Environment

Question 1

What is the first sign of hypothermia?

Answer 1

Shivering

Question 2

When treating frostbite:

Once warming has begun…

Answer 2

Once warming has begun tissue must not be allowed to cool again

Question 3

4 mechanisms of heat loss:

Answer 3

Radiation
Evaporation
Conduction
Convection

Question 4

What is the primary mechanism by which the body dissipates heat?

Answer 4

Evaporation

Question 5

What is the Wet Bulb Globe Temperature?

Answer 5

Index of environmental heat stress

Used to estimate the risk of heat related illness

Question 6

ACSM recommends cancelling sporting events if the WBGT is >____F?

Answer 6

> 82.4 F

Question 7

WBGT: < 65 F

Answer 7

Low risk

Question 8

WBGT: 65-73 F

Answer 8

Moderate risk

Question 9

WBGT: 73-82 F

Answer 9

High risk

Question 10

WBGT: >82 F

Answer 10

Very high risk

Question 11

What is the clinical definition of heat stroke?

Answer 11

1. elevated core body temperature > 40 C

2. altered mental status

Question 12

Treatment of heat stroke?

Answer 12

Cold Water Bath – ASAP!

ACSM recommends cooling first, and then transfer to emergency medical facility

• During rapid cooling:
• Rectal temperature should be monitored every 3-5 minutes
• Continue until temperature reaches an acceptable level (37.5-38 C)

Question 13

After acute heat stroke how long is an athlete required prior to return to sport?

Answer 13

Minimum of 1 week

Question 14

Primary way body looses heat?

Answer 14

radiation

Question 15

What is normal core temperature?

Answer 15

99.6F (37.6 C)

Question 16

What should be warmed first?

Answer 16

Torso

To avoid “after drop” in core temperature

Question 17

Appearance of:

Superficial frost bite (1st degree)

Answer 17

Partial skin freezing
No blisters

Symptoms:

• burning
• stinging
• throbbing/aching

Question 18

Appearance of:

Superficial frost bite (2nd degree)

Answer 18

Full thickness injury
Edema
Vesicles w/ clear fluid

Question 19

Appearance of:

Deep frost bite (3rd degree)

Answer 19

Full thickness & subcutaneous freezing

• blisters
• skin necrosis
• blue-gray discoloration

Question 20

Appearance of:

Deep frost bite (4th degree)

Answer 20

skin, muscle, tendon, bone freezing

• little edema
• deep red or cynotic
• eventually dry, black skin

Question 21

Treatment of superficial frost bite

Answer 21

Rapid rewarming in warm water 40-42 C (104 to 108 F)

Question 22

What is the 30 seconds to 30 minutes rule in regards to lightening?

Answer 22

When the time btwn seeing lightening and hearding thunder is 30 secs of less - ppl need to be in shelter

Shelter should be sought for 30 minutes from the time of the last lightening flash

Question 23

Altitude sickness is common in travels to:

Answer 23

3500 meters or more

Question 24

Types of altitude sickness:

Answer 24

AMS
HAPE
HACE

Question 25

Sx of Acute Mountain sickness

Answer 25

``` HA Anorexia Nausea or vomiting Fatigue Dizziness Difficulty sleeping ```

Question 26

How long does it take for AMS to resolve?

Answer 26

1 to 3 days

Question 27

When do sx of HAPE occur?

Answer 27

2 to 3 days after arrival to altitude

Question 28

Sx of HAPE?

Answer 28

* Dyspnea with exercise * Progressing to dyspnea at rest * Dry cough * Weakness * Poor exercise tolerance

Question 29

Sx of HACE?

Answer 29

Ataxia Progressive deterioration in conscious level ** may lead to coma or death

Question 30

Immersion/Trench foot

Answer 30

- burning - tingling - itchy feet - loss of sensation - cynotic or blotchy skin

Question 31

NATA position statement on lightening

Answer 31

Seek shelter or safe location at the first signs of thunder or lightening

Question 32

Signs of frost nip?

Answer 32

Blanches white skin

Question 33

Treatment of frost nip?

Answer 33

Firm contact pressure Place in warm area ie axilla - no rubbing

Question 34

How much fluid is required to maintain proper hydration @ less than 2%

Answer 34

7-10 oz every 10-20 minutes

Question 35

How long should athletes be acclimatized to the heat?

Answer 35

Over 10 to 14 days

Question 36

During pre-season, when is the greatest risk for EHI?

Answer 36

First 2-3 weeks of preseason

Question 37

What is the appropriate progression of equipment?

Answer 37

1. Helmets only 2. Helmets and shoulder pads 3. Full pads

Question 38

What are the aims of fluid consumption or replacement?

Answer 38

1. Prevent a BW loss of greater than 2% | 2. Keep morning urine light in color

Question 39

# Define heat syncope Treatment:

Answer 39

- brief episode of fainting - dizziness - tunnel vision - pale or sweaty skin - low rectal temperature Treatment: lay patient supine, elevate legs above the heart

Question 40

Define heat exhaustion

Answer 40

- KEY difference from EHS is rectal temp less than 40.5 C (105 F) - Headache, Dizziness, Confusion

Question 41

Define heat stroke

Answer 41

``` CNS dysfunction - confusion - disorientation - collapse Core body temp greater than 40.5 (105F) ``` *may have hot, wet skin

Question 42

When can an athlete w/ EHS return to play?

Answer 42

One month w/ physician clearance

Question 43

What is the goal temperature for a patient w/ EHS? During CWI, how often should the temperature be checked?

Answer 43

Get below 102F (38.9C) Every 5 to 10 mins

Question 44

When are patients at increased risk of EHI?

Answer 44

The following day

Question 45

What medications increase risk of EHI?

Answer 45

- stimulants - antihistamines - diuretics, - antihypertensives - attention-deficit hyperactive disorder drugs