For Friday, November 12th

1
For Friday, November 12th

• You will have an in-class project
• It will be graded
• It will be helpful to have Arnheim and Starkey
  with you you can use any resource other than an
  ATC
• Be sure to return the grade sheet only, you can
  keep the journal review

2
Bronchial Asthma

• Chronic inflammatory lung disorder with
  involuntary constriction of the smooth muscle of
  the bronchial walls
• Causes an obstruction of airways

3
Extrinsic Asthma triggers

• Exercise
• Viral infections
• Animal exposure
• Mold
• Air pollutants
• Weather
• NSAIDS

4
Exercise Induced Asthma (EIA)

• Asthmatic attack which is induced by exercise
  (esp. in cold, dry air)
• vs.
• Bronchial Asthmatriggered by environmental
  allergen, infection, stressor other than exercise
• May occur minutes after exercise
• Peak 5-10 minutes after exercise
• Resolves in 20-30 minutes

5
EIA

• Sxs difficulty breathing (?dizziness) fast
  breathing respiratory stridor (high-pitched
  noise) anxious
• Management calm athlete encourage controlled
  breathing inhaler

6
Inhaler Use

• Shake inhaler
• Breathe out fully
• Breathe in deep and slow through mouth and
  depress canister
• Hold breath as long as possible
• Breath out
• Wait 1 minute between each use
• Follow dosage as instructed by physician
• Some inhalers banned by USOC

7
Treatment for Asthma Attack

• Plan of action?know who has asthma and where to
  find their inhaler
• Medication (know where it is!!)
• Be prepared to call 911 if
• Sxs worse than normal
• No response to meds
• Severe chest pain
• Breathing emergency

8
Prevention of EIA

• Albuterol can be taken preventatively
• Gradual increase in duration, intensity of
  activity
• Exercise in warm, moist environment

9
Diabetes Mellitus

• Syndrome due to complete or partial decrease in
  the secretion of insulin by the pancreas OR the
  body resists the insulin that is produced
• metabolic disorder of endocrine system
• Type I insulin-dependent onset lt35 y.o.
• Type II non-insulin dependent onset 30-40
  y.o. associated with obesity

10
Signs and Sxs

• Frequent urination
• Constant thirst/hunger
• Weight loss
• Tiredness/Weakness
• Itchy/Dry skin
• Blurred vision
• ?Dx UA

11
Management

• Control blood-glucose levels
• Balanced diet
• Exercise
• Insulin injections/Insulin pumps
• With activity (Diabetic Athlete)
• Eat before
• If prolonged, glucose supplementation
• Insulin doseage does NOT change food intake is
  increased/adjusted

12
Diabetic Coma (Sequlae)

• Not enough insulinketoacdosis?coma
• Coma is a gradual onset
• Sxs fruity smelling breath, labored breathing,
  thirst, change in LOC
• Rx inject insulin, EMS
• See also? Starkey pgs 691-696

13
What happens?

• Loss of sodium, potassium, ketone bodies thru
  excessive urination
• Leads to ketoacidosis
• Leads to coma

14
Insulin Shock

• Too much insulinhypoglycemia?shock
• Sxs tingling sensation, HA, weakness, abdominal
  pain
• Rx prevention is key!! (proper diet, snack
  before and during exercise), treat sxs of shock,
  EMS

15
Reflex Sympathetic Dystrophy

• Abnormal and excessive response of the
  sympathetic portion of the autonomic NS that
  occurs following an injury, usually due to
  immobilization
• Most common in distal extremity after casting
• Sxs hypersensitivity to touch swollen,
  red, tight skin
• Rx sympathetic ganglion nerve block in an effort
  to disrupt the ABN response

16
Epilepsy

• Any recurrent seizure disorder
• Can be induced by altered brain activity, h/o
  injury, genetics,
• Consider athletic participation on an individual
  basis (non-collision sports)
• Can be medicated to control, but usually have
  undesirable side effects

17
Types

• Petit mal seizure
• 5-15 seconds
• space out
• Grand mal seizure
• Lasts for a few minutes
• LOC
• uncontrolled tonic-clonic contractions

18
Treatment

• During cushion fall, protect head, remove any
  potential external hazards, DO NOT restrain
  person
• Afterwards will be tired, disoriented,
  embarrassed ?need to f/u with physician

19
Raynauds Phenomenon

• Condition in which cold exposure causes vasospasm
  of digital arteries which could lead to tissue
  death
• Sxs pallor, cyanosis

20
Iron-Deficiency Anemia

• Iron stores are depleted which results in
  decrease in performance
• Iron is stored in Hgb and bone marrow
• RDA 15mg/day females 10mg/day males
• Dx bloodwork
• Rx proper diet, iron supplementation

21
Iron-Deficiency Anemia

• Sxs fatigue, SOB, weakness, pallor, brittle
  fingernails
• Who is at risk?
• What are good sources of Fe?

22
Sickle-Cell Anemia

• Chronic hereditary hemolytic anemia
• Common in African-Americans, Native Americans,
  Mediterranian
• Abnormally shaped Hgb
• Transports less O2
• Shorter life span
• Dont pass through small blood vessels
• Can lead to thrombus or embolus

23
Sickle-Cell Anemia

• May preclude from athletic participation
• Red flags high altitudes, hyperthermia,
  dehydration
• Sxs fever, severe fatigue, pain in limbs and
  abdomen
• Treat symptomatically anticoagulants

24
Exercise-Induced Amenorrhea

• Common in high level athletes and show sports
• Red flags low body weight, high intensity
  training, disordered eating
• Needs to be re-established and regulated!!!
• Important for bone health
• BCP, nutritional counseling
• Physician involvement crucial

25
Female Athlete Triad

• Disordered Eating---Amenorrhea
• \ /
• Osteoperosis
• THE BEST MANAGEMENT IS PREVENTION.

26
For Friday, November 19th

• Shock, Sudden Death, Cardiac Conditions
• Read posted readings, notes on-line
• Quiz
• Last 2 journal articles due Monday, 11-22-04 by
  5pm
• Did you find the best predictor of heat illness?