As frequent providers of emergency care at schools, sporting events, mass outdoor events, and in EDs during extreme heat weather events, emergency clinicians are uniquely positioned to offer patients strategies for prevention of heat-related illness. The primary strategies include acclimatization, hydration, and practice modification.
The goal of heat acclimatization is to gradually increase exertional heat tolerance and enhance the ability to exercise safely in a warm or hot environment. Although most recommendations for acclimatization protocols are derived from preseason football training, we recommend that coaches and trainers consider acclimatization for all outdoor activities conducted in hot, humid environments. Acclimatization should begin on the first day of conditioning in the preseason and usually follows a 14-day plan.107 Some acclimatization recommendations specific to football include no two-a-day practices in the first week and introducing protective equipment in stages, starting with the helmet and progressing to a full uniform.108
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