The irony of football being a team sport and success coming from buy in, culture change, unity, collective responsibility and LEADERSHIP is The TEAM that is responsible for caring for our players safety in preventing Exertional Heat Stroke needs to understand the same. SUPPORT NEEDS TO EXIST TO DO THE RIGHT THING. The Medical Field has said that Exertional Heat Stroke (EHS) IS 100% preventable yet often leaves judgment to intensity,duration,and frequency of practice to coaches without giving them clear guidelines to the individuals heat and exercise tolerance. Pre-participation physicals never have and never will prevent EHS unless change to include Peak Vo2 testing. Peak Vo2 testing measures a players production of heat and the circulatory system ability to release that heat. A players Peak Vo2 under 40 ml/kg /min is consider a risk factor for Heat Storage that can lead to EHS when doing High Intensity work in a repeat manner according to the ACSM guildlines.In fact some coaches are under the false impression that the athletic Trainer handles all his heat related concerns. If a player goes down from what the coach had him do in practice is having a Athletic Trainer come to the rescue is this PREVENTION or REACTING to a very bad situation that is in need of a Emergency Action Plan. Our Teams goal should be to take Evidence Based information and show Coaches HOW to practically applied it (Prepare to Prevent). However support needs to exist from all TEAM members to do the right thing.Princple, AD, AT, Team Physician, Coach, Strength & Conditioning Coach, and Parents all have a role but the most important role is respecting what is Evidence Based and not letting our attitude prevent change if it can prevent a death.Exertional Heat Stroke can occur from many combine risk factors. The number one risk factor that I see being ignore from all TEAM members at every level is High Intensity Exercise or Physical Exertion that produces more heat than the individuals Cardio system can release to environment. So Heat can be gain from environment and muscles contracting that can lead to heat storage unless there is a sufficient level of AEROBIC STRENGTH to allow Thermal Balance. Aerobic Strength can be measure though Peak Vo2 testing with the same degree of accuracy as a blood pressure test. Peak Vo2 testing can INDENTIFY low to high heat tolerance before practices even start. The American College of Sports Medicine Position Statement on heat illness list VO2 scores under 40ml/kg/min as a risk factor relating to poor physical fitness. The National Athletic Trainers Position Statement Exertional Heat Illness lists under Nonenvironmental risk factors Poor Physical Condition as Individuals who are untrained are more susceptible to heat illness than are trained athletes. As the Vo2 max of individual improves, the ability to withstand heat stress improves independent of acclimatization and heat adaptation. High Intensity work can elevate core temperature of at risk individuals to dangerous levels within 20 to 30 min.Acclimatization to heat and high intensity exercise is a Physiologic process. When describing acclimimatization we must ask to what, walking to a school bus or running wind sprints that produce heat 5 times higher. Acclimatization describes HOW the body changes to allow more work to be performed with a lower core temperature. Your Cardiovascular system is the workhorse to get more blood to muscle for muscle contractions and skin for heat release. The capacity to increase blood flow to muscle and skin comes from improvements in Peak Vo2 but to sustain comes from correct training. Aerobic Strength Training from Vo2 test results is what causes the Physiological responses to becoming HEAT FIT. Like any other form of strength (absolute, speed, short term endurance, anaerobic) AEROBIC STRENGTH has guidelines that need to be followed for safety and performance. Aerobic Strength leads to improvements of Peak Vo2 scores during steady rate training which increases the Acclimatization by being able to transfer more heat to skin. Misconception, Inconsistency, and outright fraudulent claims that doing football anaerobic drills in practice can cause the same training affect are still the mindset of many Leaders that are wrong. Physical Fitness, increase condition, in shape, in relation to being Heat Fit or a higher rate of acclimatization should only be associated with Peak Vo2.What is the best way to develop this form of strength should be just as important as INDENTIFYING low to high scores. The number one cause of Exertional Heat Stroke is an unmatched physical intensity of exercise for the athletes current level Peak Vo2 capacity. Produce more heat from muscles than you have the circulatory capacity to release. Heat that is GAIN becomes Heat that is STORED. Evidence Based Information vs. Attitude. We are losing players to EHS across the United States because we are not practically applying what we know we can prevent. SUPPORT FOR THE RIGHT THING TO DO NEEDS TO EXIST before we can see a culture change that just like water being present at all practices and encourage to drink. How could water being restricted from practices continue from 1960 though 1975 when the EVIDENCE show muscle dehydration cause blood volume to drop, which reduce stroke volume, that lower Cardio Output and cause athletes Peak Vo2 to drop 10% at 2% dehydration which leads to Heat Storage and possible death from EHS. We have more Coaches buying in today to the importance of hydration not because they understand Thermal Balance but because of other members of TEAM that support that it is the right thing to do to prevent a death. Whether your Peak Vo2 is low from dehydration or low from not training for Aerobic Strength correctly either way causes players to be at risk for Exertional Heat Stroke. Collective Responsibility is who to hold responsible for someone’s else’s action by tolerating, or ignoring them without participating in the action that you knew was wrong. A Team Physician, AT,Coach,AD,Strength& Conditioning Coach or even a Parent would not let a coach teach tackling with the head down because it has become well known to being the cause of severe injury. This support needs to exist from all TEAM members to do the right thing to prepare to prevent EHS.IF Sweargin is confident that Georgia is taking the right steps and passing the right measures to provide the best care for our young athletes then test players Peak Vo2 to INDENTIFY low to high heat tolerance and then use data to improve Safety every parent wants, performance every player desires and liability of all involved. Mike Craven True Fitness Solutions