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Study guide for Care and Prevention of Athletic Injuries
Taping
•Grade
•Positioning
•Area
•Preparation of the skin make sure it is clean and dry
oProtection of sensitive areas
•(compromise product) Under wrap vs. Taping directly to
the skin( better) Symptoms of concussion
•Retrograde amnesia- inability to recall events before the point of
concussion
•Anterograde (post-traumatic) amnesia- Inability to recall
events following the point of concussion
Heat Stroke
•Cool First…. Transport second
•Cool water immersion (gold Standard for immediate treatment)
oLowest mortality rate
oSuperior whole-body
cooling Triggers for depression
•Death of a loved one
•Academic troubles
•Romantic troubles
•Substance abuse
•Familial
history of Exertional
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Heat Stroke
•You can “Fry” them wet
•INTENSITY
•Hydration is key—but not sufficient to prevent heatstroke
•Acclimatized
•Out of shape
•Incessant Pace
•Heatstroke Habitus
•Insulating Uniform
Finding: All three studies consistently show campers exhibiting
greater total Na loss and higher sweat loss
Identification of Exertional Heatstroke
•Mental Status change is a
hallmark Hand Hygiene is Critical
•Wash hands for a minimum of 15 seconds to prevent
cross-contamination Rules Enforcement CAN make play safer
and “the game” remains “the game”
•The decline in cervical quadriplegic events after spear
tackling was banned in 1976
•Rule change, not equipment can make a
difference Concussions do not have to involve
the loss of consciousness
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Part a of NCAA rule- concussion
•Anybody exhibiting symptoms of concussion should be
removed from play and evaluated by a healthcare provider
•NCAA does allow a return to play if the player doesn’t have
a concussion after being assessed bthe y trainer
•If diagnosed with a concussion – can not return to play
the rest of the day Return to play protocol (time is not
specified)
•No activity: complete rest until asymptomatic
•Light aerobic exercise
•Sport-specific training
•Non-contact training drills
•Full- contact training after medical clearance
•Game
play Mandible
Fracture
•Deformity
•Malocclusion (loss of normal occlusion of the teeth)
•Pain with biting
•Bleeding around the teeth
•Physicians referral
Outcome- mental health (Psychosocial)
•Health of the person vs. Health of the athlete
•Return to
play?
Inappropriate
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Care
•Aural Temp
•Oral Temp
•MUST USE rectal temp—only way to truly
measure core temp. Call a concussion a concussion
•Reduces confusion
•“ding”
•“Bell ringer”
•Downplay the significance of
the injury EHS football deaths are
increasing
•1985-1994- 6 EHS football deaths
•1995-2004- 21 EHS football deaths
•2005-2011- 25 EHS football deaths
“Improved helmet design or added padding alone will not solve the
concussion problem… We need to place more emphasis on
behavior modification and improved tackling techniques.”
Can’t rely on helmets for answer
Characteristics of Non-traumatic Collapse
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Exertional Sickling
Sudden Cardiac
Death (SCD)
Exertional Heat
Stroke (EHS)
Asthma
Weakness > Pain
Gasping,
snorting,
gurgling, or
moaning
Fuzzy thinking
Usually known
asthma
Slumps to ground
Unprotected Fall
Bizarre behavior
Prior episodes,
poor control
Responsive,
initially
Unresponsive
Incoherent
Breathless,
may/may not
wheeze
No palpable cramp
Limp or seizing
Can be in a coma
Gasping,
panicky, on
hands/knees
Temp < 103
degrees F
Temp Irrelevant
Temp >106
degrees F
Auscultate:
moving little air
Can occur
early in the
workout
No warning
Usually occurs
late in the workout
Usually occurs
after sprinting
Exertional Heat Stroke- Chapter 5
•Exertional Heat stroke is diagnosed as having a core body
temp > 40.5 Degrees Celsius & CNS dysfunction
•Evaporation is the main mechanism that the body relies
upon to dissipate heat produced during exercise
•Regulation of the core body temp occurs in the hypothalamus
•Rectal Temperature allows you to rule out the vast majority of
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other emergency medical conditions when heat stroke is
suspected
•To avoid overcooling, an EHS victim should be removed
from cold-water immersion once his/her rectal
temperature reaches 101.5 degrees F
•Given that appropriate medical care is available, an athlete
with EHS should be transported to the hospital once he/she
has been sufficiently cooled
•Time taken to cool his/her body temp to below 102 degrees
F is the main factor determining recovery time from EHS
•Heat acclimatization is a series of adaptations that occur over
the course of 7-14 days that leads to improvement in exercise
heat tolerance
•An exertional heat stroke victim may have a short lucid interval
•The combination of the length of time an athlete’s temp is >
104.5 degrees F and the extent of the hyperthermia will
determine the outcome of the patient
•Ice water immersion is the fastest method to cool an EHS victim
•Exertional heat strokes can occur in any climate (doesn’t have to be
heated)
•Nutritional supplements do not contribute to EHS deaths
•Rectal temps are the only accurate temp assessment
method for exercising individuals that can be quickly
obtained
•A person does not have to be dehydrated to
succumb to EHS Concussion- Chapter 6
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•Cerebral concussion is the most common sport-related
traumatic brain injury (TBI)
•The sharp decline in the mid-1970s in the number of fatalities in
football due to brain injuries is attributed to rule changes
•Cerebral concussions occur due to direct blows to the
head and/or indirect blows to the body causing
transmission of impulsive forces to the brain.
•The severity of a singular TBI is most often related to the
acceleration forces exerted on the brain
•Unusually slow heart rate and increased systolic and
decreased diastolic pressures are indicators that an athlete
may have increased intracranial pressure
•In second impact syndrome, from the time of impact to
brainstem failure, and ultimately death is usually 2-5
minutes
•The number of nonfatal brain injuries in football has been
increasing since the 1970s
•When an impact is unanticipated and the cervical
musculature is not tensed, the head will experience a
substantially greater acceleration
•An athlete with a history of concussions is more likely to
sustain a concussion than an athlete with no history of
concussions, and this risk only increases with a greater
number of past concussions
•Loss of consciousness does not indicate the severity of a concussion
•If the athlete on the field is unconscious or just regaining
consciousness and is still confused the athlete should be
treated like that a cervical spine injury
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•Athletes with concussions should avoid medications containing
acetylsalicylic acid (aspirin) or NSAID however acetaminophen
(Tylenol) may be used sparingly if all other structural brain
injuries have been ruled out
•Concussions in collegiate athletes do not take long to resolve
than in high school athletes
Asthma- Chapter 11
•Death from asthma has been linked to anaphylaxis,
allergens, exercise, and delay in medical treatment with
a severe asthma exacerbation occurs
•Asthma involves these two physiological components:
Inflammation and Bronchoconstriction
•Risk factors for sudden death asthma include all of the
following: Previous severe or life-threatening attack, previous
hospital admission for asthma, and failure to control asthma
symptoms NOT: Recent asthma diagnosis
•Basketball and track have the highest incidence of asthma deaths
•During an asthma episode, after three uses of short-acting
beta agonist inhaler the athlete should be referred if the
symptoms do not improve
•Physical activity may help asthmatics maintain lung function
•Individuals with allergies, eczema or a genetic predisposition
may be at high risk for developing the disease
•Over-the-counter NSAIDS may exacerbate asthma episodes
•Exercise is a causative factor for developing severe asthma
exacerbations that lead to death
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•Intrinsic risk factors for sudden death asthma: Family
history, Ethnicity, and Athleticism
•Extrinsic risk factors for sudden death asthma:
Environmental factors, asthma medications
•5 symptoms of severe asthma: difficulty speaking in
complete sentences, chest pain, wheezing, drowsiness,
and shortness of breath
Hyponatremia- Chapter 12
•Symptomatic hyponatremia usually occurs in events lasting over 4 hours
•Handheld blood electrolyte analyzers are the best way to
diagnose/differentiate symptomatic hyponatremia onsite.
•If hyponatremia is not corrected, how can this potentially lead to death?
Herniation of brain structure and pulmonary arrest
•It is possible to be dehydrated and have exertional hyponatremia
•Athletes may experience symptoms of exertional
hyponatremia hours after the event
•A history of NSAID use should be taken into account for
an athlete who is suspected of having symptomatic
hyponatremia
•5 common signs and symptoms associated with
symptomatic hyponatremia: dizziness, nausea, vomiting,
headache, fatigue, cramps, and seizures
•4 predisposing factors to exertional hyponatremia
olarger volume of hypotonic fluid is consumed within a
few hours. When compared with fluid lost during
exercise, the excess volume is small
oNa or NaCl losses in sweat and urine are not
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replaced adequately by dietary foods or fluids
oAnnual seasons- hot environment and resulting
internal hyperthermia stimulate considerably greater
water turnover
oPrimary polydipsia- environmental heat stress interacts
with the mindsets or personality characteristics of some
individuals to increase the desire to consume a large
amount of hypotonic fluid. EHS occurs in people who
premediate drinking a large volume of water or believing
that consuming excess water will prevent heat illness.
Chapter 13
•Fatal anaphylaxis occurs in as little as 10 minutes
•Age does not increase risk for a fatal episode of anaphylaxis
•Urticaria and angioedema are the most common
manifestations of an anaphylaxis reaction
•In cases where victims do not respond to an initial does of
epinephrine, the victim should have a second dose of
epinephrine administered
•Hypothermia occurs when core body temperature drops below < 95
degrees F
•Rewarming of hypothermic victims should be performed by
warming the core only
•Normal blood glucose levels are between 72-100 mg/dL
•Cutaneous signs for anaphylaxis will not always be present in anaphylaxis
cases
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