway Regional Health and Fitness Center.
McDermott was the first of many speakers set to visit Conway for a speaker series, which will be free and open to the public.
“This program is open to school athletic programs as well as parents, teachers and others who are interested in learning more about the symptoms and care for heat related injuries,” Tom Roberts, medical director for the Conway Regional Comprehensive Sports Outreach program, said, in a news release. “Symptoms of heat related illness can be subtle, and it is important to recognize and treat them before serious injuries occur. This is especially important since summer practices are underway.”
McDermott is an assistant professor in the College of Education and Health Professions at the University of Arkansas in Fayetteville.
He is an athletic trainer and is expertly versed in the area of thermoregulation, heat illnesses, exertional sickling, hydration and in prevention of sudden death in sports related situations.
McDermott said he’s had a passion for this type of study for a while now but when he was a clinical instructor working at a Division 3 institution in Pennsylvania they had an athlete die on them.
He said it was a situation they were not well-educated on and having to call a parent of a 19-year-old athlete and tell them their child died was not a good situation.
The desire for knowledge, and along with the fact he was already wanting his doctorate, set him in this direction.
“Death from exertional heat stroke is 100 percent preventable,” McDermott said.
The title of McDermott’s talk was, “Heat Illness, Recognition and Treatment.”
He said 95 percent of heat stroke incidents occur in off-season for sports or in the first several days of conditioning for a variety of reasons, the biggest of all ... lack of heat acclimation.
Heat acclimation, which McDermott said is the number one thing that can be done to prepare for the heat, is the gradual onset of heat exposure and intensity which leads to increased blood volume, increased sweat efficiency, decreased body temp and decreased sodium loss.
What causes exertional heat stroke is, essentially, a battle for blood: to working muscles, to the brain, lungs and heart, the periphery for sweating and internal organs.
McDermott said when we work, we have to get the blood to these key places and the battle goes back and forth, with something eventually having to give.
With limited blood flow to the heart and brain, heat syncope, the act of fainting, occurs. The automatically going horizontal, forces blood back to the brain.
McDermott said exercises like up downs cause this but people normally recover within five minutes.
Again, he said, it comes down to acclimation.
When it comes to the differences and spotted symptoms between heat exhaustion and heat stroke, McDermott said there are a lot of misconceptions.
He pulled up a slide, which he said, was completely false.
One of those heat exhaustion symptoms included profuse sweating but pale, cool, clammy skin.
McDermott said, matter-of-factly, that a person should be sweating, they’re outside, but they wouldn’t be cool and clammy.
He said accurate symptoms include those but also faint or dizzy, headache, weak, rapid pulse, nausea or vomiting and muscle cramps but at this point, don’t need much treatment.
Under the heat stroke symptoms, absence of sweating was listed.
“I have been onsite and helped treat at least 50 exertional heat strokes,” McDermott said. “I’ve never seen one stop sweating. Never.”
He said the big differentiating issue is the body’s core temperature.
“In order to be diagnosed with heat stroke, you have to be above 104 [degrees],” McDermott said.
Physiologically, a bodies threshold for cell death is 105 degrees and above 106, cells are being lost.
McDermott said there’s a lot of misinformation out there.
“If you Google it, for me, it gets amusing, but then I’m like, wait a minute, this is where people are going for information for these days so if they’re asking Alexa what the treatment recommendation is at the time, it’s probably not a good idea,” he said.
Again, with heat stroke, another revealing symptom, he said, is in confusion and central nervous system dysfunction.
McDermott, who has worked the medical tent at the Boston Marathon numerous times, said he has countless stories regarding runners going through heat stroke that drop the F bomb, punch, try to bite or come off super sweet and humorous, but as soon as they get their core temperature lowered their completely different and don’t remember anything from before.
The need to be able to recognize and treat these heat-related conditions can be the difference between life and death.
McDermott recalled an situation with Minnesota Vikings player Korey Stringer who died from complications with a heat stroke.
He said there are photos today of Stringer vomiting on the field during practice, a sure sign of heat exhaustion.
The player was ridiculed for being fat and out of shape and had to work harder so the next day, got back to it.
Because he hadn’t recovered, it led to him developing a heat stroke.
McDermott said in the case of heat exhaustion, someone needs to recover for 24 hours before getting back to work, whether that be an athlete missing a practice or construction worker taking a day off the job, to prevent worse symptoms later.
“I throw these situations in here simply because it happens everywhere,” he said.
McDermott said he one reason these issues need to be recognized appropriately is to know whether a patient needs to be transported immediately — heat exhaustion — or treated on site — like in cases of heat stroke where cells are dying — and one way to do that correctly is through taking a rectal temperature because it accurately reads the body’s core temperature; effective treatment depends on accurate diagnosis.
“If it’s recognized and treated appropriately, no one should die,” he said.
Moving forward, McDermott said, it’s crucial for businesses, institutions and more to have adequate medical coverage, mandate proper CPR and AED training and to have and rehearse emergency action plans, which he advises, is created through working with athletic trainers.
In conclusion, he said, while heat illnesses can’t always be prevented, there are things that people can do to help including facilitating heat acclimation, avoid punishment or overwhelming work conditions, allow proper rest breaks that promote efficiency and have mandated trainings and action plans in place.