A lot of high school athletes are gearing up for practices in the hot summer sun.
Doctors are reminding coaches, trainers and athletes to be on the looking for signs of heat illness as they hit the field for fall sports.
Heat stroke can happen quickly. One minute the player can seem fine, the next minute, they're down, reported KCRA-TV in Sacramento, Calif.
When athletes are trying to do their best, they may ignore warning signs of heat illness. Even experienced athletes admit they have done it, reported KMBC-TV in Kansas City, Mo.
"I actually have a couple times," soccer player Derek Luetjen said. "Like, I got really dehydrated and got a really bad migraine and I puked a couple of times. Not fun."
The event that may have sparked the concern over hot-weather training is when Minnesota Vikings lineman Kori Stringer suddenly collapsed and died from heat stroke in August 2001.
Nationwide, 19 high school football players have died over the last decade, and dozens more have been hospitalized with heat illness.
Dr. Jim Kelly, of Children's Mercy Hospital in Kansas City, said young athletes are more susceptible to heat and need close supervision.
"Kids are at greatest risk because of their size and mass index, and they don't sweat as well as adults and sometimes don't recognize the early signs of heat illness," Kelly said.
Signs include: heat cramps, muscle aches, light-headedness and dizziness.
"Heat stroke is when the student athlete has lost all ability to lose heat after they gained so much heat, and then go into multi-organ failure," Kelly said. "They have an altered level of consciousness, confusion, core body temperature is very high; over 104 to 108 degrees."
If any heat stroke symptoms surface, it means it is time to take a break, get to a cool area and drink a lot of fluids.
"If that happens, we know to tell coach, and he'll give us a water break. And we'll go and sit down," said Chris Carter, a football player at Vacaville Christian High School in Vacaville, Calif.
Heat sickness signs include profuse sweating, unusual thirst, dizziness and headaches. If a player has suddenly stopped sweating or has muscle cramping or nausea and vomiting, and they seem confused or usually crabby, that could mean serious trouble. If that happens, coaches need to get the athlete immersed in a tub of ice immediately and call 911.
Many sports programs take the issue seriously, and the American College of Sports Medicine has new guidelines. Athletes need to hydrate before practice so they're not walking onto the field feeling thirsty. And coaches must make water readily available to all players at all times, and give water breaks every half-hour or more often if players begin to struggle.
During intense practices, sports drinks are the best bet.
"After a long workout, sometimes I drink a lot of Gatorade. It just depends how much the temperature is and stuff," said player Ben Mobbley.
It takes two weeks to acclimate the body to the heat, KCRA reported. Players be taught to recognize signs of heat illness so they can monitor each other.
"It's not a matter of being tough. It's a matter of being safe," said Victor Hall, director of Velocity Sports Performance, a sports training company.
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