Environmental Concerns: Exam 2 Flashcards
What are the 4 areas of concern for environmental stress?
- Hyperthermia
- Hypothermia
- Altitude
- Lightening storms
Hyperthermia
- condition where body temp is elevated
- caused a number of deaths over the years
What must an ATC be able to do concerning heat?
- understand heat/ humidity factors to manage and plan accordingly with coaching staff
- be able to recognize clinical signs/ symptoms of heat illness
Is heat stress preventable?
Yes
How can heat stress be avoided?
Use extreme caution when training in heat
What can increase risk of heat stress?
Underlying medical condition such as sickle cell trait
What other than hot weather can cause heat stress?
Dehydration and equipment
What 5 factors affect body temp?
- metabolic heat production
- conductive heat exchange
- convective heat exchange
- evaporative heat loss
- radiant heat exchange
Metabolic heat production
“Running” temp of the body
Conductive heat exchange
Physical contact with objects
Convective heat exchange
Circulation of medium (air/ water)
Evaporative heat loss
Sweat must evaporate to dissipate heat
Radiant heat exchange
Sun v shade
Evaporative heat loss key (3)
- evaporation of water takes heat with it
- when radiant heat> body temp, evaporation is key
- air must be relatively water free for evaporation to occur (65% impairs, 75% stops)
When should hydration begin?
24 hours prior
How can you monitor hydration?
Urine color
Mild dehydration
2% of body weight lost in fluid. This can cause problems
Is small amounts or large amounts of fluid better?
Small amounts at regular intervals prior to activity rather than large amount immediately before
Dehydration and concussions
Dehydration symptoms can mimic concussion symptoms so athlete should be removed from heat and monitored if in doubt
How can you monitor fluid loss?
Weight tracking
How much fluid does the body require?
2.5 L when engaged in minimal activity
How much water does an adult lose per hour?
1.5 L
What will trigger a thirst response?
2% drop in body weight
What is essential to replace fluid and electrolytes?
Unlimited access to fluids
Why are sports drinks more effective than water?
- flavoring increases desire to consume
- replaces fluids and electrolytes
- small amounts of sodium help in water retention
What is the optimal CHO level?
14g per 8 ounces of water
What is the most effective method of avoiding heat stress?
Acclimatization
Acclimatization
Graded intensity changes are recommended with progressive exposure over a 7-10 day period
How long does it take to get 80% acclimated?
5-6 days
What is regulated during the acclimation period?
Equipment and apparel and length and amount of practices
Susceptible individuals
- large muscle mass
- overweight (increased metabolic weight
- Poor fitness
- history of heat illness
- young and elderly
- febrile condition
- medication
How do women regulate heat compared to men?
More efficient with body temp regulation
How does weight affect risk of heat injury?
Death from heat stroke increase 4:1 as body weight increases
What must be monitored for heat index?
Heat, sunshine, and humidity
What is a measure for heat index?
Wet bulb globe temperature index
WBGT
3 thermometer readings:
- dry bulb
- wet bulb
- black bulb
Dry bulb
Standard Mercury temp
Wet bulb
Thermometer with wet gauze that is swung around in the air
Black bulb
Black casting that measures radiant heat
Heat syncope
- Associated with rapid fatigue and overexposure
- peripheral vasodilation—> pooling of blood in extremities—> dizziness and fainting
- treat by placing athlete in cool environment, consuming fluid and laying down
Heat cramps
-painful muscle spasms due to excessive water loss and electrolyte imbalance
What type of individual get heat cramps?
In good shape that overexerts themselves
How do you treat heat syncope?
Placing athlete in cool environment, consuming fluids, and laying down
Exertional heat exhaustion
- inadequate fluid replacement
- unable to sustain adequate cardiac output
Symptoms of exertions like heat exhaustion
- profuse sweating
- pale skin
- mildly elevation temp
- dizziness
- nauseous
- Vomiting
- diarrhea
- hyperventilation
- persistent muscle cramps
- loss of coordination
Core temp of heat exhaustion
Less than 104
How to mange heat exhaustion
- immediate fluid ingestion
- cool environment
- remove clothing
- monitor vial signs
When can athlete return to play after heat exhaustion?
Must be fully hydrated and cleared by physician
What can heat exhaustion progress to?
Exertional heat stroke
Exertional heat stroke
- life threatening
- Unknown specific cause
- breakdown of thermoregulatory mechanism
Characteristics of heatstroke
- sudden onset
- sudden collapse
- LOC
- CNS disfunction
- flushed hot skin
- minimal sweating
- shallow breathing
- strong rapid pulse
- core temp > 104
Heat stroke management
-strip clothing
-cold water immersion
-transport to hospital immediately
(Cool first, transport second)
When can athlete return to practice after heat stroke?
Avoid exercise for minimum of one week and gradually return
Acute Exertional Rhabdomyolysis
- sudden catabolic destruction and degeneration of skeletal muscles
- associated w/ individuals that have sickle cell trait
When does Rhabdomyolysis occur and what are the symptoms?
Intense exercise in heat and humidity
- gradual muscle weakness
- swelling
- pain
- dark urine
- renal dysfunction
- severe–> sudden collapse, renal failure and death
Exertional Hyponatremia
- fluid and electrolyte disorder
- abnormally low concentration of sodium in blood
What causes Hyponatremia?
- ingesting too much fluid before, during, and after exercise
- Too little sodium in diet or too much ingested fluid over a period of prolonged exercise
Who is at risk for hypotremia?
Athletes that ingest large quantities of water and sweat over several hours (marathon)
Signs of Hyponatremia
- progressively worsening headache, nausea, vomiting
- swelling of hands, feet
- Lethargy, apathy, agitation
- low blood sodium
- could compromise CNS and create a life-threatening condition
how to treat Hyponatremia
Transport to medical facility and deliver sodium, diuretics, or IV
Hypothermia
Abnormally low body temp
What increases risk for hypothermia?
- Temp
- wind chill
- dampness or wetness
What happens when temp drops below 85-90 degrees?
Shivering stops
What temp is death imminent?
77-85
How to prevent hypothermia
Appropriate apparel and monitoring condition
Heat loss> heat production
Impairment of neuromuscular function
What can localized cooling create?
Tissue damage—> formation of ice crystals between cells, destroys cells, disrupts blood flow, clotting may occur
Frost nip (3)
- ears, nose, chin, fingers, toes
- occurs with high wind and/ or severe cold
- skin appears firm with cold painless areas that may peal and blister (24-72 hrs)
Frost bite
Due to poor peripheral circulation
Superficial frostbite
Involves only skin and subcutaneous tissue (appears pale, hard, cold, and waxy)
Deep frost bite
Indicates frozen tissues requiring hospitalization
How else can frost bite occur?
Improper use of cold packs
How does altitude affect performance?
-max oxygen uptake decreases—> decrease in performance
How does the body compensate with altitude?
Tachycardia and hyperventilation
Acute mountain sickness
- 1/3 people will experience when jumping from 7000-8000
- headache, nausea, vomiting, sleep disturbance, dyspnea
Sickle cell trait relation to altitude
- when hemoglobin is deoxygenated, cells clump together causing blood cell to develop sickle shape making it easy to destroy
- causes enlarged spleen to rupture at high altitude
Sickle cell trait
- 8-10% African Americans have this
- most cases trait is benign
- abnormal red blood cell and hemoglobin structure
What is the #2 cause of death by weather?
Lightening
What must be set to avoid lightening injury?
Emergency plan involving chain of command, monitoring of weather service, decision making regarding removal and return to field (spectators and athletes)
Flash to bang count
- estimates distance away from storm
- Count from lightening to thunder (divide by 5 to calculate miles away)
- 30 secs indicates inherent danger
- 15 secs indicates everyone should leave the field
how long should you stay off the field during lightening delay?
30 minutes following last thunder or lightening
