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KIN 424 - Medical Aspects of Sport > Module 5 - Exercise in Heat and Cold > Flashcards

Module 5 - Exercise in Heat and Cold Flashcards

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1
Q

What heat loss comes from evaporation?

A
  • Sweat Evaporation
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2
Q

What heat loss comes from radiation?

A
  • Transmission of heat energy from a surface
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3
Q

What heat loss comes from conduction?

A
  • Transfer of heat from one substance to an adjacent substance
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4
Q

What heat loss comes from convection?

A
  • Transmission of heat to a fluid which moves away from the heat source
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5
Q

What does the evaporation of water from the liquid phase to the gas phase require?

A
  • Heat
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6
Q

What plays a role in humidity?

A
  • HUMIDEX
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7
Q

What is the equation for HUMIDEX?

A

Humidex = Air Temp + 0.5555x(6.11 x e^5417.7530(1/273.16 - 1/dewpoint in kelvin) - 10)

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8
Q

How does high humidity affect evaporation?

A
  • Interferes with evaporation
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9
Q

What can play a role in humidity’s impact on heat loss?

A
  • Garments
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10
Q

What is an example of Radiation heat loss?

A
  • Space Blankets
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11
Q

What is forced convection?

A

Fluid going to move anyway
- blood flow

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12
Q

What is free convection?

A

Heat causes the motion of the fluid
- flow of air around body

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13
Q

What are the Risk Factors for Cold Injury?

A
  • Wheather
  • Exhaustion/Dehydration
  • Clothing Consideration
  • Spinal Cord Injury
  • Trauma
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14
Q

What kind of weather is a risk factor for cold injury?

A
  • Wind chill
  • Precipitation
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15
Q

How is a spinal cord injury a risk factor for cold injury?

A
  • Impaired Vasoconstriction
  • Sensation
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16
Q

How is trauma a risk factor for cold injury?

A
  • Prolonged Exposure
  • Direct effect on hypothalamus affecting thermoregulation
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17
Q

What are the Mild Features of Hypothermia?

A
  • Cold Extremities
  • Shivering
  • Tachycardia
  • Tachypnoea
  • Urinary Urgency
  • Mild Incoordination
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18
Q

What are the features of moderate Hypothermia?

A
  • Apathy
  • Poor judgement
  • Slurred speech
  • Amnesia
  • Reduced Shivering
  • Dehydration
  • Clumsiness
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19
Q

What are the features of severe hypothermia?

A
  • Inappropriate Behaviour
  • Loss of shivering
  • Arrhythmias
  • Pulmonary Oedema
  • Hypotension and Bradycardia
  • Reduced LOC, muscle rigidity
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20
Q

What is the On-Site management of the hypothermic Athlete?

A
  • Recognition of features
  • Removal from cold, windy, or wet conditions
  • Minimal handling
  • Insulation to prevent further heat loss
  • Provision of nutritional
  • fluid support assessment
  • Possible passive or active rewarming
  • Moderate/Severe consider: Transportation to a medical facility
  • Monitor for arrhythmia/hypotension
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21
Q

What is passive Rewarming?

A
  • Remove from a cold environment
  • Remove wet clothing
  • Replace with dry blankets/clothes
  • Place the patient in a plastic bag and then insulate
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22
Q

What is Active Rewarming?

A
  • ON-site can use warm packs in axillae, groin, torso
  • Heat torso to reduce afterdrop
  • Exercise only in very mild hypothermia
  • More advanced external/internal rewarming in monitored hospital setting
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23
Q

What are the classifications of Frostbite?

A
  • Superficial: Skin and Subcutaneous Tissue
  • Deep: Affecting Bone Joint and Tendon
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24
Q

What is Frostnip?

A
  • Transient numbness and tingling without residual damage
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25
Q

How do you evaluate Blisters?

A
  • Clear = better prognosis
  • Cloudy or blood = poor prognosis
  • Blisters contain harmful thromboxane’s and prostaglandins
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26
Q

What is the guide to the removal/aspiration of blisters?

A
  • No consensus
  • Practice has been to drain clear while leaving hemorrhagic intact
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27
Q

What is the guide for ibuprofen usage to treat hypothermia?

A
  • 400mg
  • Counteracts COX vasoconstriction
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28
Q

What will definitive care for frostbite include?

A
  • Rewarming Bath
  • Aloe, Dressing
  • Eventual Surgical Management
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29
Q

How can we prevent cold injury?

A
  • Education, equipment
  • Emollients don’t work
  • Vigilant personnel with radios work
30
Q

What is metabolic cold acclimatization?

A
  • Small increase in metabolic rate
  • Includes activation of brown adipose tissue
31
Q

What is insulative cold acclimatization?

A
  • Enhanced peripheral vasoconstriction
  • Better core temperature defense
32
Q

What are the main points of cold injury knowledge?

A
  • Prevention
  • Early Recognition
  • ON-site management strategies: passive and active rewarming
33
Q

What happens when exercising in the heat?

A
  • blood transported to the periphery for cooling
  • Relative/actual central fluid deficit
  • Splanchnic Vasoconstriction to compensate for peripheral ‘steal’
34
Q

What does the transportation of blood to the periphery do during exercise in the heat?

A
  • Cooling
35
Q

What does the relative and actual central fluid deficit during exercise in heat do?

A
  • Leads to smaller cardiac stroke volume
  • Resultant increase in heart rate for given intensity
36
Q

What does splanchnic vasoconstriction to compensate for peripheral ‘steal’ do during exercising in heat?

A
  • leads to GI and Kidney adverse effects
  • Kidney Failure
  • Ischaemic Gut
  • NSAIDs
37
Q

What types of heat illness are there?

A
  • Heat Stroke
  • Heat Exhaustion
  • Hyponatremia
38
Q

How does aggressive and rapid treatment impact heat illness?

A
  • Improves outcomes
39
Q

What is a feature of heat exhaustion?

A
  • Lack of mental status changes
40
Q

What are some heat exhaustion symptoms?

A
  • Pale, cool, and moist skin
  • Sweating Profusely
  • Muscle Cramping, Pain
  • Faint or Dizzy
  • Headache
  • Nausea
41
Q

What are some Heat Stroke Symptoms?

A
  • Markedly abnormal mental status
  • Flushed, hot and dry skin
  • Slightly elevated blood pressure
  • Hyperventilating
42
Q

What abnormal mental statuses are associated with heat stroke symptoms?

A
  • Dizziness
  • Confusion
  • Hallucinations
  • Coma
43
Q

What are the Risk Factors for Heat Illness?

A
  • Age > 65
  • Alcohol, Dehydration
  • Overweight
  • Poor Fitness / sedentary
  • Poor Acclimatization
  • Recent Fever
  • Sunburn or other skin conditions
  • Certain Medications
44
Q

What types of Medications are risk factors for heat illness?

A
  • Reduce Sweating
  • Alter Skin Blood Flow
  • Increase Heat Production
  • Reduce Cardiac Contractility
45
Q

What are some complications that are involved in Exertional Heat Stroke?

A
  • Mental Status Changes and Tc>40C
  • Seizure
  • Hypotension
  • Rhabdomyolysis
  • Liver Damage
  • Arrhythmias
  • Disseminated Intravascular Coagulation
46
Q

What weather conditions can exertional heat stroke occur in?

A
  • a variety of weather conditions
47
Q

What can metabolic heat production contribute to?

A
  • Hyperthermia
48
Q

What are the causes of death from heat stroke?

A
  • Inaccurate temperature measurement/misdiagnosis
  • Inefficient cooling
  • Rapid Return to Play
49
Q

What do you need for a proper diagnosis of heat stroke?

A
  • True Core Temperature
50
Q

What is an effective cooling strategy for heat stroke?

A

Must reduce temperature to <40C within 30min
- Ice Bath
- If not available: use 12 ice-d towel in 6:6 rotation

51
Q

What is the proper protocol for return to play from heat stroke?

A
  • Determine and mitigate the cause
  • Full Recovery Necessary
  • Deacclimatisation / Deconditioning During Recovery
52
Q

What are the ACSM guidelines for return to play following Exertional Heat Stroke?

A
  • refrain from exercise for 7 day after medical care release
  • Follow-up: 1 week
  • Begin Exercise: cool environment / gradual increase 2 weeks
  • Vigorous activity: if not by 4wk more tests needed
  • full competition:
53
Q

What is Exercise Associated Hyponatremia (EAH)?

A
  • During or Up to 24 Hours after prolonged physical activity
  • Defined by a serum or plasma sodium concentration ([Na+]) below normal reference range
54
Q

What level of [Na+] shown in the lab is a sign of Exercise Associated Hyponatremia?

A
  • less than 135 mmol/L
55
Q

What are the early signs of Hyponatremia?

A
  • Bloating
  • “puffiness”
  • Nausea
  • Vomiting
  • Headache
56
Q

What are the serious signs and symptoms of Hyponatremia?

A
  • Alteration of Mental State
  • Obtundation
  • Coma
  • Seizures
  • Respiratory Distress (pulmonary edema)
57
Q

What are the alterations to the mental state during Hyponatremia?

A
  • Confusion
  • Disorientation
  • Agitation
  • Delirium
58
Q

What happens with weight during Hyponatremia?

A
  • General weight gain in most cases
59
Q

What is the Aetiology of Hyponatremia?

A
  • Consumption of fluids in excess of total body fluid losses
60
Q

What are risk factors for Hyponatremia?

A
  • Excessive drinking behaviour
  • Weight gain during exercise
  • Low body weight
  • Female Sex
  • Slow performance pace
  • Event inexperience
  • NSAIDs
  • High Availability of drinking fluids
  • > 4 hours exercise duration unusually hot environmental conditions
61
Q

What is the Treatment protocol for Hyponatremia?

A
  • Recognition
  • ABCs
  • Intravenous Access
  • 100ml of 3% NaCl (hypertonic saline)
  • Urgent EMS transfer
62
Q

What are the three pillars of performance in the heat?

A
  • Heat acclimation/acclimatization
  • Heat Mitigation: Pre-event / per-event
  • Hydration Strategy
63
Q

Why should athletes planning to compete in hot ambient conditions acclimatize?

A
  • Lowering Physiological Strain
  • Improving Exercise Capacity in Heat
64
Q

How much should athletes undergo heat acclimatization?

A
  • 60mins/day
  • Enough to increase skin temp and sweating
65
Q

Where should athletes perform heat acclimatization?

A
  • same environment as the competition venue
  • if not possible, train indoors in a hot room
66
Q

How long should athletes perform heat acclimatization?

A
  • Ideally, 2 weeks
  • See some adaptations around 1 week
67
Q

When are early adaptations seen from heat acclimatization?

A
  • first few days
  • Not complete until around 1 week
68
Q

What are some pre-competition cooling options?

A
  • Immersion - torso 10-15C
  • Vests (ice)
  • Slushies / Cool drinks
  • Avoid Shivering
  • Shorten Warm-Up
69
Q

What are some cooling options during competition? (per)

A
  • Ice Cold Drinks (water/electrolytes)
  • Ice Cold Towels
  • Ice Cold Hats
  • Ice Necklaces
70
Q

What is a good Hydration Planning protocol?

A
  • Fluid Tolerability/concentration
  • Hand-offs
  • Team Communication
  • Athlete-Support Team Individual Meetings
  • Discuss and Plan Contingencies
71
Q

What logistics do you need to know to plan ahead?

A
  • Site Visit
  • Supplies/Equipment
  • Water/ice
  • Familiarisation
  • Practice Handoffs
72
Q

What should you avoid when competing in the cold?

A
  • Shivering
  • GI distress

KIN 424 - Medical Aspects of Sport (11 decks)

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