Cold-Water Immersion for Hyperthermic Humans Wearing American Football Uniforms

Miller, Kevin; Swartz, Erik E.; Long, Blaine

doi:10.4085/1062-6050-50.6.01

Cited by 22 publications

(30 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, an individual wearing PADS during CWI with a T rec of 428C would require 4 minutes of additional cooling to reach the recommended T rec CWI removal temperature of 38.68C. 30 Thus, our current data confirmed the observation of Miller et al 17 that T rec cooling rates are still considered acceptable 9 when PADS are worn during CWI. Whereas football uniforms may be removed quickly in EHS scenarios, 16 the time needed to remove PADS is based on 5 assumptions: (1) trained individuals are present to remove PADS from AFPs with EHS, (2) the individuals treating the AFPs with EHS are familiar with PADS removal, (3) the PADS are removed easily, (4) the necessary tools for uniform removal are available, and (5) AFPs are compliant with medical personnel.…”

Section: -15supporting

confidence: 80%

“…17 Because participants cooled slower in PADS in our study despite feeling similarly hot, the observation of Miller et al 17 was likely due to skin temperatures being higher after exercise in the fully equipped condition. 2,4,18 Shivering could not explain their results, as the onset of shivering occurred 1 minute sooner in NO pads .…”

Section: -15mentioning

confidence: 58%

“…An ancillary goal of our study was to clarify the observation of Miller et al 17 of faster cooling rates when participants wore PADS during CWI versus minimal clothing. They speculated that the faster cooling of fully equipped participants was due to 1 or more of the following: (1) exercising while wearing different amounts a The Environmental Symptoms Questionnaire is rated on a 5-point Likert scale with scores ranging from 0 (not at all) to 5 (extreme).…”

Section: -15mentioning

confidence: 99%

“…First, we compared the time required to reduce the rectal temperature (T rec ) of individuals with hyperthermia cooled via CWI while wearing PADS or minimal clothing (undergarments, shorts, and crew socks [NO pads ]). However, unlike the Miller et al 17 experiment, participants exercised in PADS on both days and then removed PADS immediately before CWI on 1 day. Second, given that CWI can elicit a coldshock response or be intolerable to conscious patients, 19 we sought to determine if wearing PADS during CWI affected thermal sensations of participants, 20 the intensity of environmental symptoms, 18 or the onset of shivering.…”

mentioning

confidence: 99%

“…Miller et al 17 tested the hypothesis that participants with hyperthermia would cool slowly when wearing PADS during CWI, as implied by the ACSM 14 and NATA 15 position statements. Unexpectedly, participants cooled faster when they wore PADS than when they wore minimal clothing (ie, undergarments, shorts, crew socks).…”

mentioning

confidence: 99%

See 4 more Smart Citations

Necessity of Removing American Football Uniforms From Humans With Hyperthermia Before Cold-Water Immersion

Miller

Long

Edwards

2015

Journal of Athletic Training

Self Cite

View full text Add to dashboard Cite

Context: The National Athletic Trainers' Association and the American College of Sports Medicine have recommended removing American football uniforms from athletes with exertional heat stroke before cold-water immersion (CWI) based on the assumption that the uniform impedes rectal temperature (T rec ) cooling. Few experimental data exist to verify or disprove this assumption and the recommendations.Objectives: To compare CWI durations, T rec cooling rates, thermal sensation, intensity of environmental symptoms, and onset of shivering when hyperthermic participants wore football uniforms during CWI or removed the uniforms immediately before CWI.Design: Crossover study. Conclusions: Whereas participants cooled faster in NO pads , we still considered the PADS cooling rate to be acceptable (ie, .0.168C/min). Therefore, if clinicians experience difficulty removing PADS or CWI treatment is delayed, they may immerse fully equipped hyperthermic football players in CWI and maintain acceptable T rec cooling rates. Otherwise, PADS should be removed preimmersion to ensure faster body core temperature cooling.Key Words: clothing, equipment, exertional heat stroke, rectal temperature Key PointsBody core temperature decreased faster when participants wore undergarments, shorts, and crew socks than when they wore the full American football uniform (PADS) without shoes during cold-water immersion (CWI). If CWI is delayed or clinicians have difficulty removing PADS, they can immerse hyperthermic football players in PADS and maintain acceptable core temperature cooling rates. The PADS should be removed before CWI if that can be done properly, easily, and within 30 minutes of athlete collapse.A merican football players (AFPs) may be at higher risk of developing exertional heat stroke (EHS) in part because of the equipment-intensive uniform worn during the sport.1 These athletes compete and often practice while wearing a full uniform consisting of shoes; crew socks; undergarments; shorts; game pants; undershirt; shoulder pads; jersey; helmet; and padding over the thighs, knees, hips, and tailbone (PADS).2,3 The increased metabolic demand and physiologic strain of exercising while wearing PADS, combined with a decreased evaporative surface area to dissipate heat, can result in substantial heat storage 2-5 and may contribute to the development of exertional heat illness. In fact, the rate of exertional heat illness in secondary school AFPs is 11 times higher than that in all other sports combined. 6 If EHS develops and body core temperature stays above the critical threshold for cell damage (approximately 40.58C) longer than 30 minutes, the risk of morbidity and mortality increases. 7,8 Therefore, it is paramount to develop efficient protocols for treating AFPs with hyperthermia.The criterion standard treatment for EHS is cold-water immersion (CWI) because of its superior cooling rates (ie, .0.168C/min) 7,9 and high survival rates when implemented shortly after the onset of symptoms.

show abstract