environmental considerations(1)
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Environmental
ConsiderationsSeptember 26, 2011
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Hyperthermia
Condition in which body temperature is elevated.
Vital that you have a knowledge when heat &
humidity reach dangerous levels
Must also recognize and properly manage heat-
related illnesses
Physiological processes in the body will continue to
function only as long as body temp is maintainedwithin a normal range
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Heat is Gained or Lost Through: Metabolic heat production
Heat produced within your body as a result of metabolicfunction
As intensity of the activity increases, metabolism increases;
therefore, body heat increases Conductive heat exchange
Physical contact with other objects can result in heat loss orgain
Ex: Artificial turf
Convective heat exchange Occurs when a mass of air or water moves around an individual Ex: Cool breeze tends to cool the body OR hot tub tends to
heat the body
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Cont
Radiant heat exchange Heat from sunshine that causes an increase in
body temperature Evaporative heat loss
Sweating and the resultant evaporation is critical
for an athlete to dissipate heat
Humidity above 65% makes this difficult for the
body
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Prevention of Heat Illnesses
Appropriate hydration
Unrestricted fluid and electrolyte replacement
Gradual acclimatization Identifying susceptible individuals
Wear lightweight clothing
Keeping routine weight charts
Routine temperature and humidity readings
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NCAA Mandated Guidelines forAcclimatization in Preseason Football
Day 1-5 Only one practice per day equipment use restricted
Days 1 and 2 Helmets only
Days 3 and 4 Helmets & shoulder pads only
Day 5 Full pads
After Day 5 Two-a-day practices every otherday
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Heat Rash aka Prickly Heat Condition associated with a red, raised rash accompanied with
sensations of prickling and tingling during sweating Occurs when the skin is continuously wet with unevaporated
sweat The perspiration damages cells on the surface of the skin,
forming a barrier and trapping sweat beneath the skin, where itbuilds up, causing the characteristic bumps.
As the bumps burst and sweat is released, you may feel theprickly, or stinging, sensation that gives this condition itscommon name.
Usually localized to skin that is covered with clothing
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Prickly Heat or Heat Rash
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Heat Syncope
Usually caused by standing in the heat.
Causes a pooling of blood in the
extremities Results in dizziness, fainting & nausea.
Relieved by laying the athlete down in a
cool environment & replacing fluids
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Heat Cramps Painful muscle spasms that occur in the calf and abdomen Related to the excessive loss of water and electrolytes
especially sodium (these are all essential elements in musclecontraction)
Causes an imbalance between water & electrolytes More likely to get cramps if you are in good condition but not
acclimatized to the heat. Can be prevented by adequate replacement of electrolytes.
Treatment is large quantities of fluids (sports drinks) &stretching with ice massage.
Warning: Cramping is likely to recur if they cont activity
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Heat Exhaustion
Condition where dehydration causes an
inability to sustain adequate cardiac output
and cannot continue intense exercise Rectal temperature of < 104 & no
evidence of CNS dysfunction
Symptoms include pale skin, profusesweating, stomach cramps with nausea,
vomiting, diarrhea, headache, persistent
muscle cramps and/or dizziness
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Treatment for Heat Exhaustion
Immediate removal from activity & heat
Shelter in shade or air-conditioned building
Clothing and equipment should be removed & lie down
with legs elevated
Rehydration should begin as long as athlete is not
nauseated or vomiting
Possible IV fluids may be needed
HR, BP & Core temp should continually be monitored
If rapid improvement does not happen, they should be
taken to the ER.
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Heatstroke Serious, life-threatening emergency and is induced
by strenuous physical exercise and increasedenvironmental heat stress
Characterized by CNS abnormalities & potentialtissue damage. Results from a significantly elevated body
temperature. Can produce severe physiological dysfunction that
can ultimately result in death Can occur suddenly & without warning.
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Symptoms of Heatstroke
Altered consciousness, seizures, confusion, emotional
instability, irrational behavior
Rectal temp is >104
Hot, flushed skin & may or may not sweat (25% of thecases dont have much sweating involved)
Shallow, fast breathing
Rapid, strong pulse
Nausea, vomiting, diarrhea
Headache, dizziness or weakness
BP & dehydration
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Treatment of Heatstroke
Body temperature must be lowered to normal as soon as
possible
Key is aggressive and immediate whole-body cooling
Get athlete into a cool environment, strip off all clothingand immerse into a cold water bath.
Try to lower rectal temp to 101
Get the athlete to the hospital as soon as possible
However, it is imperative to cool the athlete FIRST, then
can be transported second.
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Exertional Hyponatremia
Condition involving a fluid/electrolyte disorder thatresults in an abnormally low sodium concentrationin the blood.
Caused by ingesting too much fluid OR by havingtoo little sodium in the diet
Do not attempt to rehydrate Should be transported to a medical facility Delivery of sodium, diuretics or IV fluids may be
necessary
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Symptoms of Hyponatremia
Gastrointestinal discomfort Nausea and vomiting
Progessively worsening headache Restlessness Swelling of the hands & feet
Lethargy, apathy or agitation Confusion
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Hypothermia
Caused by three factors: Low temperatures Wind
Dampness Prevention
Adequate clothing. Ex: Warm-up suits, hats, gloves Good warm-up
Hydration Why? If youre dehydrated, you have decreased blood volume
which means less fluid is available for warming the tissues.
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Cold Injuries
Damp, freezing cold can cause frost nip.
Dry, freezing cold causes frostbite.
Ice crystals can form within cells in below-freezing temperatures.
These crystals can eventually destroy the
cell.
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Frost Nip
Affects ears, nose, cheeks, chin, fingers &
toes.
Skin will appear very firm with cold,painless areas.
May peel in 24-72 hours.
Treatment is firm, sustained pressure (norubbing) or blowing hot breath on the spot.
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Frostnip
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Frostnip
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Frostbite
Three levels Chilblains
Abnormal skin reaction to the cold
Skin redness, swelling, tingling & pain in toes & fingers Can last for a few daysbut not a dangerous condition
Superficial Involves only the skin and subcutaneous tissue.
Skin appears pale, hard, cold & waxy. During rewarming, the area will feel numb, then sting &
burn.
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Chilblains
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Superficial Frostbite
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Frostbite cont.
Three types cont. Deep
Serious injury where tissues are frozen
It is a medical emergency that requireshospitalization Tissue is initially cold, hard, pale and numb. Rapid rewarming is essential (hot drinks, heating
pads or hot water bottles) During rewarming, the tissue will be red, swollen &
extremely painful. Tissue may become gangrenous, causing a loss of
tissue.
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Deep Frostbite
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Treatment of frostbite
Rewarming is essential
Do NOT rub the area
Do NOT use direct heat such as a heating pad Do NOT disturb blisters
Immerse area in warm water
Wrap the affected parts in sterile dressings
Do NOT smoke or drink alcohol during thawing
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Altitude Considerations
Depending on the altitude, there is a
decrease in the maximum oxygen uptake.
This decrease causes a deterioration inathletic performance.
The body may compensate by increasing
your heart rate.
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Altitude Sicknesses
Pulmonary Edema
Sickle-Cell Trait Reaction
Acute Mountain Sickness 1 out of 3 individuals who go from low to
moderate altitude (7000-8000 ft) will get this
Sx include headache, nausea, vomiting, sleep
disturbances & dyspnea
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Lightning
#2 cause of weather related deaths ~ 110 deaths per year.
An indoor facility is the best protection. Second best is a car. Prior to a strike, you may feel your hair
stand on end and your skin tingle. You should immediately assume a
crouched position. DO NOT LIE FLAT!
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Lightning cont. Lightning is always accompanied by thunder Flash-to-bang method:
From the time you see lightning, count the number of secondsuntil you hear thunder.
Divide this number by 5. This tells you how many miles awaythe lightning is.
If the number of seconds is 30 or less, you are in danger. When the count is 15 or less, everyone should leave the field. 30 minutes should pass after the last sound of thunder or strike
of lightning before allowing competition to resume.