My son, Zac, suffered a heat stroke in August 2018, he was 15 years old. Thankfully, he has a very rare, happy ending– recovering from what is usually a life-ending incident for students and was able to play football again.

Football practice was grueling on that Wednesday. The players were being “punished” for a bad scrimmage earlier in the week. When I say punishing, I mean 276 up-downs at the end of two hours of pushing sleds, sprints, and drills. For whatever reason, Zac’s body couldn’t handle the heat, and after the up-downs, he collapsed. Trainers and coaches put ice on him out on the field and then brought him to the locker room and held him in a cold shower. He was non-responsive through all this, and EMS was called. The telephone call I got said he had had some trouble with the heat that day. At the hospital, his internal temperature was 106°F. He was cooled down more and, once his body was at a safe temp (104°F), he was put on a ventilator and sedated. CT scans showed normal brain activity. He was at risk for liver failure, kidney failure, lung, and heart issues. With exertional heatstroke, every cell in your body is affected. Nine days later, he was successfully taken off the ventilator and was able to come home after another 3 days in the hospital.

We had researched exertional heat stroke while in the hospital and found an agency called The Korey Stringer Institute. Korey Stringer was an NFL player who died of heat stroke, and this is the foundation his wife started for the prevention of sudden death in athletes. I contacted KSI, and in February, we made our first trip to Connecticut and the University of Conn, where KSI is housed, for Zac to complete a heat tolerance test (HTT). The HTT test was designed for special forces in Iraq—given the hot, humid conditions—to determine a body’s ability to regulate internal heating and cooling. This test is conducted in a climate-controlled room at 104°F and 40%humidity and requires the patient to walk for two hours on a treadmill. Passing the test means your internal temp plateaus and does not rise above 101.3°F. Zac did not pass the first time, or the second, or the third. He finally passed on his 4th test.

This passing was after intensive months of conditioning and heat acclimatization work, but it paid off, and he was cleared to play football again with some safety measures in place.

The first safety measure is that we monitored his temperature with a pill that he ingests, which allows us to measure his internal temp with a handheld monitor. Shade, appropriate water breaks, and wet bulb temperatures are all being carefully monitored and enforced. But the most important tool is the ice baths that are available on the field.

Here is the most important part, and what I want athletics programs nationwide to understand—experts told us repeatedly that an ice bath, used properly, will save an athlete’s life 100% of the time. EVERY TIME.

If your school has an Emergency ActionPlan (EAP), then you know exactly where that cooling equipment is, how to use it, and who is responsible for each role. Emergency action plans (EAPs) ensure that coaches, athletic trainers, and staff can respond quickly and effectively to protect student-athletes from severe health consequences, including organ failure or death.

An EAP designates specific roles to ensure a coordinated, fast response:

●     Who removes the athlete from activity & assesses symptoms?

●     Who calls 911 & provides key details to EMS?

●     Who initiates cooling measures(ice immersion, cold towels, ColdVest)?

●     Who directs EMS to the correct location?

An effective EAP guarantees that lifesaving cooling equipment is ready and accessible, including:

●     Cold tubs – the gold standard for heat stroke treatment.

●     Cold water immersion supplies –ice bags, wet towels.

●     ColdVest – not a replacement for ice baths but serves as a critical tool when ice is unavailable and for transport.

●     Rectal thermometers – the gold standard for diagnosing heat stroke.

An EAP can also include preventive measures to reduce therisk of heat-related emergencies:

●     Monitoring Wet Bulb GlobeTemperature (WBGT) to adjust practice intensity.

●     Implementing heat acclimatization guidelines (gradual increase in practice duration & intensity).

●     Mandatory hydration breaks and electrolyte replenishment.

●     Proper clothing recommendations(light-colored, moisture-wicking gear).

Remember: COOL FIRST, TRANSPORT SECOND.

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