Heat Illness in Athletes

As summer approaches, athletes, coaches and other individuals will need to be aware of heat-related illnesses. Heat illnesses include a spectrum of conditions ranging from heat syncope, heat cramps and heat exhaustion to the more severe heat stroke.


Heat Syncope (fainting) is a form of orthostatic hypotension that is related to dehydration. It occurs due to inadequate cardiac output and hypotension. It also occurs with standing quickly after sitting or lying down for prolonged durations in the heat. Symptoms include fainting, dizziness and light-headedness. Treatment includes oral rehydration (water, juice or sports drinks) and placing the patient flat on the ground in a cool area with slight elevation of the legs to push the blood back to the vital organs such as the brain.

Heat Cramps are painful muscle cramps that occur due to decreased sodium heat2.pngconcentration in the blood. The patient’s core temperature is usually not elevated. Sodium may decrease when salts are lost in sweat or with excessive water intake that does not include electrolytes leading to a situation called dilutional hyponatremia. Symptoms include painful muscle cramps occurring commonly in the abdominal muscles, arms, legs and thighs. Treatment includes rest, cooling and IV fluids or oral rehydration with fluids rich in electrolytes (sports drinks and juices) to replenish the sodium stores. Prevention could be achieved by consumption of fluids high in electrolytes before strenuous activities.

heat3Heat Exhaustion is the most common heat illness. The body temperature becomes elevated but is less than 40°C. The core body temperature is best measured rectally. The signs and symptoms of heat exhaustion include profuse sweating, core body temperature lower than 40°C, weakness and fatigue, cramping, headaches, nausea and vomiting,  fainting, hypotension, increased heart rate, and fast shallow breathing. Treatment includes rest, IV fluids or oral rehydration and rapid cooling by whole-body immersion in an ice bath.

Heat Stroke is the most severe form of heat illness. It is a medical emergency that needs immediate attention. The patient should be transported to the hospital as soon as possible. Heat strokes occur due to failure of the body’s normal thermoregulatory mechanism. If treatment is not started promptly, end-organ failure and ultimately death may occur. Heat strokes have a high mortality rate and require quick reduction of the patient’s temperature. The three characteristic features of this condition are a lack of sweating, core body temperature above 40°C (best measured rectally) and an altered mental status. Additional signs and symptoms include hot, dry skin, disorientation, confusion and hallucinations, headache and slurred speech. This is a serious medical emergency that requires rapid core body temperature reduction. The patient should have close monitoring of airway, breathing and circulation. The physician should implement basic life support and ACLS protocols. Rapid cooling by whole-body immersion in an ice bath will be utilized as well as IV fluids.



An Overview of the Castle Connolly America’s Top Doctors Program

Castle Connolly America’s Top Doctors award
Castle Connolly America’s Top Doctors award


A board-certified orthopedic surgeon with over three decades of experience, Dr. Nabil Ebraheim serves as the chairman and a professor in the Department of Orthopedic Surgery at the University of Toledo Medical Center. Over the course of his career, Dr. Nabil Ebraheim has received many accolades for his work, including the Castle Connolly America’s Top Doctors award.

Administered by Castle Connolly Medical Ltd. (CCML), the America’s Top Doctors award program recognizes physicians who are leaders in their fields and dedicated to professional excellence. In addition to highlighting the work of outstanding medical professionals, the Top Doctors program helps connect consumers with the best health care available in their communities.

CCML bases its Top Doctors selections on an extensive survey process that invites thousands of physicians across the country to nominate their peers for the program. Each year, the organization’s physician-led research team reviews nearly 100,000 nominations through a process that examines each nominee’s education, training, certifications, and professional achievements.

CCML also reviews the nominees’ disciplinary and malpractice history before making its final selections. Those physicians whose records stand above the rest are included in CCML’s annual list of Top Doctors, which is published in the Castle Connolly Guides and on the organization’s website.