I looked at stats for SC for total strikeouts in a season as my son has 91 already with at least two games to go and playoffs so he should be 120 plus. He had 119 as a freshman and that was not close to the MO state record. The catch in both states is pitchers used to throw 140 pitches a game. A friend of ours threw over 120 pitches all 12 games he threw his senior year back in the 80's. It amazes him that my son is averaging 87 pitches a complete game the past two years. But he was a power pitcher who threw and hoped it went over the white.
I still don't have an answer for how do you handle it during a game for the original poster.