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Environmental Conditions. O bjectives. What are the main causes of heat or cold illnesses among athletes? What is the role of an athletic trainer in preventing heat and cold illnesses? What is the role of an athletic trainer in protecting athletes from other environmental concerns?.
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Objectives • What are the main causes of heat or cold illnesses among athletes? • What is the role of an athletic trainer in preventing heat and cold illnesses? • What is the role of an athletic trainer in protecting athletes from other environmental concerns?
Environmental Stress • Can adversely affect an Athlete’s performance • Can even pose serious health risks
Heat Illness • Is Preventable!!!! • You can save a life by being aware of the environment • Prepare for the unexpected • Don’t challenge the weather, it will ALWAYS win
Exertional Heat Illness • You must be proactive in identifying individuals who are at the highest risk so that these individuals can be given special attention • Who is at risk?
Risk Factors • Dehydration • Large athletes • Illness • Age • Poor physical condition • Poor acclimation or acclimatization • 3-14 days • Clothing and equipment
Exertional Heat Illness • The body’s ability to cool is related to the individual and to the environmentEvaporation is your main defense • Dependent on: • Athlete’s ability to sweat • Athletes hydration level • Humidity
Evaporative Heat Loss • Sweat glands allow water to transport to surface of skin • Evaporation of water takes heat with it • When environment temperature is higher than body temperature, loss of heat through evaporation is KEY
Environmental Risk Factors • Heat • temperature • Humidity • Relative humidity of 65% impairs evaporation • Relative humidity of 75% stops evaporation • Heat Index • The heat you feel when temperature and humidity are combines
Exertional Heat Illness • Heat Rash • Heat Cramps • Heat Syncope • Heat Exhaustion • Heat Stroke • Hyponatremia
Heat Rash • Benign condition • Red, raised rash • Combined with prickling while sweating • Generally localized to areas covered with clothing • Prevent by continually toweling off • Treat with antihistamines, remove from heat, talcum powder
Heat Cramps • Painful muscle spasms • Excessive water loss • Electrolyte imbalance • fatigue • Occurs in individuals in good and poor shape • S/S • Dehydration, thirst, fatigue • Treatment • Drink water, replace electrolytes, stretch, ice
Heat Syncope • Due to: • Rapid fatigue • Over exposure • Standing in heat for long periods of time • Treatment: • Place in cool environment • Consume fluids • Lay down
Heat Exhaustion • Result of inadequate fluid replacement and continued exposure to heat • Core temperature will be normal or below 104
Heat Exhaustion • S/S • profuse sweating • Pale skin • Dizzy • Hyperventilation • Rapid pulse • Headache • Nausea • Cramps • Weakness • Chills • Cool/ clammy skin
Heat Stroke • Serious life-threatening condition • Organ system can be damaged • Loss of consciousness can occur • Core temperature over 104
Heat Stroke • S/S: • Sudden onset • Sudden collapse • Disorientation • Aggression • Staggering • Flushed hot skin • Minimal sweating • Shallow breathing • Low blood pressure • Strong rapid pulse • vomiting
Rectal Temperature • The GOLD STANDARD of core temperature measurement • Oral, tympanic, axillary temperatures may underestimate
Treatment • COOL first, TRANSPORT second • Immersion in cold tub 50- 60 degrees • Ice bags • Fan • Shade • Air conditioning
Transport to Hospital • Heat Exhaustion • If recovery doesn’t happen quickly • Aggressive fluid replacement • Continued cooling • Heat Stroke • Always transport • Aggressive cooling • Must be lowered within 45 minutes • Fluid replacement
Guidelines for Return to Play • Physician clearance • Asymptomatic • Should avoid exercise for at least 1 week • Progression back into activity • Athlete will be hypersensitive in the future
Preventing Heat Illness • Prevention is your BEST TOOL • Prepare • Acclimatization • Check hydration status • Assess environment • Manage the event • Have treatment available
Preventing Heat Illness • Use common sense and caution • Fluid replacement • Unrestricted replacement • Replace every 15 minutes • Clear urine • Acclimatization • 3-14 days • Protective equipment
Preventing Heat Illness • ID susceptible individuals • Weight records • Weigh before and after • Loss of 3-5% of body weight= health threat • Apparel • Light weight and loose • Light colored • Protective equipment
Sun Exposure • Premature ageing of skin, cancer • Suncreen • SPF= Sun Protection Factor • # = how many times longer to burn • Ex: SPF 6= 6 times longer to burn • Apply every 15-30 minutes • Reapply after swimming or sweating
Cold Related Injuries • Process of Cold Illness • Heat Loss= Body temp. > Outside temp • Cold Injury= Heat loss > Heat production • Predisposing Factors • Hydration • Inadequate clothing • Wind-chill • Wet • Improper warm up • Fatigue • Poor circulation • Age
Body Heat Loss • 65% of body heat is lost through radiation • 1/2 through head and neck • 20% through evaporation • 2/3 through skin • 1/3 through respiration
Hypothermia • The majority of cold illness • Definition: decrease in core body temperature • Life threatening emergency • Core temp below 94º • Biochemical processes slow, simple tasks difficult, shivering • Core temp below 90º • Shivering stops, clumsy, speech problems, cyanosis, pale, slowing of biochemical process
Hypothermia • General treatment (Tx): • Maintain ABC’s, call EMS, dry clothes, heat body, warm fluids • Most activity allows for adequate heat production • Temperature along with wind chill and wetness can increase chances of hypothermia
Cold Injuries • Raynaud’s Phenomena • Cold-induced Bronchospasm • Frost Nip • Frostbite
Reynaud’s Phenomena • Spasms of digital blood vessels • Fingers turn white and painful • Cause is usually unknown • Underlying disease • Anatomical abnormality
Cold-Induced Bronchospasm • Common in young people • Brought on by cold temperature and dry air • S/S: • Difficulty breathing • Coughing • Chest tightness • Wheezing • Tx: • Bronchodilators
Cold Injuries • Localized cooling can result in tissue damage • Formation of ice crystals between cells • Destroys cells • Disrupts blood flow • Clotting may occur
Frost Nip • Occurs with high wind and/or severe cold • Can affect: • Ears • Nose • Chin • Fingers • toes
Frost Nip • S/S: • Skin appears firm • Cold painless areas • Skin may peel and blister (24-72 hrs) • Tx: • Firm pressure • Blowing warm air • Hands in warm areas (if fingers are involved) • DO NOT RUB
Frostbite • Chilblains • 1st degree • 2nd degree • 3rd degree
Frostbite • Chilblains • Result from prolonged exposure • Causes redness, swelling, tingling pain in toes and fingers
Frostbite • 1st degree- superficial frostbite • Skin and 1st layer of subcutaneous tissue • Skin soft to touch • Appears red, then white, then swollen • Usually painless • Typically noticed by others first
Frostbite • 2nd degree • Skin is firm to touch • Appears red and swollen then later white and waxy • When rewarming the area it will feel numb then sting and burn • May blister and be painful for several weeks
Frostbite • 3rd degree- Deep frostbite • Indicates frozen skin requiring hospitalization • Reaches deep tissue damage (bone, tendon, joint) • Rapid rewarming is necessary (100-110º) • Skin is hard to touch • Totally numb • Blotchy white, yellow, or blue • Swollen • painful
Frostbite • Management • Remove from cold • Careful, rapid warming • Water immersion (warm water) • Do not touch edges of basin • Remove clothing, jewelry, rings • Sterile dressing applied • Transport to medical facility • Elevation
Prevention • Cold weather gear • Waterproof and windproof • Allows passage of heat and sweat • Allows movement • Layers (and adjusting them) • Hydration