Sudden Death

The concept strongly encouraged in treating Heat Stroke

"cool first, transport second"

factors that could be considered both intrinsic and extrinsic

A mismatch between one's physical effort and one's physical fitness = Sleep deprivation, improper heat acclimatization and dehydrations may also increase the risk for exertional heat stroke =Drugs

The sport that experiences the highest number of concussion is

American football

should not be relied upon in the absence of a valid device.

An inferior measure

vaso-occlusion within the muscle

As the cells change shape they begin to get caught in the vessel, slow down and aggregate.

has the highest incidence of all sports with an overall incident rate of 1:11,394 athletes per year.

Basketball

the gold standard for treatment of exertional heat stroke

Cold water immersion

the second leading cause of sudden cardiac death

Congenital coronary artery anomalies

Brain deaths have been decreasing over time, but brain injuries with disability has been increasing.

Helmets do not prevent concussion, but they do reduce the incidence of skull fracture and major head trauma.

Rhabdomyolysis definition

Impaired blood flow to muscle causing damage

atherosclerotic coronary artery disease

In older individuals (> 35 years) sudden cardiac death is predominantly caused by

primary risk factors for concussion.

Linear and rotational head acceleration

hypertrophic cardiomyopathy.

Most common cardiovascular disease resulting in sudden death

hypertrophic cardiomyopathy

Most common cause of sudden cardiac arrest in the pediatric/ young adult athlete

Sickle Cell Trait

One gene is normal and the other gene is affected

only methods proven to be valid for accurate temperature measurement in patients with exertional heat stroke

Rectal temperature and gastrointestinal temperature measures

leading cause of death in athletes during sport participation

Sudden cardiac arrest

leading medical cause of death in NCAA athlete

Sudden death from cardiovascular causes

appear to continue even after the neurocognitive function returns.

The cerebrovascular abnormalities

stimulates additional sickling

The hypoxic environment and lowering of pH (increased acidity)

cerebral concussions

The vast majority of brain injuries in sport

Sickle Cell Trait Basic problem

a mutation in the hemoglobin gene

Marfan's syndrome

an autosomal dominant disorder of connective tissue -

The reduced oxygen carrying capacity results in

anemic response

The cause of exertional heat stroke

appears to be multifactoria

often referred to as mild traumatic brain injuries

cerebral concussions

Major problem: Athlete whose cells are sickling

continues through the pain and fatigue

Sudden death from cardiovascular causes generally occurred when

during or just after physical exertion while the athlete was engaged in practice or competition

incidences of sickle cell trait resulting in death have generally occurred when

during the initial days of strength and conditioning practices when the athletes are detrained

present in 50% of the athletes that died from sickle cell trait,

exertional rhabdomyolysis

Most athletes diagnosed with heat stroke present with

hot, sweaty skin, which contrasts with the dry skin often seen in classical heat stroke.

Rhabdomyolysis will cause

hyperkalemia and acidosis

inherited diseases

in the younger athlete (< 35 years) sudden cardiac death is more likely related

Heat stroke predisposing factors

intrinsic, extrinsic or both

Hypertrophic cardiomyopathy definition

is considered in an individual with apparent cardiac disease characterized by unexplained left ventricular hypertrophy associated with non-dilated ventricular chambers in the absence of another cardiac or systemic disease.

The primary danger of an aortic aneurysm

is that it can lead to aortic rupture

As perfusion is decreased to the gut, muscles and other non-vital tissues, the lack of sufficient blood flow to these areas will lead to

ischemia and potentially endotoxemia

impaired blood flow to muscle will lead to

ischemic rhabdomyolysis

A goal of ____ minutes from time of collapse to delivery of the first shock is strongly recommended

less than 3 - 5

Intrinsic factors of Heat stroke

low level of fitness, underlying illness and obesity.

The treatment for exertional heat stroke is primarily centered on

lowering core temperature to under 102ºF (38.9ºC) as soon as possible

Muscle cramps experienced during sickling are

more generalized to the muscle and not pinpointed and excruciating.

The initial injury will result from the direct impact and damage t

neuronal and parenchyma tissue

Considering that nearly 50 - 75% of athletes do not report their concussions, the use of ____ is important

objective measures becomes very important.

Traumatic brain injury occurs

occurs in a number of helmeted and non-helmeted sports.

The most common causes of these deaths were exercise-related sudden death associated with

sickle cell trait, exertional heat stroke, and cardiac events

Two etiologies of sudden cardiac event

structural defect or an electrical defect

ion channel disorders symptoms

syncope or unexplained seizure activity

Heat stroke is a condition that

systemic inflammatory response leading to multiorgan failure that might result in a fatal outcome

Exertional heat stroke is classified as a core temperature

temperature above 104ºF (40.0ºC) with central nervous system dysfunction.

A secondary or delayed phase of injury occurs as a result o

the inflammatory response, edema, ischemia and the effects of free radicals and ions that cause additional insult to the brain

The primary method used to screen for sudden cardiac death is

the preparticipation physical examination that includes a standardized medical history and attention to episodes of exertional syncope or presyncope.

result of second-impact syndrome.

there is a vascular engorgement leading to massive Intracranial pressure and brain herniation resulting in severe brain damage or death.

Extrinsic factors attributed to exertional heat stroke

training at the wrong time of day (i.e., at the hottest part of the day), insufficient rehydration regimen, inappropriate uniform ensembles for athletes during practice (e.g. increase uncompensable heat stress), improper work to rest cycles, and absence of appropriate medical personnel

An athlete that suddenly collapses and is unresponsive should be assumed to be

under cardiac arrest

The sport that experiences the highest rate of concussion is

women's ice hockey