Environmental Considerations

September 26, 2011

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 heatrelated illnesses Physiological processes in the body will continue to function only as long as body temp is maintained within a normal range

Heat is Gained or Lost Through:

Metabolic heat production

Heat produced within your body as a result of metabolic function As intensity of the activity increases, metabolism increases; therefore, body heat increases Physical contact with other objects can result in heat loss or gain Ex: Artificial turf 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

Conductive heat exchange

Convective heat exchange

Cont

Radiant heat exchange

Heat from sunshine that causes an increase in body temperature Sweating and the resultant evaporation is critical for an athlete to dissipate heat Humidity above 65% makes this difficult for the body

Evaporative heat loss

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

NCAA Mandated Guidelines for Acclimatization in Preseason Football

Day 1-5 Days 1 and 2 Days 3 and 4 Day 5 After Day 5 Only one practice per day equipment use restricted Helmets only Helmets & shoulder pads only Full pads Two-a-day practices every other day

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 it builds up, causing the characteristic bumps. As the bumps burst and sweat is released, you may feel the prickly, or stinging, sensation that gives this condition its common name. Usually localized to skin that is covered with clothing

Prickly Heat or Heat Rash

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

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 muscle contraction) 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

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, profuse sweating, stomach cramps with nausea, vomiting, diarrhea, headache, persistent muscle cramps and/or dizziness

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.

Heatstroke

Serious, life-threatening emergency and is induced by strenuous physical exercise and increased environmental heat stress Characterized by CNS abnormalities & potential tissue damage. Results from a significantly elevated body temperature. Can produce severe physiological dysfunction that can ultimately result in death Can occur suddenly & without warning.

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 the cases dont have much sweating involved) Shallow, fast breathing Rapid, strong pulse Nausea, vomiting, diarrhea Headache, dizziness or weakness BP & dehydration

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 clothing and 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.

Exertional Hyponatremia

Condition involving a fluid/electrolyte disorder that results in an abnormally low sodium concentration in the blood. Caused by ingesting too much fluid OR by having too 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

Symptoms of Hyponatremia
Gastrointestinal discomfort Nausea and vomiting Progessively worsening headache Restlessness Swelling of the hands & feet Lethargy, apathy or agitation Confusion

Hypothermia

Caused by three factors:

Low temperatures Wind Dampness Adequate clothing. Ex: Warm-up suits, hats, gloves Good warm-up Hydration Why?

Prevention

If youre dehydrated, you have decreased blood volume which means less fluid is available for warming the tissues.

Cold Injuries

Damp, freezing cold can cause frost nip. Dry, freezing cold causes frostbite. Ice crystals can form within cells in belowfreezing temperatures. These crystals can eventually destroy the cell.

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 (no rubbing) or blowing hot breath on the spot.

Frostnip

Frostnip

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 Involves only the skin and subcutaneous tissue. Skin appears pale, hard, cold & waxy. During rewarming, the area will feel numb, then sting & burn.

Superficial

Chilblains

Superficial Frostbite

Frostbite cont.

Three types cont.

Deep

Serious injury where tissues are frozen It is a medical emergency that requires hospitalization 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.

Deep Frostbite

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

Altitude Considerations

Depending on the altitude, there is a decrease in the maximum oxygen uptake. This decrease causes a deterioration in athletic performance. The body may compensate by increasing your heart rate.

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

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!

Lightning cont.

Lightning is always accompanied by thunder Flash-to-bang method:

From the time you see lightning, count the number of seconds until you hear thunder. Divide this number by 5. This tells you how many miles away the 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.