Environment related conditions

Dr. Bareera Amjad

DPT, MS.NMPT, BCMT, Dip-HCHM, MPPTA
• 1. Heat exposure and illness including heat exhaustion
• and heat stroke
• 2. Cold exposure and illness including hypothermia
• and frostbite
• 3. Severe thunderstorms and lightning emergencies
• 4. Altitude illness including acute mountain sickness
• 5. Prevention and care of environmental emergencies
• in athletics
Methods of Core Temperature
Regulation
It is important for the athlete to replace both
fluids and electrolytes as they are lost through
sweating
associated with exercise.
As the body’s core temperature rises and water
and
electrolytes deplete, heat illnesses can become
a reality if
immediate proper care does not take place.
 Types of Heat Illnesses

■ Heat cramps
■ Heat exhaustion
■ Heat stroke*
 Heat related emergencies
• HEAT CRAMPS
 common in sports
 Never ignore, first step towards heat related emergency
 Calf & hamstrings
 Intense pain e persistent ms spasm in working ms
during prolong Ex.
• caused by muscle fatigue with rapid water and
electrolyte loss via the sweating mechanism.
• Lack of acclimatization
• Excess sweating,irregular meals
 Treatment
1. removing the athlete from activity
2. Rehydrate and replace electrolyte losses.
3. gentle passive stretching of the involved muscle
group
4. Cryotherapy Try light massage with ice to reduce the
5. muscle spasm.
6. Immediate HOH & electrolyte replacement
To prevent further cramping and avoiding more serious
heat related illness
 Heat Exhaustion

Heat exhaustion is a condition when the body is

near to total collapse because of dehydration and
a dangerously elevated core temperature.

An athlete suffering from heat exhaustion will

experience difficulty losing heat, but the body’s
cooling mechanism will remain intact.
 Sweat Rate

•  the amount of fluid you lose, primarily through sweat,

during each hour you exercise under your normal exercise
conditions.
• Weight loss between practice sessions should be kept to only
2% to 3% of the athlete’s pre-practice bodyweight, or less if
at all possible.
• 5% should be monitored closely.
• It is commonly recommended that athletes drink
approximately 15 ounces of fluid for every pound of body
weight lost during a practice session.
• (1 cup = 8 oz; 1 gulp = about 1 oz)
Heat stroke
 Preventing heat related emergencies in
sports
• Onsite presence of trained staff
• Pre participation physical exam
• Education of athlete & coaches
• Game guideline according heat index table
• Measuring factors of temp & humidity using
wet bulb globe temp
• Scheduling activity in low temp time
• Proper acclimatization before season
• Sufficient fluid replacement.
• Minimizing clothes & equipment
• Estimating water loss during activity
 Cold-Related Emergencies
The most common cold-related emergencies
are hypothermia and frostbite.
Inadequately clothed athletes are
at risk for accidental cold injuries caused by
prolonged
exposure to air temperature, humidity,
and wind.
 Hypothermia

Hypothermia is a condition in which the body’s

temperature
becomes dangerously low.
Many of the body’s organs can be
damaged by hypothermia.
Normal body temperature ranges
between 97.2°F and 99.5°F.
If the body temperature is just a
few degrees lower than this, bodily functions tend to slow
down and become less efficient.
If the body temperature
drops too low and stays low for more than a couple of hours,
the body’s organs can begin to shut down, and death will
ultimately result
 Signs and Symptoms
of Hypothermia
Progressively:
■ Individual feels cold and begins to shiver.
■ Individual has difficulty thinking and
becomes mentally confused.
■ Individual loses the ability to shiver.
■ Individual’s heart starts beating irregularly.
■ Individual falls into a coma and death may
occur.
 Treatment of Hypothermia

1. Monitor/maintain airway, breathing, and

circulation.
2. Move the athlete out of the cold.
3. Take off cold and wet clothing.
4. Wrap the athlete in warm blankets and
cover the head.
5. Do not try to warm cold skin by rubbing or
massage.
6. Do not allow the athlete to walk.
7. Do not give anything by mouth if the athlete
is not alert.
8. Transport to an emergency care facility as
soon as possible.
 Frostbite

Frostbite is a medical condition in which the nerves, blood

vessels, and other cells of the body are temporarily frozen
by exposure to cold temperature.

In frostbite, intracellular
water actually freezes and blood supply to the affected
areas is compromised or even stopped altogether,
resulting
in a skin injury
Frostbite commonly occurs at
the extremities: the toes, fingers, tip of the
nose,
earlobes, and cheeks.
 Treatment for Frostbite
■ Do not rub area.
■ Remove all wet clothing.
■ Cover area with dry bandage and/or
clothing.
■ Gently rewarm the area by blowing warm
air on area.
■ Place the area against a warm body part.
■ Place the area into warm (98°F –102°F)
water for several minutes.
■ If not certain that the area will stay warm
after rewarming, do not rewarm it.
Refreezing thawed frostbitten tissue can
cause more extensive tissue damage.
■ If an athlete is also suffering from
hypothermia, the first concern is core
rewarming.
■ Transport athlete to an emergency care
facility as soon as possible.
Prevention of cold-related emergencies in athletics

2. Dress in layers.
3. Cover the head to prevent excessive heat loss.
4. Stay dry by wearing breathable and water-repellent
clothing materials.
5. Stay adequately hydrated before and during activity.
6. Eat regular and nutritious meals so the body is wellfueled
and therefore more efficient; this also ensures
adequate calories available for shivering.
7. Avoid alcohol and nicotine because they accelerate
heat loss.
8. Educate athletes, coaches, officials, and parents to
recognize cold-related emergencies.
9. If unsure whether an athlete is suffering from
hypothermia and/or frostbite, always stay on the
side of caution and treat accordingly.
Lightning
 Mechanisms of Lightning Injury
1.Direct strike
2.Contact strike
3. Side flash
4. Ground current.
5. Blunt injury
 Mechanisms of Lightning Injury
• Injury from lightning can occur via five mechanisms:
• Direct strike: most commonly occurs to the head,and lightning current
enters the orifices.
• Contact strike: most commonly occurs when the lightning victim is
touching an object that is in the pathway of the lightning current.
• Side flash: most commonly occurs when the lightning strikes an object
near the victim and then jumps from the object to the victim.
• Ground current: most commonly occurs when the lightning current
flowing in the ground radiates outward in waves from the strike point.
• Blunt injury: most commonly occurs when the lightning current causes
violent muscular contractions that throw victims a distance from strike
point.
 thunderstorm Flash-to-Bang
Method

Begin counting after seeing a lightning flash.

Counting is stopped when the associated
bang of thunder is heard.
Divide this count
by five to determine the distance to the
lightning flash in miles.
Example: a flash-to bang
count of 30 seconds equates to a distance
of 6 miles.
 Emergency First Aid Procedures:

Lightning Strike
■ Activate local emergency medical service.
■ Lightning victims do not “carry a charge”
and are safe to touch.
■ Move the victim with care to a safer location.
■ Evaluate airway,breathing, and circulation.
■ Begin cardiopulmonary resuscitation (CPR)
or rescue breathing if necessary.
■ Evaluate for apnea and asystole.
■ Evaluate and treat for shock and hypothermia.
■ Evaluate and treat for fractures and/or
burns.
■ Transport to emergency care facility.
 What Is High Altitude?
• Some medically defined examples of high
altitude:
• High altitude: 1500–3500 m (5000–11,500 ft)
• Very high altitude: 3500–5500 m
• (11,599–18,000 ft)
• Extreme altitude: above 5500 m (18,000 ft)
 Acute Mountain Sickness
• Acute mountain sickness is common in people who ascend
from near sea level to altitudes higher than approximately
3000 m, but it may occur in altitudes as low as 2000 m.
• General symptoms for acute mountain sickness are
characterized by headache, lightheadedness, breathlessness,
fatigue,insomnia, loss of appetite, and nausea.
• Usually, these symptoms will begin 2 to 3 hours after the
person has reached peak ascent, but the condition is
generally self-limiting and most of the symptoms disappear
after 2 to 3 days.
 Acute Mountain Sickness Treatment
• The best way to prevent acute mountain sickness is by
ascending gradually and allowing for acclimatization.
• Acclimatization is the process of the body adjusting to
the decreasing availability of oxygen.
• Some authors suggest that with any ascent to an
altitude above 3000 m, there should be a 2- to 3-day
rest before engaging the person in strenuous activities.
• Treatment of acute mountain sickness by oxygen or
descent is not usually required; aspirin, acetaminophen,
or ibuprofen may relieve most headaches.
 High-Altitude Pulmonary Edema
• Another form of altitude illness is high-altitude
pulmonary edema, or fluid in the lungs.
• The treatment for high-altitude pulmonary edema is
immediate descent to a safe altitude level.
• This must be done with the utmost urgency.
• Delay may be fatal.
• A safe altitude is usually described as the last elevation
where the person felt well on awakening from a restful
sleep.
• Oxygen should be administered if available.
 Signs and symptoms of highaltitude
pulmonary edema
• Signs and symptoms of highaltitude
pulmonary edema may include:
• Extreme fatigue
• Breathlessness at rest
• Severe cough with sputum
• Gurgling breaths
• Chest tightness
• Blue- or gray-colored lips and fingernails.
 High-Altitude Cerebral Edema
• High-altitude cerebral edema is rare but potentially serious,even fatal.
• The condition often follows acute mountain sickness,and many people
think that the two are closely related and that high-altitude cerebral
edema is the extreme end of the spectrum.
• It is defined as a condition in which the brain swells and ceases to
function properly, like high-altitude pulmonary edema, the cause of
high-altitude cerebral edema is poorly understood but is again likely
related to changes in cellular permeability.
• Once high-altitude cerebral edema is present, it can progress rapidly
and can be fatal within a few hours.
• Athletes with this illness are often confused and may not recognize
that they are ill.
High-Altitude Cerebral Edema
High-altitude cerebral edema is rare but
potentially serious,
even fatal.
The classic sign of high-altitude
cerebral edema is a change in the ability to
think.
 Signs of high-altitude cerebral edema

• The classic sign of high-altitude cerebral

edema is a change in mental status.
• Signs and symptoms may include
• Confusion
• Changes in behavior
• Unusual or irrational behavior
• Lethargy
 The treatment for high-altitude cerebral
edema
• The treatment for high-altitude cerebral
edema is descent to a lower altitude as quickly
as possible.
• Oxygen should be administered if available.
• Medications such as dexamethasone can be
given to decrease the severity of the
symptoms
 Acute Mountain Sickness
General symptoms for acute
mountain sickness are characterized by
headache,
lightheadedness, breathlessness, fatigue,
insomnia,
anorexia, and nausea.
High-Altitude Pulmonary Edema
Another form of altitude illness is high-altitude
pulmonary
edema, or fluid in the lungs.