Hosting any sort of athletic event outdoors in October in Central Texas is always a gamble. You either get the benefit of a much-anticipated cool front that stalls just north of the city, making everything feel like summer is still with us, or the cool front that instead, drops the temperature by maybe a a couple of degrees. So, consider this: 70.3 miles of race, add some heat and humidity and plenty of sunshine and not surprisingly, people will exhaust their energy supply.

This year, the temperature and the heat index were a little more tolerable for the estimated 2,500 expected half-Ironman athletes who particpated in the Longhron Triathlon. With that said there were still some 400+ athletes who might recount this year's event a little differently. That's how many participants were treated by the Seton Southwest Hospital volunteers this year during the race's "cooler" temperatures.

Last year, the Longhorn half-ironman distance race -- with some warmer temperatures added to the mix -- coincided with the Chicago Marathon. Given relatively the same conditions, the Chicago race was eventually halted with more than 400+ people being treated for heat-related illnesses. The 2007 Longhorn race finished with just a few people being treated for the heat. The number of athletes starting the Longhorn race then totaled 759 with 728 finishing. This year, although given slightly better weather, some 2,400 athletes started the race with 1,822 finishing. Thus, the number of people that didn't finish the race increased as did the number that needed medical attention.

Seton Southwest Hospital volunteers along with other medical personnel from St. David's provided support for the Longhorn Triathlon .

"We saw everything from Myocardial Infarctions, severe dehydration, loss of consciousness, feet that had no skin remaining after the run, to a young boy that fell and cut his chin open," said Whitney Zant, Seton Southwest Hospital Supervisor and Longhorn Medical Tent Coordinator.

Similar to the setup for the Austin Marathon , the medical team established a portable hospital, complete with ER physicians, ER Nurses, NICU Nurses, Dell Children's Medical Center of Central Texas Nurses, Physical Therapists and Respiratory Therapists.

"The race requires all levels of care from complete one-on-one interaction with a physician dealing with a heat attack to physical therapy dealing with wounds. The Longhorn Triathlon brought every volunteer together to get the athletes back on their feet. This was an incredible event that saw more patients in a two-hour time period than any area Emergency Department," explained Whitney. "In addition, we saw numerous patients that had exercise-induced asthma that required immediate treatment for breathing."

Plenty of aid stations dosed out words of encouragement along with water, Gatorade, electrolyte replacement pills and flattened cola. After six-and-a-half hours on the course, athletes slowed the running pace to 12-minute miles, dripped cold water sponges over their heads and tried to make it to the next aid station. Most made it to the finish line although many sought refuge in the medical tent. More than 500 who registered didn't show up or didn't finish.

Obviously, the Central Texas heat can be brutal, even in October. So, keep that in mind as you train -- and remember that you need to be prepared. If you want to finish strong -- or for that matter, simply finish! -- you've got to train in the heat and take the necessary precautions to compete for any distance, not to mention 70.3-miles.

Heat-related Illnesses

If you are an athlete in Central Texas, it's a good idea to learn more about heat-related illnesses. There are three major types:

• heat cramps
• heat exhaustion
• heat stroke

What are heat cramps?

Heat cramps are the mildest form of heat injury and consist of painful muscle cramps and spasms that occur during or after intense exercise and sweating in high heat.

What is heat exhaustion?

Heat exhaustion is more severe than heat cramps and results from a loss of water and salt in the body. It occurs in conditions of extreme heat and excessive sweating without adequate fluid and salt replacement. Heat exhaustion occurs when the body is unable to cool itself properly and, if left untreated, can progress to heat stroke.

What is heat stroke?

Heat stroke, the most severe form of heat illness, occurs when the body's heat-regulating system is overwhelmed by excessive heat. It is a life-threatening emergency and requires immediate medical attention.

Symptoms and first-aid measures for heat injuries:

The following chart contains the most common symptoms of heat-related injuries. However, each person may experience symptoms differently. In addition specific treatment will be determined by your physician and may include some, or more, of the following:

Condition	Symptoms	First-aid and treatment
Heat cramps	painful cramps, especially in the legs flushed, moist skin mild fever, usually less than 102 F	Move to a cool place and rest. Remove excess clothing and place cool cloths on skin; fan skin. Give cool sports drinks containing salt and sugar such as Gatorade. Stretch cramped muscles slowly and gently.
Heat exhaustion	muscle cramps pale, moist skin usually has a fever over 102 F nausea vomiting diarrhea headache fatigue weakness anxiety, and faint feeling	Move to a cool place and rest. Remove excess clothing and place cool cloths on skin; fan skin. Give cool sports drinks containing salt and sugar such as Gatorade. If no improvement or unable to take fluids, call your physician or go to an emergency department immediately. IV (intravenous) fluids may be needed.
Heat stroke	warm, dry skin high fever, usually over 104 F rapid heart rate loss of appetite nausea vomiting headache fatigue confusion agitation lethargy stupor seizures, coma, and death are possible	Move to a cool place and rest. Call 911 or your local emergency medical service. Heat stroke is a life-threatening medical emergency and needs to be treated by a physician. Remove excess clothing and drench skin with cool water; fan skin. Place ice bags on the armpits and groin areas. Offer cool fluids if alert and able to drink.

Heat Effects on the Runner's Body

In the May 2007 issue of Austin Runner, Dr. Joseph Kozusko, an expert in the area of heat stress adaptation and hydration passed along these tips to keep the athlete's engine running optimally during an event where the heat index is high.

Mouth - When we need to hydrate, we develop flavor fatigue very quickly. Regardless of how tasty something is at first, we tend to get bored with the flavor even water so be sure to have a variety of options and flavors available.

Kidneys - The addition of electrolytes in some beverages (Gatorade, Ultima, Powerade, etc.) helps us retain fluid in our kidneys for urine production a key process in keeping the body working as efficiently as possible.

Stomach - We want fluids to empty from the stomach into our intestines at a fairly fast rate so they can be absorbed into other internal organs and the bloodstream to continue the cooling effort.

Skin - Overall maintenance of blood volume is the greatest factor in allowing our body to release the heat in our muscles via sweat, acting to keep our entire surface cool and safe.

Brain - With even small levels of dehydration, the ability of the brain to effectively operate is reduced. By entering a workout or race fully hydrated, were better able to focus on the task at hand.

Heart/Lungs - When fluids reach our bloodstream, the total blood volume increases to adequate levels so we can maintain the cardiovascular needs of our heart and lungs during exercise.

Muscles - By keeping the muscles well-lubricated, fluid replacement is critical to the proper contraction of working muscle groups, as well as prevention of injury.