1.) SUDDEN CARDIAC ARREST (SCA)

Recognizing SCA:

SCA is a condition in which the heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs. SCA usually causes death if it's not treated within minutes. Symptoms of SCA include sudden collapse, not breathing or only gasping, seizures, or convulsions, dizziness, feeling faint, and loss of consciousness.

Treatment:

1. Check to ensure scene is safe.
2. Call 911 or instruct someone to call.
3. Send for someone to grab the AED.
4. Begin chest compressions.
5. Send someone to meet the ambulance at the access point
6. Prepare/apply AED
7. Transport victim and contact family.
8. Contact AD and athletic trainer

2.) EXERTIONAL HEAT STROKE (EHS)

Recognizing EHS:

Exertional heat stroke occurs when body temperature is elevated to a dangerous level (105°F) with concomitant signs of organ system failure due to hyperthermia. This condition occurs when the temperature regulation system is overwhelmed to due excessive heat production. EHS may or may not arise slowly and is most common in intense exercising lasting approximately 30-90 minutes. Symptoms associated with EHS are as follows:

Signs & Symptoms

• Rectal temperature >105°F
• CNS dysfunction such as…
• Dizziness
• Collapse
• Confusion
• Irrational behavior
• Hysteria
• Aggression
• Disorientation
• Seizures
• Coma
• Hot, wet skin
• Dehydration
• Tachycardia
• Hyperventilation
• Hypotension
• Vomiting
• Diarrhea

Prevention:

1. Individuals should be acclimatized to the heat gradually over 7-14 days.
2. Athletes who are currently sick with a viral infection, fever, or serious skin rash should not participate until the condition is resolved.
3. Individuals should maintain hydration and appropriately replace fluids lost during practices and games.
4. Players should have free access to readily available fluids at all times.
5. Individuals who may be particularly susceptible to exertional heat stroke must be identified and closely monitored during stressful environmental conditions.
6. To anticipate potential problems, the Florida High School Athletics Association guidelinesare to be followed by all sports teams; listed in Policy 41.

 Management:

The key to prevent and manage EHS is early recognition and immediate intervention. Minimizing the length of time at which a person’s temperature remains elevated above 105°F is imperative. 

1. Within the first 5 minutes of collapse or onset, if possible and trained, assess core temperature then immerse in ice water (cold ice water immersion tub)
2. Core body temperature MUST be lowered to 102°F or until shivering in order for individual to be transferred to hospital
3. If rectal thermometer is not available, EHS victim must remain submerged for a minimum of 20-30 minutes prior to transferring

 “COOL BEFORE TRANSPORT”

3.) EXERTIONAL SICKLING

Recognizing Exertional Sickling:

Exertional sickling is a medical emergency when a working athlete with sickle cell trait (SCT) experiences the sickling of red blood cells. Sickling can begin within a few minutes of any sustained, intense exertion or successive bouts of maximal exertion with little to no rest. Sickling within the body can “logjam” blood vessels leading to fulminant ischemic rhabdomyolysis, which is the rapid breakdown of muscle tissue due to decreased blood flow.

Differentiating between exertional sickling and other common athletic injuries is crucial in order to prevent death.

Management:

1. Check and monitor vitals
2. Monitor for shock, responsiveness, tachycardia (fast heart rate) that begins to evolve into bradycardia (slow heart rate)
3. If available, give supplemental oxygen at 15 L/min by non-breather mask
4. Cool athlete if necessary
5. Failing immediate improvement, call 911 and attach an AED. Be ready to start CPR if needed
6. Transfer athlete to hospital

4.) HEAD & NECK INJURIES

>>CERVICAL SPINE INJURY

Recognizing C-Spine Injury:

A catastrophic cervical spinal cord injury (CSI) is an injury in which a structural distortion of the cervical spinal column has occurred and is associated with actual or potential damage to the spinal cord. The most common mechanism of CSI is an axial load in which the neck is flexed and the head serves as a point of contact. This type of loading can lead to cervical fracture, dislocation, disc herniation, torn ligaments, or combination of these that invades the space surround the spinal cord. The invasion of space or even direct contact with the spinal cord can lead to acute tissue trauma.

Management:

1. Stabilize the cervical spine using manual stabilization
2. Assess the athlete’s airway, breathing, circulation, disability, and exposure
3. With assistance and the use of proper maneuvers, ensure athlete’s spine is in neutral alignment
4. Maintain/monitor vitals until trained personnel arrive on site (EMS, physician, athletic trainer)

>>CONCUSSIONS

Recognizing Concussion:

Concussions rarely involve a loss of consciousness. ANY traumatic blow to the head or to another part of the body is considered a mechanism of injury for concussions. While headache is the most common symptom of concussion, each individual will experience a concussion differently. Therefore, all of the potential signs and symptoms of a concussion should be considered. A symptom checklist can assist the evaluator in making a more objective return to play decision.

If a player sustains any signs or symptoms of a concussion, he/she must be removed from play. Only a physician may clear the athlete to return to play. 

Concussion Signs and Symptoms

OTHER EMERGENCY MEDICAL CONDITIONS IN SPORTS

Asthma

What is Asthma?

Asthma affects the way in which people breathe.  Your airways are like “hollow tree branches” and air sacs are the gas-exchanging “leaves” of your lung tree.  Your airways are surrounded by muscle, like bark covering a tree trunk and its branches.  People with asthma have very “twitchy” airways that tend to become irritated (inflamed) easily.  These airways tend to overreact when they come in contact with a trigger.

Common triggers include:

•   Weather change or cold air

•   Colds, upper respiratory infections, ear or sinus infections

•   Exercise

•   Allergens such as pet dander, dust mite, mold, pollen and cockroaches

•   Irritants such perfumes, cigarette smoke and strong odors

 What happens during an asthma attack?

1. The muscles surrounding the airways tighten (bronchospasm)

2. Excessive mucus is secreted into the airway. The sticky mucus can plug up the airway

3. The airway becomes inflamed and swollen

4. With these 3 reactions, your airways become very narrow.  It may become difficult to breathe when you try to push air through the very narrow airways.

 Signs and Symptoms of an asthma attack

•   Frequent cough worse at night and with exercise

•   High-pitched sound (wheezing) made by the lungs while breathing out

•   Chest tightness

•   Sucking in of the skin between the ribs (retractions)

•   Fast breathing at rest and shortness of breath

•   Difficulty with speaking or eating because of fast breathing

 For up-to-date information on asthma and controlling it, visit http://www.communityasthmajax.org/