Transcript Sports Medicine

10/13/14
Entry Task: Why do we perform a progressional return to play
for concussions?
 Certain environmental conditions can adversely
impact performance and pose serious health
threats
 Most common:
 Hyperthermia
 Hypothermia
 Lightning storms
 Over exposure to the sun
Hyperthermia
 Increase in body temperature
 Understand information about temperature, humidity, and weather to
be able to make decisions about environmental dangers
 Weather channel
 Newspaper
 Cell phone apps / internet
 Prolonged exposure to hot, humid weather can lead to heat illness
 Preventable, but also deadly
 Body must dissipate heat to maintain homeostasis (98.6 degrees)
 Four mechanisms to dissipate heat
 Conduction:
 Direct contact with a cooler object
 Convection:
 Contact with cooler air flow or water flow
 Radiation:
 Heat generated from metabolism (within the body)
 Evaporation:
 Sweat evaporating from the skins surface
 Sweat glands allow water transport to skin surface
 Evaporation of water takes heat with it
 Air must be relatively water free for this to occur
 Relative humidity of 65% impairs process
 Relative humidity of 75% stops process
 Heat illness in a cold environment?
 Ambient air temperature + relative humidity = how hot it actually feels to human
body
 Heat, sunshine, humidity must be monitored
 Tools:
 Psychrometer (WBT, DBT)
 Sling
 Digital
 Associated with rapid fatigue during overexposure to heat
 Caused by peripheral vasodilation, hypotension, or pooling of blood in extremities
leading to dizziness, fainting, and nausea
 Treat by removing from environment and replacing fluids
 Painful muscle spasms (calf, abdomen) due to imbalance between water and
electrolytes
 Typical in someone who is in shape who overexerts themselves
 Treatment
 Prevent with hydration (balance)
 Treat with fluids, electrolytes, and light stretching with ice massage
 Return to play?
 Result of inadequate fluid replacement
 Signs
 Profuse sweating
 Pale skin
 Elevated temperature (102 degrees)
 Dizziness / light headed
 Hyperventilation
 Rapid pulse
 Disoriented
 Performance will decrease
 As little as 3% water loss
 Treatment:
 Fluid ingestion
 May need to be intravenous
 Place in cool environment
 Ice bags
 On neck, arm pits, groin
 Serious, life-threatening emergency
 Characterized by:
 Sudden collapse with loss of consciousness
 Flushed, red, hot skin
 Minimal or cessation of sweating
 Shallow breathing
 Rapid, strong pulse
 Core temperature of 104 degrees or higher
 Can occur suddenly and without warning
 Possibility of death greatly decreased if body temperature is lowered to normal
within 45 minutes
 Treatment
 Remove clothing is possible
 Immerse in ice bath
 Transport to hospital / activate EMS
 They’ll take care of rehydration
 Low concentration of sodium and too much fluid
 Caused by too much water before, during, and after exercise
 Too little sodium in diet or fluids over prolonged period of exercise
 Signs and Symptoms:
 Worsening headache
 Nausea and vomiting
 Swelling of hands / feet
 Lethargy, apathy, or agitation
 Low blood sodium
 Should match sweat loss
 Replace at regular intervals (15 min.)
 Absorbed rapidly from intestine
 Drink with 6% CHO
 Cold drinks
 Drinks with caffeine and alcohol?
 Levels monitored via urine color
 Appropriate hydration=clear urine within 60 minutes of exercise
 Becoming accustomed to heat and exercising in heat
 Pre-season conditioning and graded intensity changes
 80% can be achieved within 5-6 days
 2 hours in the morning, 2 hours in the afternoon
 Complete after 10-14 days
 Athletes with large muscle mass
 Overweight athletes
 Increased fluid loss
 Medications or supplements that may impair sweating
 Poor fitness levels, history
 Measure before and after practice for at least first 2 weeks
 A loss of 3-5% of body weight reduces blood volume and could lead to health threat
 Temperature, wind chill, dampness or wetness can increase chances of hypothermia
 Muscular fatigue > exercise drops > heat loss > impaired neuromuscular responses
and exhaustion
 Drop in core temp. stimulates shivering
 Shivering stops below 85-90 degrees
 Death: below 77-85 degrees
 Fluid replacement just as critical
 Dehydration > decreased blood volume > less fluid to warm
tissues
 May need to monitor weight of athletes
training in cold
temperatures
 Loss through
respiration
 Involves ears, nose, chin, fingers, and toes
 During high wind and/or severe cold
 Skin appears very firm with cold, painless areas that may peel or blister (24-72
hours)
 Treatment:
 Firm, sustained pressure
 Blowing warm air on area
 Fingertips in armpits
 Do not rub!
 Superficial Frostbite involves skin and subcutaneous tissue
 Appears pale, hard, cold, and waxy
 When re-warming the area will feel numb, then sting and burn
 May blister and be painful for several weeks
 Deep Frostbite indicates frozen skin / tissue requiring hospitalization
 Rapid re-warming is necessary (100-110 degrees)
 Tissue becomes blotchy, red, swollen, and extremely painful and may become gangrenous
 Due to Ultra Violet Radiation (UVR)
 Premature aging of skin
 Dryness, cracking, and inelasticity
 Skin cancer
 Most common malignant tumor found in humans
 Rate of cure exceeds 95% with early detection
 Use sunscreen!!
 NATA has established position statement to be followed by
athletic trainers, coaches, athletic directors, etc.
 Included in EAP
 Shelter indoors should be obtained
 Avoid large trees, flag/light poles, standing water,
telephones, pools, showers, and metal objects (bleachers,
equipment, umbrellas)
 Last resort: find car, ravine, ditch or valley for safety
 If hair stands up on neck > crouch to the ground
 Estimates how far away lightning is
 From time of lightning, count seconds until thunder is heard
and divide by 5
 This equals how many miles away the lightning is
 Count of 30
 Count of 15
 NATA and National Weather Service recommend returning to
the field 30 minutes following the last clap of thunder or
lightening strike