HOT / COLD/ ALTITUDE Flashcards
Exercise related causes of unwell athlete
Exertional Heat stroke
Exercise related Hyponatremia
Hypothermia
General Management of Unwell athlete
A - Airway B - Breathing C - Circulation and temperature D - Disability (AVPU, PEARL, CGG) E - Environment F - Fluid status G - Glucose and sodium H - History, incl site of collapse
Exertional Heat Exhaustion
Inability to continue exercise
Can happen in all temperatures but more common in hot; dehydration, esp after running
Patho
- Heat and dehydration => tachycardia, central fatigue and peripheral vasodilation
- Peripheral vasodilation => hypotension, CV insufficiency + blood pooling
- Blood pooling further worsens hypotension and reduces heat transfer to periphery
S&S
Sweaty, pale/ashen. Headache. Dizziness. N&V. Muscle fatigue. - reduced coordination and cramps, weakness
ABCDEFGH B - Tachypnoea C - Tachycardia, Postural hypotension E - <40 degrees F - normal or dry H - likely collapse after cessation of exercise
How do you differentiate between EHE and EHS?
Core body temp
Mental function
Exertional Heat Stroke
Predisposing Factors
Strenuous exercise, hot-humid environment, poor acclimatization, poor physical fitness
Patho
Core temperature reaches >40 causing cellular membrane damage and disrupting the cellular energy systems. This causes cell and organ dysfunction and subsequently failure. Multiple system involved - brain, liver, kidneys, heart, muscle. GI
Tachycardia. May or may not be sweating. Altered mental state (confusion/disorientation → seizures → coma). Irrational behavior. Vomiting. Diarrhoea. Post episode do not recall last 35-45min.
ABCDEFGH B - Tachypnoea C - Hypotensive, tachycardic D - Altered mental state E - Rectal temp >40 F - Exercise induced hyponatremia => fluid retention, puffy H - During event, can also occur after
EHS Treatment
MEDICAL EMERGENCY - ACTIVE COOLING ASAP
- Remove excessive clothing
- Ice baths and fans
- Ice packs: 2 at neck, 2 under armpits, 2 on groin
- PO fluids
Exercise Associated Muscle Cramps
Painful spasms of skeletal muscle
common after long, high intensity sports
Risk factors
Dehydration, large sweat Na loss, exercise induced muscle fatigue
Rx
Rest, stretching, oral Na-containing foods and fluids
Prevention of heat related problems
Good schedule of events, activity modification and appropriate clothing
Heat acclimatisation e.g. heat baths
Hydration and nutrition
Normothermia
35-39
Mild hypothermia
& physiological response
33-35
Maximal shivering
Dysarthria, amnesia, poor judgment
Moderate hypothermia
& physiological response
29-32
Shivering ceases
Stupor, arrhythmias, unconsciousness
Severe hypothermia
& physiological response
<29
VF
Loss of reflexes and voluntary motion, acid-base distur
Physiological responses to cold
- Peripheral vasoconstriction
2. Skeletal muscle contraction (voluntary modified behaviour)
Mechanisms of hypothermia
decreased heat production
increased heat loss
impaired thermoregulation
Aetiology of decreased heat production
Training
Inactivity, fatigue, energy depletion
Endocrine
Hypothyroidism, hypopituitarism, hypoglycaemia