Body sweat loss can be significant in summer endurance races and may result in a body water deficit of – of body weight. Such dehydration will reduce the ability to exercise in the heat because decreases in circulating blood volume, blood pressure, sweat production, and skin blood flow all inhibit heat loss, and predispose the runner to heat exhaustion or the more dangerous hyperthermia and exertional heatstroke.
Heat exhaustion, typically the most common heat illness among athletes, is defined as the inability to continue exercise in the heat. It represents a failure of the cardiovascular responses to workload, high external temperature, and dehydration. Heat exhaustion has no known chronic, harmful effects. Symptoms may include headache, extreme weakness, dizziness, vertigo, heat sensations on the head or neck, heat cramps, chills, goose flesh goose bumps, vomiting, nausea, and irritability. Hyperventilation, muscular incoordination, agitation, impaired judgment, and confusion also may be seen. Heat syncope fainting may or may not accompany heat exhaustion. The onset of heat exhaustion symptoms is usually sudden and the duration of collapse brief. During the acute stage of heat exhaustion, the patient looks ashen-gray, the blood pressure is low, and the pulse rate is elevated. Hyperthermia may add to the symptoms of heat exhaustion, even on relatively cool days ,
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Although it is improbable that all heat exhaustion cases can be avoided, the most susceptible individuals are those who either exert themselves at or near their maximal capacities, are dehydrated, not physically fit, and not acclimatized to exercise in the heat. It is imperative that runners be adequately rested, fed, hydrated, and acclimatized; they should drink ample fluids before, during, and after exercise. Also, repeated bouts of exercise in the heat heat acclimatization reduce the incidence of both heat exhaustion and heat syncope. Heat acclimatization can best be accomplished by gradually increasing the duration and intensity of exercise training during the initial – days of heat exposure.
Oral rehydration is preferred for heat exhaustion patients who are conscious, coherent, and without vomiting or diarrhea. Intravenous IV fluid administration facilitates rapid recovery. Although a variety of IV solutions have been used at races, a dextrose sugar in eithersaline NaCl orNaCl are the most common. Runners may require up to L of IV fluid if severely dehydrated.
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