Environmental Conditions

1. Environmental Conditions

2. Objectives • What are the main causes of heat or cold illnesses among athletes? • What is the role of an athletic trainer in preventing heat and cold illnesses? • What is the role of an athletic trainer in protecting athletes from other environmental concerns?

3. Environmental Stress • Can adversely affect an Athlete’s performance • Can even pose serious health risks

4. Heat Illness • Is Preventable!!!! • You can save a life by being aware of the environment • Prepare for the unexpected • Don’t challenge the weather, it will ALWAYS win

5. Exertional Heat Illness • You must be proactive in identifying individuals who are at the highest risk so that these individuals can be given special attention • Who is at risk?

6. Risk Factors • Dehydration • Large athletes • Illness • Age • Poor physical condition • Poor acclimation or acclimatization • 3-14 days • Clothing and equipment

7. Exertional Heat Illness • The body’s ability to cool is related to the individual and to the environmentEvaporation is your main defense • Dependent on: • Athlete’s ability to sweat • Athletes hydration level • Humidity

8. Evaporative Heat Loss • Sweat glands allow water to transport to surface of skin • Evaporation of water takes heat with it • When environment temperature is higher than body temperature, loss of heat through evaporation is KEY

9. Environmental Risk Factors • Heat • temperature • Humidity • Relative humidity of 65% impairs evaporation • Relative humidity of 75% stops evaporation • Heat Index • The heat you feel when temperature and humidity are combines

11. Exertional Heat Illness • Heat Rash • Heat Cramps • Heat Syncope • Heat Exhaustion • Heat Stroke • Hyponatremia

12. Heat Rash • Benign condition • Red, raised rash • Combined with prickling while sweating • Generally localized to areas covered with clothing • Prevent by continually toweling off • Treat with antihistamines, remove from heat, talcum powder

13. Heat Cramps • Painful muscle spasms • Excessive water loss • Electrolyte imbalance • fatigue • Occurs in individuals in good and poor shape • S/S • Dehydration, thirst, fatigue • Treatment • Drink water, replace electrolytes, stretch, ice

14. Heat Syncope • Due to: • Rapid fatigue • Over exposure • Standing in heat for long periods of time • Treatment: • Place in cool environment • Consume fluids • Lay down

15. Heat Exhaustion • Result of inadequate fluid replacement and continued exposure to heat • Core temperature will be normal or below 104

16. Heat Exhaustion • S/S • profuse sweating • Pale skin • Dizzy • Hyperventilation • Rapid pulse • Headache • Nausea • Cramps • Weakness • Chills • Cool/ clammy skin

17. Heat Stroke • Serious life-threatening condition • Organ system can be damaged • Loss of consciousness can occur • Core temperature over 104

18. Heat Stroke • S/S: • Sudden onset • Sudden collapse • Disorientation • Aggression • Staggering • Flushed hot skin • Minimal sweating • Shallow breathing • Low blood pressure • Strong rapid pulse • vomiting

19. Rectal Temperature • The GOLD STANDARD of core temperature measurement • Oral, tympanic, axillary temperatures may underestimate

20. Treatment • COOL first, TRANSPORT second • Immersion in cold tub 50- 60 degrees • Ice bags • Fan • Shade • Air conditioning

21. Transport to Hospital • Heat Exhaustion • If recovery doesn’t happen quickly • Aggressive fluid replacement • Continued cooling • Heat Stroke • Always transport • Aggressive cooling • Must be lowered within 45 minutes • Fluid replacement

22. Guidelines for Return to Play • Physician clearance • Asymptomatic • Should avoid exercise for at least 1 week • Progression back into activity • Athlete will be hypersensitive in the future

23. Preventing Heat Illness • Prevention is your BEST TOOL • Prepare • Acclimatization • Check hydration status • Assess environment • Manage the event • Have treatment available

24. Preventing Heat Illness • Use common sense and caution • Fluid replacement • Unrestricted replacement • Replace every 15 minutes • Clear urine • Acclimatization • 3-14 days • Protective equipment

25. Preventing Heat Illness • ID susceptible individuals • Weight records • Weigh before and after • Loss of 3-5% of body weight= health threat • Apparel • Light weight and loose • Light colored • Protective equipment

26. Sun Exposure • Premature ageing of skin, cancer • Suncreen • SPF= Sun Protection Factor • # = how many times longer to burn • Ex: SPF 6= 6 times longer to burn • Apply every 15-30 minutes • Reapply after swimming or sweating

27. Cold Related Injuries

28. Cold Related Injuries • Process of Cold Illness • Heat Loss= Body temp. > Outside temp • Cold Injury= Heat loss > Heat production • Predisposing Factors • Hydration • Inadequate clothing • Wind-chill • Wet • Improper warm up • Fatigue • Poor circulation • Age

30. Body Heat Loss • 65% of body heat is lost through radiation • 1/2 through head and neck • 20% through evaporation • 2/3 through skin • 1/3 through respiration

31. Hypothermia • The majority of cold illness • Definition: decrease in core body temperature • Life threatening emergency • Core temp below 94º • Biochemical processes slow, simple tasks difficult, shivering • Core temp below 90º • Shivering stops, clumsy, speech problems, cyanosis, pale, slowing of biochemical process

32. Hypothermia • General treatment (Tx): • Maintain ABC’s, call EMS, dry clothes, heat body, warm fluids • Most activity allows for adequate heat production • Temperature along with wind chill and wetness can increase chances of hypothermia

33. Cold Injuries • Raynaud’s Phenomena • Cold-induced Bronchospasm • Frost Nip • Frostbite

34. Reynaud’s Phenomena • Spasms of digital blood vessels • Fingers turn white and painful • Cause is usually unknown • Underlying disease • Anatomical abnormality

35. Cold-Induced Bronchospasm • Common in young people • Brought on by cold temperature and dry air • S/S: • Difficulty breathing • Coughing • Chest tightness • Wheezing • Tx: • Bronchodilators

36. Cold Injuries • Localized cooling can result in tissue damage • Formation of ice crystals between cells • Destroys cells • Disrupts blood flow • Clotting may occur

37. Frost Nip • Occurs with high wind and/or severe cold • Can affect: • Ears • Nose • Chin • Fingers • toes

38. Frost Nip • S/S: • Skin appears firm • Cold painless areas • Skin may peel and blister (24-72 hrs) • Tx: • Firm pressure • Blowing warm air • Hands in warm areas (if fingers are involved) • DO NOT RUB

39. Frostbite • Chilblains • 1st degree • 2nd degree • 3rd degree

40. Frostbite • Chilblains • Result from prolonged exposure • Causes redness, swelling, tingling pain in toes and fingers

41. Frostbite • 1st degree- superficial frostbite • Skin and 1st layer of subcutaneous tissue • Skin soft to touch • Appears red, then white, then swollen • Usually painless • Typically noticed by others first

42. Frostbite • 2nd degree • Skin is firm to touch • Appears red and swollen then later white and waxy • When rewarming the area it will feel numb then sting and burn • May blister and be painful for several weeks

43. Frostbite • 3rd degree- Deep frostbite • Indicates frozen skin requiring hospitalization • Reaches deep tissue damage (bone, tendon, joint) • Rapid rewarming is necessary (100-110º) • Skin is hard to touch • Totally numb • Blotchy white, yellow, or blue • Swollen • painful

44. Frostbite • Management • Remove from cold • Careful, rapid warming • Water immersion (warm water) • Do not touch edges of basin • Remove clothing, jewelry, rings • Sterile dressing applied • Transport to medical facility • Elevation

45. Prevention • Cold weather gear • Waterproof and windproof • Allows passage of heat and sweat • Allows movement • Layers (and adjusting them) • Hydration