s ports m edicine e ducational p lan hillsborough county public schools committee members: lauren...
TRANSCRIPT
SPORTS MEDICINE EDUCATIONAL PLAN
Hillsborough County Public Schools
Committee Members:Lauren Otero, APA, Leto High School
Evanitta Omensetter, APSA, Leto High School
William Sargable, Wrestling Coach, Riverview High School
Jayson Roberts, Football Coach, Tampa Bay Tech High School
Joel Kennedy, ATC, Plant High School
Are you hydrated? Dehydrated?
If you are thirsty, you are already dehydrated.
What are you drinking?
HYDRATE TO ELEVATE
HYDRATED: HAVING ADEQUATE FLUIDS THAT ALLOW THE BODY TO FUNCTION AT MAXIMUM CAPACITY
Dehydrated: is a deficiency of body water, with an accompanying
disruption of metabolic processes, performance and may lead to heat-
related illnesses
HYDRATE TO ELEVATE
WHAT EFFECTS HYDRATION LEVEL?
Stool, urination, breathingand most significantly……
SWEATINGHYDRATE TO ELEVATE
WHAT EFFECTS ONE’S SWEAT RATE?
Ambient temperature Humidity Genetics Gender Body weight Fitness level Intensity
HYDRATE TO ELEVATE
SIGNS & SYMPTOMS OF DEHYDRATION
Headache, Fatigue, Confusion, Nausea, Cramps, Dizziness
Decrease of Stamina, Speed, Energy, and Muscular Strength
HYDRATE TO ELEVATE
MONITOR YOUR HYDRATION
Check your urine color Measure your water weight loss
BEFORE
PRACTICE
GAME
AFTER
HYDRATE TO ELEVATE
DECREASE IN ATHLETIC PERFORMANCE
2-4% weight loss - reduced muscular endurance time
4-6% weight loss - reduced muscular strength & endurance, heat cramps
6% weight loss - severe heat cramps, heat exhaustion, heat stroke, coma, DEATH
HYDRATE TO ELEVATE
HOW TO GET AND STAY HYDRATED…
Drink plenty of water EVERYDAY
AVOID or LIMIT sugary and caffeinated drinks
HYDRATE TO ELEVATE
GAME DAYGENERAL RULE OF THUMB
NOTE: Room temperature fluids
absorb more quickly.
Pre-Game
16 oz. 4 hours BEFORE game time &
8 oz. 2 hours BEFORE game time
During Game: 7-10 oz. every 15 minutes throughout the game
Post Game: 16 oz. bottle of sports drink (Gatorade) to replace carbs & sodium
HYDRATE TO ELEVATE
PROPOSED ACTION STEPS
Chart containing timeline of hydration for pre-game, during game, and post-game measures.
Emphasis to players of how hydration is directly tied to athletic performance.
Explanation to athletes of what not to drink and limitations on caffeine.
HYDRATE TO ELEVATE
HOW HEAT EFFECTS YOUR BODY Places extra stress on the body Increases core body temperature Increases heart rate
Cool first, treat second!
HEAT RELATED ILLNESS
Body temperatures can rise to dangerous levels.
Types of Illnesses Across a Spectrum:Heat RashHeat CrampsHeat ExhaustionHeat Stroke
Cool first, treat second!
HEAT RELATED ILLNESS: HEAT RASH Occurs when pores
are blocked and perspiration is trapped under skin
Symptoms include: Superficial blisters,
itchy or prickly in feeling
Mainly found on neck, shoulders and chest.
Usually develops where clothing causes friction.
Methods of Treatment: Symptoms usually
go away on their own when skin is cooled.
Cool first, treat second!
HEAT RELATED ILLNESS: HEAT CRAMPS Symptoms
Painful, involuntary muscle spasms.
Most likely to occur in arm, calf, abdomen and back.
Affected muscles firm to touch.
Body temperature may be normal
Method of Treatment: Rest briefly and cool
down. Drink clear juice or
electrolyte-containing drink
Gently stretch and massage affected area
Contact medical personnel if cramps do not subside within an hourCool first, treat second!
HEAT RELATED ILLNESS: HEAT EXHAUSTION
Definition: Body Temperatures
rise as high as 104° Causes stem from
exposure to high temperatures, particularly when combined with high humidity, and strenuous physical activity
Can lead to heat stroke if left untreated
Symptoms: Often begin suddenly Resemble those of
shock Cool, moist skin with
goose bumps when in the heat
Heavy sweating Faintness/Dizziness Nausea Low blood pressure
upon standing Muscle cramps Dark-colored urine
Cool first, treat second!
HEAT ILLNESS: HEAT EXHAUSTION
Treatment: Stop all activity and rest in a cool place Drink cool water or sports drink Apply cool water to your skin Submerge in ice bath Loosen/Remove excess clothing
Contact doctor if signs/symptoms do not improve or worsen within one hour.
Seek immediate attention if body temperature reaches 104° or higher. Brain damage occurs when body temperature reaches 106°. Death can occur when body temperature reaches 108°.
Cool first, treat second!
RISK FACTORS OF HEAT EXHAUSTION
Certain Factors Increase Sensitivity to Heat: Young or old age Certain medications Obesity Sudden temperature changes High heat index
Cool first, treat second!
HEAT ILLNESS: HEAT STROKE
Results from untreated heat exhaustion Life-threatening condition that occurs when a
person’s body temperature reaches 104° or higher
Skin may be hot, but body may stop sweating to help cool itself
Person may develop confusion and irritability Seek immediate medical attention to prevent
brain damage, organ failure, or even death.
Cool first, treat second!
PREVENTING HEAT RELATED ILLNESS
Wear loose fitting, lightweight, light-colored clothing
Avoid sunburn Seek shelter/cooler
places Drink plenty of fluids Take extra
precautions with medications
Avoid hot spots Allow your body to
acclimate to the heat
Know your fitness level
Avoid mid-day sun (10am-4pm)
Wear sunscreen Have a back up plan
Cool first, treat second!
COOLING PROTOCOLS Move victim to a cool
spot Lay the victim down Elevate their feet Loosen/remove excess
clothing Give cool (NOT ice) water Cool victim until body
temperature is between 100°-102° degrees
Call 911 to transport
Cool first, treat second!
PROPOSED ACTION STEPS
Purchase of thermometers for use at practices and games
Expanded use of cooling methods “Dipping” into ice baths to be routine at
practice Coolers at practice filled with iced towels Display of signs and symptoms posters to be
hung in restroom stalls and above urinals Examples of proper clothing to combat heat
illness
Cool first, treat second!
WHAT IS SICKLE CELL DISEASE?
Sickle Cell Disease is an inherited genetic disorder that affects the red blood cells.
Red blood cells in a person with sickle cell disease have an abnormal version of a protein called hemoglobin.
This abnormal protein causes the blood cell to have a crescent or sickle shape instead of the normal round shape that red blood cells should have.
WHO GETS SICKLE CELL DISEASE?
Sickle cell disease affects almost only people of African, South American, Caribbean, or Mediterranean countries decent.
A person can only have sickle cell disease from genetic inheritance from parents.
SICKLE CELL TRAIT VS SICKLE CELL DISEASE
Sickle Cell Trait Child inherits a recessive sickle cell gene from one parent and a dominant normal cell gene from the other.
Sickle Cell Disease Child inherits a recessive sickle cell genes from both parents.
SICKLING IN SICKLE CELL TRAIT CARRIERS
Under normal non-stressful conditions, people with sickle cell trait have virtually no health issues from the trait.
Sickle cell trait carriers can have issues when dehydrated, under heavy physical demand, or at high altitudes due to cells starting to sickle.
THE PROBLEM WITH SICKLE CELL TRAIT
Many athletes have no idea that they are sickle cell trait carriers.
If an athlete does know they are sickle cell trait carriers, many are under the impression that they have no risk of sickle cell crisis.
In either scenario the athlete is at risk of physical overexertion, leading to sickling of red blood cells.
EFFECTS AND COMPLICATIONS FROM SICKLE CELL
The sickled red blood cells become problematic due to their shape causing the cells to become blocked and stuck in blood vessels. The sickled shaped renders them unable to carry adequate oxygen as well.
EFFECTS AND COMPLICATIONS FROM SICKLE CELL
Sickle cell disease can affect the body in 2 ways:
1. Anemia – reduced amounts of oxygen that can be carried by the sickled shaped cells, causing the following: 1. Fatigue 2. Paleness 3. Shortness of breath 4. Rapid heart rate 5. Yellowing of Skin
EFFECTS AND COMPLICATIONS FROM SICKLE CELL
2. Sickle Cell Crisis – blockage of blood vessels taking blood to the limbs and organs due to the sickle shaped cells causing : 1. Pain in extremities and lungs 2. Small strokes (lack of
oxygen causing interruption of blood flow)in brain 3. Ulcers on lower legs 4. Enlarged Spleen
SICKLE CELL CRISIS VS HEAT ILLNESS
Person has heat cramps. They hobble to the ground and cry out in pain
Muscles are locked and rock hard
Person falls to the ground immediately from weakness and doesn’t cry out in pain
Muscles look and feel normal
Heat Illness Sickle Cell Crisis
Sickle cell crisis in a person with the trait and heat illness can appear very similar in their symptoms.
However there are a few key difference in symptoms that allow you to differentiate between the two.
vs.
RECOMMENDATIONS FOR MANAGING ATHLETES WITH SICKLE CELL TRAIT
If coaches are aware that they have an athlete with sickle cell trait there are some recommendation on how to manage them to reduce chances of a crisis
• Do not allow the athlete to condition heavily• Monitor the athlete’s body temperature on warm
humid days• Be aware of the altitude that the athlete is
participating at • Allow the athlete to drink water whenever they feel
the need
PROPOSED ACTION STEPS
Collaborating with FHSAA to add doctor’s sign off on EL2 physical form
Signs and symptoms poster to be hung in locker rooms
Addition of lines to medical release card for parent(s) to write in “medical conditions” and allergies
Adjustment of practice and drills
WHAT IS A CONCUSSION?
A Traumatic Brain Injury (TBI) Your brain jarring against your skull No grades of concussions. No mild or severe. Use to be called “Dinged” or “Bell rung” Treatment: REST!
A concussion is an interruption of the
brain’s ability to work properly.
When in doubt, sit them out.
SIGNS AND SYMPTOMS
Headache Dizziness Nausea Balance problems Sensitivity to light and sound Amnesia Difficulty concentrating
Every concussion has different signs and symptoms,
it does not determine the severity.When in doubt, sit them out.
STATISTICS 2013: 11.2 concussions/10,000 games & practice in high
school football
2008-2009: 400,000 TBI in high school athletics
2/3 of concussions occur in events, 1/3 at practice
2011: 15% of injuries reported in high schools with a certified athletic trainer (ATC) were concussions
15.8% of athletes who suffered Loss of Consciousness (LOC) returned to play the same day!!
Three times more likely to suffer a 2nd concussion in the same season.
When in doubt, sit them out.
2ND IMPACT SYNDROME (SIS) What is it? Experiencing a second concussion
before the original signs and symptoms are gone from the first concussion.
Adolescents are particularly susceptible to SIS
Athletes who suffer multiple TBI within a short period of time(days or weeks) may suffer catastrophic or fatal reactions
In a 13 year study, out of 92 high school athletes with SIS, 71% had a previous concussion in the same year and 39% were playing with symptoms
When in doubt, sit them out.
PROPER PROTOCOLS—RETURN TO LEARNING
Limit visual stimulants, such as texting and computer use
Allow extra time for tests/assignments
Break assignments into smaller chunks
Provide alternative methods to learning
Set reasonable expectations
When in doubt, sit them out.
PROPER PROTOCOLS—RETURN TO PLAY Athlete must be seen & evaluated by medical
doctor If athlete has no symptoms and is cleared by
physician, then FHSAA’s AT18 form is initiated and a step-by-step process can begin for athlete to return. Aerobic activity: bike, jog, etc. Increase activity to include sport-specific exercise Non-contact practice Full practice
Athlete must get steps signed off on by an ATC, coach or Athletic Director on the AT18
Athlete then returns to physician, is re-examined and AT 18 is signed off to return to play (RTP)
AT18 is filed in student’s athletic packetWhen in doubt, sit them out.
PROPOSED ACTION STEPS SCAT cards to all coaches
(tests to determine if an athlete has a concussion)
Handouts to parents/coaches on signs & symptoms of concussions
In-service by medical doctor on concussions (pre-season or summer)
Review/discuss Return to Play (RTP) protocols (per FHSAA) with coaches/parents.
Must see a medical doctor (preferably one with experience in diagnosing concussions).
Complete 5-step process with coach or ATC
Follow up with medical doctor to RTP. Must be cleared by medical personnel on FHSAA’s AT18
A neuro/cognitive computer baseline test (example: ImPact) on athletes
When in doubt, sit them out.