Athletic Directors Want Athletic Trainers For Higher Warmth Insurance policies 

Exertional Warmth Sickness: Adoption of Insurance policies and Influencing Contextual Elements as Reported by Athletic Directors

Scarneo-Miller SE, Adams WM, Coleman KA, Lopez RM. Sports activities Well being. 2023 Mar 5:19417381231155107. doi: 10.1177/19417381231155107. Epub forward of print. PMID: 36872595.

Take-Dwelling Message

Most highschool athletic directors reported adopting a written exertional warmth sickness coverage, however they typically missed key parts. The presence of an athletic coach helped facilitate having a written coverage that included extra parts.


Athletic directors play an necessary position in coverage adoption. Insurance policies like these dealing with emergency exertional warmth diseases are important since improper administration might result in poor outcomes. Sadly, we all know little concerning the facilitators and limitations to adopting exertional warmth sickness insurance policies.

Examine Objective

The authors surveyed highschool athletic directors in the US to explain the adoption of exertional warmth sickness insurance policies and discover elements that affect the adoption of those insurance policies.


Through the 2018-2019 tutorial college 12 months, the examine group emailed virtually 7,000 athletic directors to ask them to finish a questionnaire that requested about 1) demographics, 2) exertional well being sickness insurance policies, 3) oversight and modification of written coverage, and 4) facilitators and limitations to coverage growth. The investigators used the precaution adoption course of mannequin to evaluate an athletic administrator’s readiness to undertake insurance policies. The adoption mannequin is predicated on 8 levels, from being unaware to sustaining a written coverage for over 6 months.


Among the many 466 athletic directors (~48 years of age, 82% male, 77% labored within the discipline for over 15 years), 78% reported adopting a written coverage on exertional warmth sickness prevention and therapy. Solely 6% adopted all 11 important parts of an exertional warmth sickness coverage. Nearly half of the directors reported adopting lower than 5 important parts.

Older athletic directors, those that beforehand handled an exertional warmth sickness, or these with an athletic coach on employees have been extra prone to have a written coverage. Moreover, state mandates and having a medical skilled have been probably the most generally reported facilitators for adopting a coverage on exertional well being sickness prevention and utilizing a rectal thermometer. Equally, probably the most generally reported barrier to a complete exertional warmth sickness coverage was lack of a full-time athletic coach (11). Directors additionally acknowledged price range restrictions that restricted using a chilly water immersion tub (23%), and key limitations to utilizing a rectal thermometer have been discomfort utilizing the thermometer (32%), resistance from dad and mom/guardians (30%), resistance from coaches (30%), and legal responsibility considerations (27%).


Practically 80% of the sampled athletic directors reported adopting a written exertional warmth sickness coverage. Nevertheless, only a few included or have been conscious of all the mandatory parts to stick to finest medical practices. The authors discovered that entry to athletic coaching companies was related to higher adoption of exertional well being insurance policies. This discovering aligns with the truth that it could be an athletic coach finishing up such insurance policies. It’s value recognizing that solely 7% of contacted directors accomplished the survey. Therefore, these outcomes might not precisely replicate what’s going on in excessive faculties across the nation. One risk is that folks extra occupied with insurance policies or exertional warmth sickness accomplished the survey. Therefore, these outcomes might present us the best-case state of affairs for having written insurance policies (78%) that embody all of the parts (6%) – which is a worrying signal.

Medical Implications

Encouraging state mandates and faculties to rent athletic trainers can assist guarantee written insurance policies are in place to handle exertional warmth sickness. Clinicians may wish to take into account methods to teach coaches and fogeys/guardians concerning the rationale for these insurance policies, like rectal thermometers and chilly water immersion tubs.

Questions for Dialogue

Do you will have issue including rectal temperature into your exertional warmth sickness protocol? Do you talk together with your athletic administrator concerning the adoption, implementation, and annual assessment/follow of your emergency insurance policies?

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Written by Jane McDevitt
Reviewed by Jeffrey Driban

9 EBP CEU Courses

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