Heat Illnesses and Basic First Aid

1. Heat Illnesses and Basic First Aid

2. Heat Illnesses • Exercising in hot, humid environments can cause various forms of heat illnesses • Heat Rash • Heat Syncope • Heat Cramps • Heat Exhaustion • Heatstroke

3. Heat Rash • Occurs when skin is continually wet with unevaporated sweat • Shoulders under pads, behind knees, armpits, groins, behind knees • Red, raised rash, tingling during sweating • Localized to areas covered with wet clothing • Change shirts often, towel off skin • Use of baby powder or Gold Bond

4. Heat Syncope • Rapid physical fatigue during prolonged exposure to heat • Dizziness, fainting, nausea • Lay athlete down in a cool environment and replenish fluids • Gradually acclimatize to exercise in a hot, humid environment

5. Heat Cramps • Hard work in heat, sweating heavily, imbalance between water and electrolytes • Muscle twitching and cramps • Ingest large amounts of fluid, stretching, ice massage of affected muscle • Acclimatize athlete properly, provide fluids, replenish electrolytes (Gatorade)

6. Heat Exhaustion • Prolonged sweating leading to dehydration • Excessive thirst, dry tongue/mouth, fatigue, weakness, incoordination, low urine output, elevated body temperature • Bed rest in cool room, replenish fluids, IV if needed, increase fluid intake (6-8 L/day) • Supply adequate fluids, provide adequate rest and opportunity for cooling

7. Heatstroke • Life-threatening emergency • Strenuous physical exercise and increased environmental heat stress • Abrupt onset • Headache, fatigue, flushed skin, lack of sweating, rapid pulse, increased respiration, low blood pressure, diarrhea, vomiting • Call 911, immersion in ice water, air fan over body • Adapt activities to environment, proper hydration, proper acclimatization

8. Prevent Heat Illnesses • Acclimatize athletes to heat • Educate coaches/athletes on prevention, recognition, and treatment of heat illnesses • Educate on proper hydration (9-11 cups of water/day) • Sleep 6 to 8 hours/day in cool environment • Monitor environmental conditions, make adaptations if necessary (no pads/helmets)

9. Preventing Heat Illnesses, cont. • Provide adequate supply of water to maintain hydration • Give water breaks often (every 15-20 minutes) • Minimize amount of equipment and clothing worn in hot, humid conditions • Allow athletes to practice in shaded areas

10. Lightning Safety • If thunder and/or lightning can be heard or seen • Stop activity immediately • Seek protective shelter • Indoor facility is recommended • Avoid standing under large trees and telephone poles • Avoid metal bleachers • Allow 30 minutes to pass after the last sound of thunder or lightning strike before resuming play

11. Cuts/Wounds • Wear latex gloves • Place barrier between you and athlete • Apply direct pressure • Cover the wound with sterile gauze and press firmly against wound • Elevate the injured area (if possible) to slow/stop blood flow • Cleanse wound or apply triple antibiotic ointment • Cover with clean bandage

12. Sprains/Strains • Remove athlete from activity • Help athlete off of the field • Apply ice; Follow RICE principles • Rest • Ice • Compression • Elevation • Seek evaluation from a medical professional

13. Fractures and Dislocations • Pain/tenderness • Difficulty moving injured part • Obvious deformity • Immediate swelling and discoloration • Keep limb from moving • Keep athlete calm • Call for medical help

14. Concussions Based on: NFHS “Concussion in Sports: What you need to know”

15. What is a Concussion? • Injury to the brain • No such thing as a “minor brain injury” • Must be taken seriously • Bump, blow, or jolt to the head or body • Causes head to bounce around or twist in the skull • Less than 10% of all concussions involve loss of consciousness

16. More on Concussions… • Problem with function, not structure • CT Scans and MRIs are normal with most concussions • Studies show it usually takes 2 weeks or more for brain cells to recover from an injury, and may take even longer • Occur in all sports • A suspected concussion is serious no matter how/where it occurred

17. 4 Areas Affected • The way the person feels • Headache or fatigue • The way the person thinks • Memory and/or concentration • Change in Emotions • Irritable or sad • Problems with Sleep • Trouble falling asleep

18. Signs of a Concussion • Signs (seen by parent/coach) • Dazed or stunned • Confused • Forgets plays • Moves clumsily • Answers questions slowly • Loses consciousness • Behavior changes • Memory problems (events before or after injury)

19. Symptoms of a Concussion • Symptoms (felt by player) • May exhibit one or more of the following: • Headache • Nausea • Balance problems/Dizziness • Fuzzy vision • Feels sluggish • Light/noise sensitive • Concentration/memory problems • Confusion

20. If a Potential Concussion Arises • Any signs/symptoms of a concussion = Immediate removal from play • When in doubt, sit them out • Notify parent/guardian • Advised to contact primary care physician and/or seek nearest emergency department on the day of the injury

21. When to Call 911 • Indicate a medical emergency and activation of EMS • Player with a witnessed lost of consciousness of any duration • Player exhibits these symptoms: • Decreased level of consciousness • Unusual drowsiness or inability to be awakened • Difficulty getting attention • Breathing irregularities • Severe or worsening headache • Persistent vomiting • Seizures

22. If a player with a suspected head injury is not sent for immediate medical attention: • Must be continuously observed until evaluated by a health care professional • Never send a player to the bus or locker room alone • Any worsening symptoms or signs indicate a medical emergency

23. Head’s Up 4-Step Action Plan • Remove the participant from play • Ensure that the participant is evaluated by a health care professional • Inform the participant’s parents or guardians about the concussion and give them information on concussions • Keep the participant out of play the day of the injury and until an appropriate health care professional says the player is symptom-free and it’s OK to return to play

24. Complications • Most players recover in 1-2 weeks • Others may have prolonged symptoms for months • Prolonged Symptoms: • Headaches • Difficulty concentrating • Poor memory • Sleep problems • Can affect performance in school

25. Second Impact Syndrome • A player that returns to activity before healing fully from the concussion is at risk for a repeat concussion • Slow recovery • Increase chance for long-term problems • Can result in severe swelling of the brain • Can be fatal

26. Return to Play • Work closely with health care provider or athletic trainer to return athlete to activity properly • Rest • Full return to school • Symptom-free • Receive clearance from medical professional • Gradual return to activity

27. How to Rest? • Rest at Home • Sleep Often • Limit brain “stimulation” from: • Phone • Computer • Music • TV • Texting • Gaming • Rest at School • Stay home or attend school half days • Take naps or allow rest time • Extend time to complete assignments • Allow time to visit school nurse for treatment of headaches • Written instructions for homework • Repeat and present new information slowly • Share progress and difficulties

28. Return to Play Protocol • Step 1: Light Exercise • 5 to 10 minutes on an exercise bike or light jog • No weight lifting • Step 2: Running in the gym or on the field without a helmet or other equipment • Step 3: Non-contact training drills in full uniform • Begin light weight training • Step 4: Full contact practice or training • Step 5: Get back into the game!

29. Return to Play, cont. • Athlete must be symptom free before starting progression • Progression usually takes 1 week • Player progresses one step each day • Activity must be stopped immediately if signs/symptoms of a concussion returns • If symptoms occur at any step, player must be re-evaluated by a medical professional

30. Role as a Coach • Bring about a change in culture about the seriousness of this injury when talking with players, parents, and other coaches • No proven protection from a concussion • Can aim to reduce the risk • Educate others on concussions • Fact sheet for parents and players