AN expert in heat-related illnesses has testified that “more could have been done” by coaching staff to treat a teenager who suffered heat stroke at rugby league training and later died.

But emergency medicine professor Ian Rogers said current guidelines for sports trainers surrounding the recognition and treatment of the potentially fatal condition were confusing.

Talented rugby league player Torran Jake Thomas, 15, died from multiple organ failure three days after he suffered heat stroke during training for NRL development squad the West Coast Pirates at Curtin University’s sporting grounds on January 5, 2015.

It was the first session for the year after the Christmas break on a day where temperature had peaked at 44.4C but had eased to about 34.3C at 5.44pm, when it was decided training would go ahead with extra breaks.

This week, a coronial inquest has examined the circumstances around the teenager’s death and whether the “guidance material on heat-related illnesses adequately address the identification, recognition and treatment of heat stroke”.

The inquest was told Torran was showing signs of fatigue during a running exercise about 6.25pm before stopping and laying down on the grass.

It was told that between 6.30pm and 6.40pm, after being helped to the sideline, Torran laid back in a “star fish” fashion and was of breath but appeared to be getting better.

Torran’s head coach and Luke Young and program co-ordinator Edward Easter both testified earlier this week that they initially thought the teenager, who had performed well in the running drill, was exhausted.

But between 6.40pm and 6.50pm, the teenager’s condition declined and he eventually became unresponsive. A decision was made to call an ambulance at 6.54pm.

Giving evidence today, Dr Rogers said there were “subtle” signs that Torran had heat stroke in the first 10-minute period but it may not have been obvious.

While he said fatigue would have been a fair assumption early on, it would have been “absolutely clear” in the minutes following that he had “all the classic signs” of the condition. He said the most “telling sign” was Torran’s “altered state of consciousness”.

Dr Rogers said guidelines developed for the NRL by Sports Medicine Australia relating to the signs and symptoms of heat exhaustion and the more serious heat stroke could be confusing.

He said a person would recover quickly from heat exhaustion but the “critical part of recognising heat stroke is that failure to recover after the initial event”.

He said it should be made clear that there was no “downside” for treating heat stroke on “suspicions alone”, saying early treatment and “aggressive cooling” could be the difference between life and death.

“The best heat stroke victim I can see in the emergency department are those who have already been treated on the field,” he said.

Dr Rogers said while there had been efforts to cool Torran by using ice packs and dousing him with water, “more could have been done’, including stripping the teenager of his clothes, fanning him or using an ice-bath.

He said Torran did not have a genetic susceptibility to heat stroke and drugs were not a factor, but said his big body size — he was 192cm tall and weighed 135kg — may have made it harder for him to lose heat.

The inquest will continue at a date yet to be set.