front 1 Assessment of the collapsed runner | back 1 ABCDEFGH Airway Breathing Circulation Disability (Mental Status) Environment (Rectal Temperature) Fluid status including change in body weight Blood Glucose and Sodium History including site of collapse |
front 2 Collapse during exercise (Common medical causes) | back 2 • Cardiac arrest • Hypoglycaemia • Anaphylaxis • Other medical conditions • Trauma/Orthopaedic injuries |
front 3 Collapse during exercise (exercise related causes) | back 3 • Heatstroke • Hypothermia • Exercise-associated hyponatraemia • Exercise-associated postural hypotension |
front 4 Most common cause of collapse Presents after the finish | back 4 Exercise-associated postural hypotension |
front 5 Exercise-associated postural hypotension definition | back 5 “The inability to stand or walk unaided as the result of light headedness, faintness, dizziness or syncope”
|
front 6 EAPH field management | back 6
|
front 7 Hyperthermia | back 7 Hyperthermia is high rectal temperature (usually >40oC) in an athlete who, other than feeling exhausted, is usually well. |
front 8 Exertional Heatstroke | back 8
|
front 9 39-40oC is considered ... | back 9 is a normal physiological response to intense exercise or physical activity |
front 10 Heat gain in exercise | back 10 Endogenous heat production: muscle activity and metabolism + Exogenous heat absorbtion: environmental |
front 11 Heat loss in exercise | back 11 In low environmental temperatures, heat is lost through: Convection + Radiation + (Small contribution from conduction) Increasing environmental temperatures: sweating = effective heat loss through evaporation In Humid conditions: evaporation is reduced > ineffective cooling Athlete is unable to lose heat > begins to overheat |
front 12 Heatstorke effects | back 12 Cerebral hyperthermia:
Intense inflammatory response: Inflammatory cytokines trigger a systemic inflammatory response (SIRS):
|
front 13 third leading cause of death in athletes | back 13
|
front 14 Heatstroke: Field management | back 14
|
front 15 What is Exertional Heat Illness (EHI) | back 15 Pathophysiological continuum from mild symptoms (fatigue, headache) to collapse, coma and death because of a rise in core temperature |
front 16 What is “Heat Exhaustion” | back 16 a physiological response to inadequate acclimatisation |
front 17 What is “Heat cramps” | back 17 a physiological response to inadequate training |
front 18 What is Exercise-associated hyponatraemia | back 18 [Na+] <135 mmol/L1 dilutional hyponatraemia occurring during or <24hr after exercise |
front 19 EAH: pathophysiology | back 19 Relative hyponatraemia in the vascular compartment causes an osmotic fluid shift into adjacent tissues |
front 20 EAH symptoms | back 20 Cerebral edema
GI symotoms
Other
|
front 21 EAH causes | back 21 Excessive fluid intake • Excessive consumption irrespective of fluid type Reduced fluid output (Altered renal function)
|
front 22 EAH: who is at risk? | back 22
|
front 23 EAH: Field management (Asymptomatic) | back 23 ● Observe closely ● Salty snacks or salty broth ● No oral fluids until onset of urination ● No iv fluids |
front 24 EAH: Field management (Symptomatic) | back 24 ● Oxygen ● 100ml bolus iv 3% Hypertonic Saline ● May require hospital admission |
front 25 EAH: Hospital management (Symptomatic) | back 25 ● Check and treat [Na+] before imaging ● Use 2.7% or 3% Hypertonic Saline ● AVOID Normal Saline |
front 26 EAH: Prevention | back 26 1. Drink according to thirst: ad libitum 2. Avoid excessive drinking during and after exercise 3. Sports drinks do not prevent EAH 4. Sodium supplementation does not prevent EAH |
front 27 Variation in human water turnover associated with environmental and lifestyle factors. | back 27
|
front 28 EAH: drinking myths | back 28 1. We need to drink 2 liters of water a day 2. Sports drinks prevent EAH 3. Thirst is imperfect |
front 29 Metabolic water | back 29 • The energy cost of running a marathon for an average 70 kg male is roughly 12,000 kJ (4.18 kJ·kg−1·min−1). • Estimates of carbohydrate oxidation indicate that an elite male runner would utilise 400 g of glycogen • given the accepted value of 3 g of water per gram of oxidised glycogen, this would result in a 1200 mL endogenous water release |