Weather

Game administrators, officials and the sports medicine staff can be aware of adverse weather by following local forecasts and by monitoring the National Weather Service (NWS).  The NWS issues storm watches and warnings during times of severe weather. A watch means that the conditions are favorable for severe weather to develop, whyle a warning indicates severe weather has been reported and appropriate precautions should be taken.  It must be remembered that any thunderstorm poses a risk of injury, even if not deemed "severe" by the NWS.

Management

As soon as lightning is seen or thunder is heard, practice and competition should be suspended immediately.  A Lightning Safety Plan should be a component of the Emergency Action Plan and should be in place for every sport and facility.  This plan should contain instructions for participants and spectators, designation of safe shelters, and designation of warning and all clear signals.  This plan must be disseminated to the proper personnel and reviewed and practiced on a routine basis.

There should also be a systematic plan for monitoring weather.  The weather forecast should be closely followed throughout the day prior to any practice or competition.  A weather radio is helpful in providing current information.  Weather can also be monitored over the Internet or through the use of lightning strike monitors.  However, such technology should never be a substitute for directly hearing or seeing dangerous weather.  There should also be one person designated to monitor threatening weather and make decisions regarding participation.  However, if anyone hears thunder or sees a lightning strike, appropriate action should begin.

If lightning is imminent or a thunderstorm is approaching, all personnel, athletes, and spectators should be evacuated to safe structures.  A list of the closest safe structures should be announced and displayed on placards at all venues. The ideal  safe structure is a fully enclosed building with plumbing, telephone and electrical service, which aid in grounding the structure.  A fully enclosed automobile or school bus with all the windows rolled up is a reasonable shelter, although care must be taken to avoid contact with any metal inside the vehicle.  The hard metal frame and roof, not the rubber tires, dissipate the current around the vehicle.  Golf carts and convertible cars are not safe shelters.  Dugouts and golf shelters are not safe shelters and are not grounded for the effects of lightning.

Avoid the use of shower facilities and do not use showers or plumbing during a thunderstorm as the electrical current from lightning can enter the building through plumbing connections.  It is also unsafe to stand near utilities or use a landline telephone during a thunderstorm because of the risk of the current traveling through the lines.  Cellular and cordless telephones are considered to be safe.

If a suitable safe shelter is not available, it is best to avoid tall objects (trees, light poles, etc.) that allow lightning an easy path to the ground.  It is important to avoid being the tallest object.  In an open field, people should crouch with their legs together, the weight on the balls of their feet, arms wrapped around their knees, and head down with their ears covered.  The person should minimize contact with the ground and should NOT lie flat.

People who have been struck by lightning do not carry an electric charge.  Therefore, it is safe to perform CPR, if needed.  Ideally, injured persons are moved into a safe shelter.  Lightning-strike victims showing signs of cardiac or respiratory arrest need emergency help.

Prevention

In order to prevent lightning-related injuries, it is important to formulate and implement a Lightning Safety Plan and provide adequate education for all athletes and personnel.  The plan needs to be reviewed and practiced periodically.  The plan also must include a systematic approach for monitoring local weather activity and recognizing signs of nearby danger (thunder and lightning strikes). Criteria for suspension and resumption of activity should be clear.  Appropriate safe shelters for each athletic venue should be clearly identified.

References

• Bennett BL. A model lightning safety policy for athletics. Journal of Athletic Training 1997; 32:251-253.
• Cooper MA, et al. Lightning injuries. In: Auerbach PS, ed. Management of Wilderness and Environmental Emergencies. 5th ed. C.V. Mosby, 2007:6-108.
• Holle R, Lopez, R. Lightning-impacts and safety. WMO Bulletin 1998;47: 148-155.
• National Collegiate Athletic Association. Guideline 1d: Lightning safety. 2010-11 Sports Medicine Handbook (21st edition).

Material from the NFHS Sports Medicine Handbook (4th ed): 37-39

These guidelines provide a default policy to those responsible or sharing duties for making decisions concerning the suspension and restarting of practices and contests based on the presence of lightning or thunder. The preferred sources from which to request such a policy for your facility would include your state high school activities association and the nearest office of the National Weather Service.

Proactive Planning

1. Assign staff to monitor local weather conditions before and during practices and contests.

2. Develop an evacuation plan, including identification of appropriate nearby safe areas and determine the amount of time needed to get everyone to a designated safer area:

a. A designated safer place is a substantial building with plumbing and wiring where people live or work, such as a school, gymnasium or library. An alternate safer place from the threat of lightning is a fully enclosed (not convertible or soft top) metal car or school bus.

3. Develop criteria for suspension and resumption of play:

a. When thunder is heard or a cloud-to-ground lightning bolt is seen, the leading edge of the thunderstorm is close enough to strike your location with lightning. Suspend play for thirty minutes and take shelter immediately.
b. 30-minute rule. Once play has been suspended, wait at least 30 minutes after the last thunder is heard or lightning is witnessed* prior to resuming play.
c. Any subsequent thunder or lightning* after the beginning of the 30-minute count will reset the clock and another 30-minute count should begin.
d. When lightning-detection devices or mobile phone apps are available, this technology could be used to assist in making a decision to suspend play if a lightning strike is noted to be within 10 miles of the event location. However, you should never depend on the reliability of these devices and, thus, hearing thunder or seeing lightning* should always take precedence over information from a mobile app or lightning-detection device.
* – At night, under certain atmospheric conditions, lightning flashes may be seen from distant storms. In these cases, it may be safe to continue an event. If no thunder can be heard and the flashes are low on the horizon, the storm may not pose a threat. Independently verified lightning detection information would help eliminate any uncertainty.

4. Review the lightning safety policy annually with all administrators, coaches and game personnel and train all personnel.

5. Inform student-athletes and their parents of the lightning policy at start of the season.

Revised and Approved March 2018 (Source: NFHS Rule Book)

Guidelines on Handling Contests During Lightning or Thunder Disturbances

The NFHS Sports Medicine Advisory Committee (SMAC) convened in March 2018 and revised its “Guidelines on Handling Practices and Contests During Lightning or Thunder Disturbances” (see Appendix H).  These revised guidelines provide a model policy for consideration by those responsible or sharing duties for making decisions concerning the suspension and restarting of practices and contests based on the presence of lightning or thunder.

Even though large, substantial buildings containing electrical wiring and plumbing are generally considered as safe, there may still be a potential risk of lightning injury in certain situations indoors. Lightning can enter a building through electrical or telephone wiring and plumbing, which makes locker-room shower areas, swimming pools (indoor and outdoor), landline telephones, and electrical appliances unsafe during thunderstorms because of the potential contact injury. Even if the building is customarily grounded for electricity, lightning is often fast enough and powerful enough to spread and injure someone before the ground fault interrupters or other systems are triggered to protect the person touching any of these systems. Indoor swimming pools are just as dangerous as outdoor pools because lighting, heating, plumbing, and drains used in indoor pools ultimately connect to materials outside the building that can be used to transmit the lightning energy into the building or pool.  If people cannot reach a safer location when thunderstorms are in their area, they should at least avoid the riskiest locations and activities, including elevated places, open areas, tall isolated objects, and being in, on, or at the edge of large bodies of water, including swimming pools, as all of these locations are not lightning safe! 

Remember, The NFHS Guidelines state that activities should be suspended at the first sound of thunder or sighting of lightning and should not be resumed until 30 minutes after the last thunder is heard or lightning is seen.  Host management should have a plan in place regarding inclement weather that includes assignment of a staff member to monitor local weather conditions, development of an evacuation plan, and development of criteria for suspension and resumption of play.  The lightning safety policy should be reviewed annually with all administrators, coaches, officials, and meet personnel.  Student-athletes and their parents should be informed of the lightning policy at the start of each sports season.   A lightning safety policy is only effective if it is enforced.  Everyone should be aware of lightning as a threat, and those who oversee participants, whether they are responsible for health care, are coaches, or meet officials, should be proactive in vacating all student-athletes and spectators to a safer location.

2018-19 NFHS Swimming and Diving Rules Book, page 97

• Fall Football Acclimatization Regulations | Q&A
• Minimum Days of Practice/Acclimatization (from the WIAA Fall Regulations)
• Fall Football Acclimatization (Course)
• Model Policy for Managing Heat & Humidity
• NFHS Heat Related Illness (WBGT)
• Recognize to Recover (WBGT)
• OSHA Heat Safety Tool
• NFHS Heat Acclimatization/Illness Prevention
• NFHS Hydration to Minimize Risk
• Urine Color Chart
• Hyponatremia - Over-hydration
• Preseason Heat Acclimatization
• KSI - Emergency Action Plan
• NWS - Heat Safety
• Heat Index Chart
• NFHS Health and Wellness Course
• Tips for Safer Two-A-Days

Exertional Heat Stroke (or EHS) is the leading cause of preventable death in high school athletics. Exertional heat stroke can be prevented through acclimatization and taking  basic safety precautions. And knowing the signs of exertional heat stroke and heat illness, and having an  emergency action plan in place can prevent serious illness and save lives.

1. Physical exertion and training activities should begin slowly and continue progressively. An athlete cannot be “conditioned” in a period of only two to three weeks. See WIAA Football Season Regulations
2. Begin with shorter, less intense practices and training activities, with longer recovery intervals between bouts of activity.
3. Minimize protective gear (such as helmets and pads) during first several practices, and introduce additional uniform and protective gear progressively over successive days.
4. Emphasize instruction over conditioning during the first several practices. 
   Rationale: The majority of heat-related deaths happen during the first few days of practice, usually prompted by doing too much, too soon, and in some cases with too much protective gear on too early in the season (wearing helmet, shoulder pads, pants and other protective gear). Players must be allowed the time to adapt safely to the environment, intensity, duration, and uniform/equipment.
5. Keep each athlete’s individual level of conditioning and medical status in mind and adjust activity accordingly. These factors directly affect exertional heat illness risk.
   Rationale: Athletes begin each season’s practices and training activities at varying levels of physical fitness and varying levels of risk for exertional heat illness. For example, there is an increased risk if the athlete is obese, unfit, has been recently ill, has a previous history of exertional heat illness, or has Sickle Cell Trait.
6. Adjust intensity (lower) and rest breaks (increase frequency/duration), and consider reducing uniform and protective equipment, while being sure to monitor all players more closely as conditions are increasingly warm/humid, especially if there is a change in weather from the previous few days.
   Rationale: Coaches must be prepared to immediately adjust for changing weather conditions, while recognizing that tolerance to physical activity decreases and exertional heat illness risk increases, as the heat and/or humidity rise. Accordingly, it is imperative to adjust practices and/or competitions to maintain safety and performance. Coaches can monitor the athletes’ weights pre and post practice to ensure adequate fluid replacement, and can follow guidelines for hot and humid weather including using Wet Bulb Globe Temperature (WBGT) readings.
7. Athletes must begin practices and training activities adequately hydrated.
   Rationale: While proper hydration alone will not necessarily prevent exertional heat illness, it will decrease risk. Athletes can observe the color of their urine, which should be straw yellow or the color of lemonade, when adequately hydrated. A Urine Color Chart can be accessed at: http://www.urinecolors.com/themes/uctheme/assets/dehydration-chart.pdf
8. Recognize early signs of distress and developing exertional heat illness, and promptly adjust activity and treat appropriately. First aid should not be delayed!
   Rationale: An athlete will often show early signs and/or symptoms of developing exertional heat illness. If these signs and symptoms are promptly recognized and the athlete is appropriately treated, serious injury can be averted and the athlete can often be treated, rested and returned to activity when the signs and symptoms have resolved.
9. Recognize more serious signs of exertional heat illness (clumsiness, stumbling, collapse, obvious behavioral changes and/or other central nervous system problems), immediately stop activity and promptly seek medical attention by activating the Emergency Medical System (call 911). On-site rapid cooling should begin immediately.
   Rationale: Immediate medical treatment and prompt rapid cooling can prevent death or minimize further injury in the athlete with EHS. Ideally, equipment for Tarp-assisted Cooling Oscillation (TACO) method, or pools /  tubs of ice water to be used for rapid cooling of athletes should be available on-site and personnel should be trained and practiced in using these facilities for rapid cooling. Ice water baths are the preferred method for rapid cooling, however, if ice water pools or tubs are not available, then applying ice packs to the neck, axillae, and groin and rotating ice-water soaked towels to all other areas of the body can be effective in cooling an affected athlete. Remember, cool first, transport later.
10. An Emergency Action Plan (EAP) with clearly defined written and practiced protocols should be developed and in place ahead of time.  It can be helpful to engage the local EMS team to help understand when to transport athletes, ideally cooling the athlete prior to transportation, as the ambulance will not have a cooling mechanism.
    Rationale: An EAP should be in place in case of any emergency, as a prompt and appropriate response in any emergency situation can save a life. The EAP should be designed and practiced to address all teams (freshman, junior varsity, and varsity) and all practice and game sites. For heat illness emergencies, emphasis must be placed on full body cooling prior to transport.

Heatstroke and heat exhaustion is preventable if the proper precautions are taken.  Have water available at all times and to allow the athlete to drink water whenever he/she needs it.  Never restrict the amount of water an athlete drinks, and be sure the athletes are drinking the water. In addition, allow time for young athletes to adapt to the weather and provide rest more often.  Progressive acclimatization is critical.  Provide for gradual increases in frequency, duration and intensity of physical activity. The key is recovery.  Also, remove equipment during rest periods and change to dry shirts.