by Rudy Dressendorfer, PhD, PT, FACSM - July 10, 2001

General Guidelines

• Provide for and encourage fluid replacement.
• Recognize signs of dehydration and remove overheated athlete from activity into a cool, shaded area.
• Consider restraints on activity using the wet-bulb, gloe temperature (WBGT) index.
• Recommend maintenance of normal daily urinary output.

Fluid Intake & Replacement Guidelines*

• Before event (during warm up): 8-16 gulps (4-8 oz)
• During event: 8 gulps (4 oz) every 15 to 20 minutes
• After event: 32-48 gulps (16-24 oz) for every 1-1.5 lbs lost

* To drink, individual must be mentally alert and have no abdominal pain

Early Signs of Dehydration

• Dry lips or excessive lip licking
• Flushed cheeks
• Sunken eyes
• Decreased performance with general weakness
• Infrequent urination
• Irritability
• Fast pulse and breathing rates (can be misleading in kids)

Signs/Symptoms Requiring Immediate Attention

• Hot, red, dry skin (not sweating in the heat)
• Muscle cramps
• Chills
• Headache
• Vomiting or nausea
• Heat sensations in the head or neck
• Dizziness
• Disorientation
• Bright-red or dark-bown urine
• Shortness of breath or trouble breathing

Fluid Replacement

• Remind athletes to drink. Dehydration may exceed 2% of body weight before thirst kicks in; i.e., "voluntary dehydration".
• Distribute transparent squeeze bottles to eath athlete.
• Offer flavored drinks, especially properly formulated sports drinks.
• Avoid sugary drinks such as fruit juices (high fructose) and soft drinks (high glucose).
• Cool beverages between 10-15°C (50-60°F) are recommended.
• Ask children athletes to count their gulps.
• Maximize time for fluid replacement.
• Take body weight before, during and after sporting events.

Body Cooling Methods

• Shade
• Wet towels
• Spray bottles
• Fans
• Water immersion tank

References

1. American Academy of Pediatrics: Policy statement: Climatic Heat Stress and the Excercising Child and Adolescent. Pediatrics 106 (01): 158-159, 2000
2. American College of Sports Medicine: Position stand: Heat and Cold Illnesses during Distance Running. Medicine & Science in Sports & Exercise 2 (12): i-x. 1996.
3. NATA: Position statement: Fluid Replacement for Athletes. Journal of Athletic Training 35 (2): 212-224, 2000

Text © Rudy Dressendorfer