Scientific Articles on Sudden Death in Sport

Causes of Sudden Death in Sport


Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2008;121:S402-S407.

John M. Exercise induced anaphylaxis: one more cause for syncope. W VA Med J. 1994;90(12):518.

Gani F, Selvaggi L, Roagna D. Exercise-induced anaphylaxis. Recenti Prog Med. 2008;99(7-8):395-400.

Nichols AW. Exercise-induced anaphylaxis and urticaria. Clin Sports Med. 1992;11(2):303-312.

Shadick NA, Liang MH, Partridge AJ, et al. The natural history of exercise-induced anaphylaxis: Survey results from a 10-year follow-up study. J Allergy Clin Immunol. 1999;104(1):123-127.


Becker JM, Rogers J, Rossini G, Mirchandani H, D’Alonzo GE. Asthma deaths during sports: report of a 7-year experience. J Allergy Clin Immunol. 2004;113(2):264-267.

Global Strategy for Asthma Management and Prevention 2012 Update.  Retrieved from:  Accessed July 2013.

Hough DO, Dec KL. Exercise-induced asthma and anaphylaxis. Sports Med. 1994;18(3):162-172.

LaBella CR, Sanders DB, Sullivan C. Athletic trainers’ experience and comfort with evaluation and management of asthma: a pilot study. J Asthma. 2009;46(1):16-20.

Lang DM. Asthma deaths and the athlete. Clin Rev Allergy Immunol. 2005;29(2):125-129.

Mellion MB, Kobayashi RH. Exercise-induced asthma. Am Fam Physician. 1992;45(6):2671-2677.

Miller MG, Weiler JM, Baker R, Collins J, D’Alonzo G. National athletic trainers’ association position statement: management of asthma in athletes. J Athl Train. 2005;40(3):224-245.

Rundell KW, Im J, Mayers LB, Wilber RL, Szmedra L, Schmitz HR. Self-reported symptoms and exercise-induced asthma in the elite athlete. Med Sci Sports Exerc. 2001;33(2):208-213.

Rundell KW, Jenkinson DM. Exercise-induced bronchospasm in the elite athlete. Sports Med. 2002;32(9):583-600.

Weiler JM. Exercise-induced asthma: A practical guide to definitions, diagnosis, prevalence, and treatment. Allergy Asthma Proc. 1996;17(6):315-325.

Cardiac Conditions

Basavarajaiah S, Shah A, Sharma S. Sudden cardiac death in young athletes. Heart. 2007;93(3):287-289.

Basavarajaiah S, Wilson M, Whyte G, Shah A, McKenna W, Sharma S. Prevalence of hypertrophic cardiomyopathy in highly trained athletes: relevance to pre-participation screening. J Am Coll Cardiol. 2008;51(10):1033-1039.

Davies SW. Clinical presentation and diagnosis of coronary artery disease: stable angina. Br Med Bulletin. 2001;59(1):17-27.

Harmon KG, Asif IM, Klossner D, Drezner JA. Incidence of sudden cardiac death in national collegiate athletic association athletes. Circulation. 2011:1594-1600.

Koehler SA, Shakir A, Ladham S, Rozin L, Omalu B, Dominick J, Wecht CH. Cardiac contusion: definition, differential diagnosis, and cases presentation and the legal ramification of a misdiagnosis. Am J Foren Med Path. 2004;25(3):205-208.

Link MS, Wang PJ, Pandian NG, Bharati S, Udelson JE, Lee MY, Vecchiotti MA, VanderBrink BA, Mirra G, Maron BJ, Estes NA. An experimental model of sudden death due to low-energy chest-wall impact. New Engl J Med. 1998;338:1805-1811.

Maron BJ. Hypertrophic cardiomyopathy: a systematic review. J Am Med Assoc. 2002;287(10):1308-1320.

Maron BJ. Hypertrophic cardiomyopathy and other causes of sudden cardiac death in young competitive athletes, with considerations for preparticipation screening and criteria for disqualification. Cardiol Clin. 2007;25(3):399-414.

Maron BJ. The young competitive athlete with cardiovascular abnormalities: Causes of sudden death, detection by preparticipation screening, and standards for disqualification. Card Electrophysiol Rev. 2002;6(1-2):100-103.

Maron BJ, Estes, NAM, Link MS. Task force 11: commotio cordis. J Am Coll Cardio. 2005;45:1371-1373.

Maron BJ, Gohman TE, Kyle SB, Estes NAM, Link, M. Clinical profile and spectrum of commotio cordis. J Am Med Assoc. 2002;287(9):1142-1146.


Maron BJ, Poliac LC, Kaplan JA, Mueller FO. Blunt impact to the chest leading to sudden death from cardiac arrest during sports activity. New Engl J Med. 1995;333:337-342.

Maron BJ, Thompson PD, Puffer JC, McGrew CA, Strong WB, Douglas PS, Clark LT, Mitten MJ, Crawford MH, Atkins DL, Driscoll DJ, Epstein AE. Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee (cardiovascular disease in the young), American Heart Association. Circulation. 1996;94(4):850-6.

Salib EA, Cyran SE, Cilley RE, Maron BJ, Thomas NJ. Efficacy of bystander cardiopulmonary resuscitation and out-of-hospital automated external defibrillation as life-saving therapy in commotio cordis. J Pediat, 2005;147:863-866.

Thompson PD, Balady GJ, Chaitman BR, Clark LT, Levine BD, Myerburg RJ. Task force 6: coronary artery disease. J Am Coll Cardiol. 2005;45(8):1348-1353.

Thompson PD, Franklin BA, Balady GJ, Blair SN, Corrado D, Estes NA, Fulton JE, Gordon NF, Haskell WL, Link MS, Maron BJ, Mittleman MA, Pelliccia A, Wegner NK, Willich SN, Costa F. Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation. 2007;115(17):2358-2368. 

Cervical Spine Injury

Bailes JE, Petschauer M, Guskiewicz KM, Marano G. Management of cervical spine injuries in athletes. J Athl Train.  2007;42(1):126-134.

Boden BP, Prior C. Catastrophic spine injuries in sports. Curr Sports Med Rep. 2005;4(1):45-49.

Boden BP, Tacchetti RL, Cantu RC, Knowles SB, Mueller FO. Catastrophic cervical spine injuries in high school and college football players. Am J Sports Med. 2006;34(8):1223-1232.

Gill SS, Boden BP. The epidemiology of catastrophic spine injuries in high school and college football. Sports Med Arthrosc. 2008;16(1):2-6.

Heck JF, Clarke KS, Peterson TR, Torg JS, Weis MP. National athletic trainers’ association position statement: head-down contact and spearing in tackle football. J Athl Train. 2004;39(1):101-111.

Holly LT, Kelly DF, Counelis GJ, Blinman T, McArthur DL, Cryer HG. Cervical spine trauma associated with moderate and severe head injury: Incidence, risk factors, and injury characteristics. J Neurosurg. 2002;96(3 Suppl):285-291.

Lawrence DW, Stewart GW, Christy DM, Gibbs LI, Ouellette M. High school football-related cervical spinal cord injuries in louisiana: The athlete’s perspective. J La State Med Soc. 1997;149(1):27-31.

Swartz EE, Boden BP, Courson RW, Decoster LC, Horodyski M, Norkus SA, Rehberg RS, Waninger KN. National athletic trainers’ association position statement: acute management of the cervical spine-injured athlete. J Athl Train. 2009;44(3):306-331.

Swartz EE, Waninger KN. Cervical Spine Injury. Casa DJ. Preventing Sudden Death in Sport and Physical Activity. Sudbury, MA: Jones and Bartlett Learning; 2012:129-126. 

Torg JS, Quedenfeld TC, Burstein A, Spealman A, Nichols C,3rd. National football head and neck injury registry: report on cervical quadriplegia, 1971 to 1975. Am J Sports Med. 1979;7(2):127-132.

Torg JS, Quedenfeld TC, Moyer RA, Truex R,Jr, Spealman AD, Nichols CE. Severe and catastrophic neck injuries resulting from tackle football. Del Med J. 1977;49(5):267-8,271-3,275.

Waninger KN, Swartz EE. Cervical spine injury management in the helmeted athlete. Curr Sports Med Rep. 2011;10(1):45-49.


Draznin MB. Type 1 diabetes and sports participation; strategies for training and competing safely. Physician Sportsmed. 2000;28(12):49-56.

Jimenez CC, Corcoran MH, Crawley JT, Hornsby WG, Peer KS, Philbin RD, Riddell MC. National athletic trainers’ association position statement: management of the athlete with type 1 diabetes mellitus. J Athl Train. 2007;42(4):536-545.

Perry E, Gallen IW. Guidelines on the current best practice for the management of type 1 diabetes, sport and exercise. Pract Diabetes Int. 2009;26(3):116-123.

Exertional Heat Stroke

Prevention/Predisposing Factors

Almquist J, Valovich McLeod TC, Cavanna A, Jenkinson D, Lincoln AE, Loud K, Peterson BC, Portwood C, Reynolds J, Woods TS. Summary statement: appropriate medical care for the secondary school-aged athlete. J Athl Train. 2008;43(4):416-427.

Bartley JD. Heat stroke: is total prevention possible? Mil Med. 1977;142:528,533–5.

Bedno SA, Li Y, Han W, Cowan DN, Scott CT, Cavicchia MA, Niebuhr DW. Exertional heat illness among overweight U.S. Army recruits in basic training. Aviat Space Environ Med. 2010;81:107–11.

Dougherty KA, Chow M, Kenney WL. Critical environmental limits for exercising heat-acclimated lean and obese boys. Eur J Appl Physiol. 2010;108:779–789.

Heat Stress Control and Heat Casualty Management. Army/Air Force Bulletin (USARIEM). TB Med 507/AFPAM 48-152 (I). 2003..pdf

Maron BJ. Can sudden cardiac death be prevented? Cardiovasc Pathol. 2010;19(6):329-335.

Mass participation event management for the team physician: a consensus statement. American College of Sports Medicine. Med Sci Sports Exerc. 2004;36(11):2004-2008.

Rav-Acha M, Hadad E, Epstein Y, Heled Y, Moran DS. Fatal exertional heat stroke: a case series. Am J Med Sci. 2004;328:84–87.

Sunderland C, Morris JG, Nevill ME. A heat acclimation protocol for team sports. Br J Sports Med. 2008;42:327–333.

Wallace RF, Kriebel D, Punnett L, Wegman DH, Wenger CB, Gardner JW, Kark JA. Risk factors for recruit exertional heat illness by gender and training period. Aviat Space Environ Med. 2006;77:415–421.

Yeargin SW, Casa DJ, Armstrong LE, Watson G, Judelson DA, Psathas E, Sparrow, SL. Heat acclimatization and hydration status of american football players during initial summer workouts. J Strength Cond Res. 2006;20:463–470.

Recognition/Temperature Assessment

Brennan FH, O’Connor FG. Emergency triage of collapsed endurance athletes: a stepwise approach to on-site treatment. Phys Sportsmed. 2005;33:28–35.

Byrne C, Lim CL. The ingestible telemetric body core temperature sensor: a review of validity and exercise applications. Br J Sports Med. 2007;41:126–133.

Casa DJ, Armstrong LE, Ganio MS, Yeargin SW. Exertional heat stroke in competitive athletes. Curr Sports Med Rep. 2005;4:309–317.

Casa DJ, Becker SM, Ganio MS, Brown CM, Yeargin SW, Roti MW, Siegler J, Blowers JA, Glaviano NR, Huggins RA, Armstrong LE, Maresh CM. Validity of devices that assess body temperature during outdoor exercise in the heat. J Athl Train. 2007;42:333–342.

Coso JD, Aguado-Jimenez R, Mora-Rodriguez R. Infrared tympanic thermometry in a hot environment. Int J Sports Med. 2008;29:713–718.

Ganio MS, Brown CM, Casa DJ, Becker SM, Yeargin SW, McDermott BP, Boots LM, Boyd PW, Armstrong LE, Maresh CM. Validity and reliability of devices that assess body temperature during indoor exercise in the heat. J Athl Train. 2009;44(2):124–135.

Goodman DA, Kenefick RW, Cadarette BS, Cheuvront SN. Influence of sensor ingestion timing on consistency of temperature measures. Med Sci Sports Exerc. 2009;41:597–602.

Gunga HC, Werner A, Stahn A, Steinach M, Schlabs T, Koralewski E, Kunz D, Belavý DL, Felsenberg D, Sattler F, Koch J. The double sensor-A non-invasive device to continuously monitor core temperature in humans on earth and in space. Respir Physiol Neurobiol. 2009;169 Suppl 1:S63–8.

Heat Stress Control and Heat Casualty Management. Army/Air Force Bulletin (USARIEM). TB Med 507/AFPAM 48-152 (I). 2003..pdf

Kistemaker JA, Den Hartog EA, Daanen HA. Reliability of an infrared forehead skin thermometer for core temperature measurements. J Med Eng Technol. 2006;30:252–261.

Pryor RR, Seitz JR, Morley J, Suyama J, Guyette FX, Reis SE, Hostler D. Estimating core temperature with external devices after exertional heat stress in thermal protective clothing. Prehosp Emerg Care. 2012;16(1):136-141.

Ronneberg K, Roberts WO, McBean AD, Center BA. Temporal artery temperature measurements do not detect hyperthermic marathon runners. Med Sci Sports Exerc. 2008;40:1373–1375.

Shapiro Y, Seidman DS. Field and clinical observations of exertional heat stroke patients. Med Sci Sports Exerc. 1990;22:6–14.

Treatment/Cold Water Immersion

Belval LNCasa DJ, Adams WM, Chiampas GT, Holschen JC, Hosokawa Y, Jardine J, Kane SF, Labotz M, Lemieux RS, McClaine KB, Nye NS, O’Connor FG, Prine B, Raukar, NP, Smith MS, Stearns RL. Consensus Statement- Prehospital Care of Exertional Heat Stroke. Prehospital Emergency Care. 2018: Epub ahead of print.

Casa DJ, Kenny GP. In defense of cold water. Med Sci Sports Exerc. 2009;41(5):1164.

Casa DJ, McDermott BP, Lee EC, Yeargin SW, Armstrong LE, Maresh CM. Cold water immersion: The gold standard for exertional heatstroke treatment. Exerc Sport Sci Rev. 2007;35:141–149.

Clements JM, Casa DJ, Knight J, et al. Ice-water immersion and cold-water immersion provide similar cooling rates in runners with exercise-induced hyperthermia. J Athl Train. 2002;37:146–150.

Heat Stress Control and Heat Casualty Management. Army/Air Force Bulletin (USARIEM). TB Med 507/AFPAM 48-152 (I). 2003..pdf

McDermott BP, Casa DJ, O’Connor FG, McClung JM, Blake AS, Meenen PM, Gilmer AM, Caldwell KA. Cold-water dousing with ice massage to treat exertional heat stroke: A case series. Aviat Space Environ Med. 2009;80:720–722.

Proulx CI, Ducharme MB, Kenny GP. Effect of water temperature on cooling efficiency during hyperthermia in humans. J Appl Physiol. 2003;94:1317–1323.

Return to Play

Armstrong LE, De Luca JP, Hubbard RW. Time course of recovery and heat acclimation ability of prior exertional heatstroke patients. Med Sci Sports Exerc. 1990;22:36–48.

McDermott BP, Casa DJ, Yeargin SW, Ganio MS, Armstrong LE, Maresh CM. Recovery and return to activity following exertional heat stroke: considerations for the sports medicine staff. J Sport Rehabil. 2007;16:163–181.

Moran DS, Erlich T, Epstein Y. The heat tolerance test: an efficient screening tool for evaluating susceptibility to heat. J Sport Rehabil. 2007;16:215–221.

Moran DS, Heled Y, Still L, Laor A, Shapiro Y. Assessment of heat tolerance for post exertional heat stroke individuals. Med Sci Monit. 2004;10:CR252–7.

O’Connor FG, Williams AD, Blivin S, Heled Y, Deuster P, Flinn SD. Guidelines for return to duty (play) after heat illness: a military perspective. J Sport Rehabil. 2007;16:227–237.


Mazerolle SM, Casa TM, Casa DJ. Heat and hydration curriculum issues: part 1 of 4 – hydration and exercise. Athl Ther Today. 2009;14(2):39-44.

Mazerolle SM, Casa TM, Casa DJ. Heat and hydration curriculum issues: part 2 of 4 – exercising in the heat. Athl Ther Today. 2009;14(3):42-47.

Mazerolle SM, Yeargin SW, Casa TM, Casa DJ. Heat and hydration curriculum issues: part 3 of 4 – rectal thermometry. Athl Ther Today. 2009;14(4):25–31.

Mazerolle SM, Lopez R, Casa TM, Casa DJ. Heat and hydration curriculum issues: part 4 of 4 – cold water immersion. Athl Ther Today. 2009;14(5):12–17.

Mazerolle SM, Scruggs IC, Casa DJ, Burton LJ, McDermott BP, Armstrong LE, Maresh CM. Current knowledge, attitudes, and practices of certified athletic trainers regarding recognition and treatment of exertional heat stroke. J Athl Train. 2010;45:170–180.

McDermott BP, Casa DJ, Yeargin SW, Ganio MS, Lopez RM, Mooradian EA. Hydration status, sweat rates, and rehydration education of youth football campers. J Sport Rehabil. 2009;18:535–552.

EHS History

Casa DJ, Armstrong LE, Carter R, Lopez R, McDermott BP, Scriber K. Historical perspectives on medical care for heat stroke, part 1: ancient times through the nineteenth century. Athl Train Sports Health Care. 2010;2(3):132-138.

Knochal JP. Dog days and siriasis. how to kill a football player. J Amer Med Assoc. 1975;233:513–515.

Kupperman KO. Fear of hot climates in the anglo-american colonial experience. William Mary Quart. 1984;41(2):213–240.

Russell TG, Russell TM. Medicine in egypt at the time of napoleon bonaparte. Br Med J. 2003;327:1461–1464.

Exertional Sickling

Browne RJ. Sickle cell trait and sudden death. Sports Med. 1994;18(6):373-374.

Eichner ER. Pearls and pitfalls: Exertional sickling. Curr Sports Med Rep. 2010;9(1):3-4.

Eichner, ER. Sickle cell considerations in athletes. Clin Sports Med. 2011; 30:3,537-549.

Eichner ER. Sports medicine pearls and pitfalls–sickle cell trait and athletes: three clinical concerns. Curr Sports Med Rep. 2007;6:134–135.

Ferster K, Eichner ER. Exertional sickling deaths in Army recruits with sickle cell trait. Mil Med. 2012;177(1):56-59.

Kark JA, Posey DM, Schumacher HR, Ruehle CJ. Sickle-cell trait as a risk factor for sudden death in physical training. N Engl J Med. 1987;317(13):781-787.

Kerle KK, Nishimura KD. Exertional collapse and sudden death associated with sickle cell trait. Mil Med.1996;161(12):766-767.

Kerle KK, Runkle GP. Sickle cell trait and sudden death in athletes. JAMA. 1996;276(18):1472.

Makaryus JN, Catanzaro JN, Katona KC. Exertional rhabdomyolysis and renal failure in patients with sickle cell trait: is it time to change our approach? Hematology. 2007;12(4):349-352.

Mitchell BL. Sickle cell trait and sudden death–bringing it home. J Natl Med Assoc. 2007;99(3):300-305.

National Athletic Trainers’ Association consensus statement: sickle cell trait and the athlete. 2010:1-5..pdf


Hew-Butler T, Ayus JC, Kipps C, Maughan RJ, Mettler S, Meeuwisse WH, Page AJ, Peid SA, Rehrer NJ, Roberts WO, Rogers IR, Rosner MH, Siegel AJ, Speedy DB, Stuempfle KJ, Verbalis JG, Weschler LB, Wharam PM. Statement of the second international exercise-associated hyponatremia consensus development conference, New Zealand. Clin J Sport Med. 2008;18(2):111-121.

Hew-Butler T, Verbalis JG, Noakes TD. Updated fluid recommendation: Position statement from the international marathon medical directors association. International Marathon Medical Directors Association. (IMMDA). Clin J Sport Med. 2006;16:283–292.

Kipps C, Sharma S, Tunstall Pedoe D. The incidence of exercise-associated hyponatraemia in the London marathon. Br J Sports Med. 2011;45:14-19.

Montain SJ, Cheuvront SN, Sawka MN. Exercise associated hyponatraemia: quantitative analysis to understand the aetiology. Br J Sports Med. 2006;40:98–105; discussion 98–105.

Montain SJ, Sawka MN, Wenger CB. Hyponatremia associated with exercise: risk factors and pathogenesis. Exer Sport Sci Rev. 2001;29(3):113-117.

Noakes TD, Sharwood K, Speedy D, Hew T, Reid S, Dugas J, Almond C, Wharam P, Weschler L. Three independent biological mechanisms causeexercise-associated hyponatremia: evidence from 2,135 weighed competitive athletic performances. Proc Natl Acad Sci USA. 2005;102:18550–18555.

Noakes TD, Speedy DB. Case proven: exercise associated hyponatraemia is due to overdrinking. so why did it take 20 years before the original evidence was accepted? Br J Sports Med. 2006;40:567–572.

Rosner MH. Exercise-associated hyponatremia. Semin Nephrol. 2009;29(3):271-281.

Siegel AJ, Verbalis JG, Clement S, et al. Hyponatremia in marathon runners due to inappropriate arginine vasopressin secretion. Am J Med. 2007;120(5):461.e11-461.e17.

Weschler LB. Exercise-associated hyponatraemia: a mathematical review. Sports Med. 2005;35:899–922.


Cooper MA. Emergent care of lightning and electrical injuries. Semin Neurol. 1995;15(3):268-278.

Edlich RF, Farinholt HM, Winters KL, Britt LD, Long WB. Modern concepts of treatment and prevention of lightning injuries. J Long Term Eff Med Implants. 2005;15(2):185-196.

O’Keefe Gatewood M, Zane RD. Lightning injuries. Emerg Med Clin North Am. 2004;22(2):369-403.

Walsh KM, Bennett B, Cooper MA, Holle RL, Kithil R, Lopez RE. National athletic trainers’ association position statement: lightning safety for athletics and recreation. J Athl Train. 2000;35(4):471-477.

Walsh, K. M., et al. (2013). “National Athletic Trainers’ Association position statement: lightning safety for athletics and recreation.” J Athl Train 48(2): 258-270.


Curtin SM, Tucker AM, Gens DR. Pneumothorax in sports: issues in recognition and follow-up care. Phys Sportsmed. 2000;28(8):23-32.

Davis PF. Primary spontaneous pneumothorax in a track athlete. Clin J Sports Med. 2002;12:318-319.

Kizer KW, MacQuarrie MB. Pulmonary air leaks resulting from outdoor sports: a clinical series and literature review. Am J Sports Med. 1999;27(4):517-520.

Marnejon T, Sarac S, Cropp AJ. Spontaneous pneumothorax in weightlifters. J Sports Med Phys Fitness. 1995;35(2):124-126.

Partridge RA, Coley A, Bowie R, Woolard RH. Sports-related pneunothorax. Ann Emerg Med. 1997;30(4):539-541.

Putukian M. Pneumothorax and pneumomediastinum. Clin Sports Med. 2004;23(3):443-54.

Soundappan SVS, Holland AJA, Brown G. Sports-related pneumothorax in children. Pediatr Emerg Care. 2005;21(4):259-260.

Severe External Trauma

Bergqvist D, Hedelin H, Karlsson G, Lindblad B, Matzsch T. Abdominal injury from sporting activities. Br J Sports Med. 1982;16(2):76-79.

Bergqvist D, Hedelin H, Karlsson G, Lindblad B, Matzsch T. Abdominal trauma during thirty years: analysis of a large case series. Injury. 1981;13(2):93-99.

Bergqvist D, Hedelin H, Karlsson G, Lindblad B, Matzsch T. Patients with abdominal trauma and fatal outcome: analysis of a 30-year series. J Trauma. 1983;23(6):499-502.

Diamond DL. Sports-related abdominal trauma. Clin Sports Med. 1989;8(1):91-99.

Ray R, Lemire JE. Liver laceration in an intercollegiate football player. J Athl Train. 1995;30(4):324-326.

Rifat SF, Gilvydis RP. Blunt abdominal trauma in sports. Curr Sports Med Rep. 2003;2(2):93-97.

Schroeppel TJ, Croce MA. Diagnosis and management of blunt abdominal solid organ injury. Curr Opin Crit Care. 2007;13(4):399-404.

Wilson DH. Incidence, aetiology, diagnosis, and prognosis of closed abdominal injuries. A study of 265 consecutive cases. Br J Surg. 1963;50:381-389.

Traumatic Brain Injury

Bailes JE, Cantu RC. Head injury in athletes. Neurosurgery. 2001;48(1):26-45; discussion 45-6.

Guskiewicz KM, Bruce SL, Cantu RC, Ferrara MS, Kelly JP, McCrea M, Putukian M, Valovich McLeod TC. National Athletic Trainers’ Association position statement: management of sport-related concussion. J Athl Train. 2004;39(3):280-297.

Guskiewicz KM, Weaver NL, Padua DA, Garrett WE. Epidemiology of concussion in collegiate and high school football players. Am J Sports Med. 2000;28(5):643-650.

Logan SM, Bell GW, Leonard JC. Acute subdural hematoma in a high school football player after 2 unreported episodes of head trauma: A case report. J Athl Train. 2001;36(4):433-436.

McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Cantu R. Consensus statement on concussion in sport: 3rd international conference on concussion in sport held in Zurich, November 2008. Clin. J. Sport Med. 2009; 19:185-200.

Mueller FO. Catastrophic head injuries in high school and collegiate sports. J Athl Train. 2001;36(3):312-315.

Stieg PE, Kase CS. Intracranial hemorrhage: Diagnosis and emergency management. Neurol Clin. 1998;16(2):373-390.

Emergency Preparedness

Andersen JC, Courson RW, Kleiner DM, McLoda TA. National Athletic Trainers’ Association position statement: emergency planning in athletics. J Athl Train. 2002;37(1):99-104.

Casa DJ, Guskiewicz KM, Anderson SA, Courson RW, Heck JF, Jimenez CC, McDermott BP, Miller MG, Stearns RL, Swartz EE, Walsh KM. National Athletic Trainers’ Association position statement: preventing sudden death in sports. J Athl Train. 2012;47(1):96-118.

Courson R. Preventing sudden death on the athletic field: the emergency action plan. Curr Sports Med Rep. 2007;6:93–100.

Pagnotta KD, Mazerolle SM, Casa DJ. Exertional heat stroke and emergency issues in high school sports. J Strength Cond Res. 2010;24(7):1707-1709.

Heat Acclimatization

Armstrong LE, Stoppani J. Central nervous system control of heat acclimation adaptations: an emerging paradigm. Rev Neurosci. 2002;13:271–285.

Casa DJ, Csillan D. Preseason heat-acclimatization guidelines for secondary school athletics. J Athl Train. 2009;44(3):332–333.

Gisolfi CV. Work-heat tolerance derived from interval training. J Appl Physiol. 1973;35:349–354.

Gisolfi CV, Robinson S. Relations between physical training, acclimatization, and heat tolerance. J Appl Physiol. 1969;26:530–534.

Kampmann B, Brode P, Schutte M, Griefahn B. Lowering of resting core temperature during acclimation is influenced by exercise stimulus. Eur J Appl Physiol. 2008;104:321–327.

Heat Physiology

Brotherhood JR. Heat stress and strain in exercise and sport. J Sci Med Sport. 2008;11:6–19.

Gisolfi CV, Copping JR. Thermal effects of prolonged treadmill exercise in the heat. Med Sci Sport Med. 1974;6:108–113.

Gonzalez-Alonso J, Mora-Rodriguez R, Below PR, Coyle EF. Dehydration markedly impairs cardiovascular function in hyperthermic endurance athletes during exercise. J Appl Physiol. 1997;82:1229–1236.

Knochel JP, Beisel WR, Herndon EG, Gerard ES, Barry KG. The renal, cardiovascular, hematologic and serum electrolyte abnormalities of heat stroke. Am J Med. 1961;30:299–309.

Montain SJ, Coyle EF. Influence of graded dehydration on hyperthermia and cardiovascular drift during exercise. J Appl Physiol. 1992;73:1340–1350.

Noakes TD. Heat stress in sport–fact and fiction. J Sci Med Sport. 2008;11:3–5.

Sawka MN, Montain SJ, Latzka WA. Hydration effects on thermoregulation and performance in the heat. Comp Biochem Physiol A Mol Integr Physiol. 2001;128:679–690.

Wingo JE, Cureton KJ. Body cooling attenuates the decrease in maximal oxygen uptake associated with cardiovascular drift during heat stress. Eur J Appl Physiol. 2006;98:97–104.

Wingo JE, Cureton KJ. Maximal oxygen uptake after attenuation of cardiovascular drift during heat stress. Aviat Space Environ Med. 2006;77:687–694.

Wingo JE, Lafrenz AJ, Ganio MS, Edwards GL, Cureton KJ. Cardiovascular drift is related to reduced maximal oxygen uptake during heat stress. Med Sci Sports Exerc. 2005;37:248–255.

Critical Threshold vs Anticipatory Regulation

Ely BR, Ely MR, Cheuvront SN, Kenefick RW, Degroot DW, Montain SJ. Evidence against a 40 degrees C core temperature threshold for fatigue in humans. J Appl Physiol. 2009;107:1519–1525.

Gonzalez-Alonso J, Teller C, Andersen SL, Jensen FB, Hyldig T, Nielsen B. Influence of body temperature on the development of fatigue during prolonged exercise in the heat. J Appl Physiol. 1999;86(3):1032-1039.

Jay O, Kenny GP. Current evidence does not support an anticipatory regulation of exercise intensity mediated by rate of body heat storage. J Appl Physiol. 2009;107:630–631.

Marino FE. Anticipatory regulation and avoidance of catastrophe during exercise-induced hyperthermia. Comp Biochem Physiol B Biochem Mol Biol. 2004;139:561–569.

Noakes TD. The central governor model of exercise regulation applied to the marathon. Sports Med. 2007;37:374–377.

Schlader ZJ, Stannard SR, Mundel T. Exercise and heat stress: performance, fatigue, and exhaustion – a hot topic. Br J Sports Med. 2011;45(1):3-5.

Shephard RJ. Is it time to retire the ‘central governor’? Sports Med. 2009;39:709–721.

Tucker R. The anticipatory regulation of performance: the physiological basis for pacing strategies and the development of a perception-based model for exercise performance. Br J Sports Med. 2009;43:392–400.

Wet Bulb Globe Temperature/Environmental Considerations

Armstrong LE, Casa DJ, Millard-Stafford M, Moran DS, Pyne SW, Roberts WO. American College of Sports Medicine position stand: exertional heat illness during training and competition. Med Sci Sports Exerc.2007;39:556–572.

Binkley HM, Beckett J, Casa DJ, Kleiner DM, Plummer PE. National Athletic Trainers’ Association position statement: exertional heat illnesses. J Athl Train. 2002;37:329–343.

Cooper ER, Ferrara MS, Broglio SP. Exertional heat illness and environmental conditions during a single football season in the southeast. J Athl Train. 2006;41:332–336.


Armstrong LE. Assessing hydration status: the elusive gold standard. J Am Coll Nutr. 2007;26:575S–584S.

Armstrong LE. Hydration assessment techniques. Nutr Rev. 2005;63:S40–54.

Baker LB, Lang JA, Kenney WL. Change in body mass accurately and reliably predicts change in body water after endurance exercise. Eur J Appl Physiol. 2009;105:959–967.

Bozzetto S, Piccoli A, Montini G. Bioelectrical impedance vector analysis to evaluate relative hydration status. Pediatr Nephrol. 2010;25:329–334.

Casa DJ, Armstrong LE, Hillman SK, Montain SJ, Beiff RV, Rich BSE, Roberts WO, Stone JA. National athletic trainers’ association position statement: Fluid replacement for athletes. J Athl Train. 2000;35:212–224.

Godek SF, Bartolozzi AR, Burkholder R, Sugarman E, Dorshimer G. Core temperature and percentage of dehydration in professional football linemen and backs during preseason practices. J Athl Train. 2006;41:8–14; discussion 14–7.

Lopez RM, Casa DJ. The influence of nutritional ergogenic aids on exercise heat tolerance and hydration status. Curr Sports Med Rep. 2009;8(4):192-199.

Maughan RJ, Shirreffs SM. Dehydration and rehydration in competitive sport. Scand J Med Sci Sports. 2010;20:40-47.

Maughan RJ, Shirreffs SM. Development of individual hydration strategies for athletes. Int J Sport Nutr Exerc Metab. 2008;18(5):457-472.

Maughan RJ, Shirreffs SM, Leiper JB. Errors in the estimation of hydration status from changes in body mass. J Sports Sci. 2007;25:797–804.

Murray B. Hydration and physical performance. J Am Coll Nutr. 2007;26:542S–548S.

Noakes TD, Adams BA, Myburgh KH, Greeff C, Lotz T, Nathan M. The danger of an inadequate water intake during prolonged exercise. A novel concept re-visited. Eur J Appl Physiol Occup Physiol. 1988;57:210–219.

Nolte HW, Noakes TD. Comments on Baker et al.’s “Change in body mass accurately and reliably predicts change in body water after endurance exercise”. Eur J Appl Physiol. 2010;108:1061–1064.

Parents’ and coaches’ guide to dehydration and other heat illnesses in children. National Athletic Trainers’ Association. June 2003..pdf

Passe D, Horn M, Stofan J, Horswill C, Murray R. Voluntary dehydration in runners despite favorable conditions for fluid intake. Int J Sport Nutr Exerc Metab. 2007;17:284–295.

Rowland T. Fluid replacement requirements for child athletes. Sports Med. 2011;41(4):279-288.

Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS. American College of Sports Medicine position stand: exercise and fluid replacement. Med Sci Sports Exerc. 2007;39:377–390.

Shirreffs SM. Hydration: Special issues for playing football in warm and hot environments. Scand J Med Sci Sports. 2010;20:90-94.

Shirreffs SM, Armstrong LE, Cheuvront SN.  Fluid and electrolyte needs for preparation and recovery from training and competition. J Sports Sci. 2004;22:57-63.


Armstrong LE, Johnson EC, Casa DJ, Ganio MS, McDermott BP, Yamamoto LM, Lopez RM, Emmanuel H. The american football uniform: uncompensable heat stress and hyperthermic exhaustion. J Athl Train. 2010;45:117–127.

Cooper ER, Ferrara MS, Broglio SP. Exertional heat illness and environmental conditions during a single football season in the southeast. J Athl Train. 2006;41:332–336.

Godek SF, Bartolozzi AR, Burkholder R, Sugarman E, Dorshimer G. Core temperature and percentage of dehydration in professional football linemen and backs during preseason practices. J Athl Train. 2006;41:8–14; discussion 14–7.

Godek S, Godek JJ, Bartolozzi AR. Thermal responses in football and cross-country athletes during their respective practices in a hot environment. J Athl Train. 2004;39:235–240.

Johnson EC, Ganio MS, Lee EC, Lopez RM, McDermott BP, Casa DJ, Maresh CM, Armstrong LE. Perceptual responses while wearing an american football uniform in the heat. J Athl Train. 2010;45:107–116.

Kulka TJ, Kenney WL. Heat balance limits in football uniforms how different uniform ensembles alter the equation. Phys Sportsmed. 2002;30:29–39.

Yeargin SW, Casa DJ, Judelson DA, McDermott BP, Ganio MS, Lee EC, Lopez RM, Stearns RL, Anderson JM, Armstrong LE, Kraemer WJ, Maresh CM. Heat acclimatization and hydration status of american football players during initial summer workouts. J Strength Cond Res. 2006;20:463–470.

Medications and Effects on Thermoregulation

Roelands B, Hasegawa H, Watson P, Piacentini MF, Buyse L, De Schutter G, Meeusen RR. The effects of acute dopamine reuptake inhibition on performance. Med Sci Sports Exerc. 2008;40:879–885.

Watson P, Hasegawa H, Roelands B, Piacentini MF, Looverie R, Meeusen R. Acute dopamine/noradrenaline reuptake inhibition enhances human exercise performance in warm, but not temperate conditions. J Physiol. 2005;565:873–883.

Ergogenic Aids

Bailes JE, Cantu RC, Day AL. The neurosurgeon in sport: awareness of the risks of heatstroke and dietary supplements. Neurosurgery. 2002;51:283–6; discussion 286–8.

Lopez RM, Casa DJ. The influence of nutritional ergogenic aids on exercise heat tolerance and hydration status. Curr Sports Med Rep. 2009;8:192–199.

Lopez RM, Casa DJ, McDermott BP, Ganio MS, Armstrong LE, Maresh CM. Does creatine supplementation hinder exercise heat tolerance or hydration status? A systematic review with meta-analyses. J Athl Train. 2009;44:215–223.


Armstrong LE. Exertional Heat Illnesses. Human Kinetics; 2003.

Armstrong LE. Performing in Extreme Environments. Human Kinetics; 2000.