CONCUSSION/HEAD INJURY, HEAT ILLNESS,
& SUDDEN CARDIAC ARREST
HEAT RELATED ILLNESS
What is a heat related illness?
Normally, the body has ways of keeping itself cool, by letting heat escape through the skin, and by evaporating sweat (perspiration). If the body does not cool properly or does not cool enough, the victim may suffer a heat-related illness. Anyone can be susceptible although the very young and very old are at greater risk. Heat-related illnesses can become serious or even deadly if unattended.
See also the US Center for Disease Control and Prevention site on Exteme Heat.
How can I Prevent Heat-Related Illness
What are the causes of a heat-related illness?
What are the Stages of Heat-Related Illness?
The first stage begins with heat cramps in muscles. These cramps can be very painful. If you are caring for a person who has heat cramps, have that person stop activity and rest. If the person is fully awake and alert, suggest drinking small amounts of cool water or a or a decaffeinated/non-alcoholic beverage. If the victim has no other signals of heat-related illness, the person may resume activity after the cramps stop.
The signals of the next, more serious stage of a heat-related illness‑ heat exhaustion‑include,
The signals of the late stage of a heat-related illness‑called heat stroke‑include,
This late stage of a heat-related illness is life threatening. Call “911 for help.
Is there any General Care for Heat Emergencies?
For heat cramps or heat exhaustion: Get the person to a cooler place and have him or her rest in a comfortable position. If the person is fully awake and alert, give a half glass of cool water every 15 minutes. Do not let him or her drink too quickly. Do not give liquids with alcohol or caffeine in them, as they can make conditions worse. Remove or loosen tight clothing and apply cool, wet cloths such as towels or wet sheets. Call 9-1-1 or the local emergency number if the person refuses water, vomits or loses consciousness.
For heat stroke: Heat stroke is a life-threatening situation! Help is needed fast. Call 9-1-1 or your local EMS number. Move the person to a cooler place. Quickly cool the body. Wrap wet sheets around the body and fan it. If you have ice packs or cold packs, wrap them in a cloth and place them on each of the victim's wrists and ankles, in the armpits and on the neck to cool the large blood vessels. (Do not use rubbing alcohol because it closes the skin's pores and prevents heat loss.) Watch for signals of breathing problems and make sure the airway is clear. Keep the person lying down.
Source: American Red Cross
A concussion is a brain injury. Concussions are caused by a bump, blow, or jolt to the head. A concussion can also occur from a blow to the body that causes the head to move rapidly back and forth. They can range from mild to severe and can disrupt the way the brain normally works. Even a “ding” or a bump on the head can be serious and result in a long-term or lifelong disability.
A concussion is a brain injury.
Most concussions occur without a loss of consciousness.
Recognition and proper response to concussions when they first occur can help prevent further injury or even death.
Athletes who have ever had a concussion are at increased risk for another concussion.
Children and teens are more likely to get a concussion and take longer to recover than adults.
Sometimes people do not recognize that a bump, blow, or jolt to the head can cause a concussion. As a result, athletes may receive no medical care at the time of the injury, but they may later report symptoms such as headache and dizziness. These symptoms can be a sign of a concussion.
Remember, a concussion is a brain injury. Student athletes, parents, and coaches of every school athletic team and every extracurricular athletic activity should be trained to recognize the signs and symptoms of brain injury, including concussions and second impact syndrome.
You cannot see a concussion. Signs and symptoms of concussion can show up right after the injury or can take days or weeks to appear and may include:
• Nausea or vomiting
• Balance problems or dizziness
• Double or fuzzy vision
• Sensitivity to light or noise
• Feeling groggy, foggy or sluggish
• Concentration or memory problems
• Nervousness or anxiety
• Sleeping more or less than usual
• Trouble falling asleep
Medical attention should be sought immediately if an athlete:
Appears dazed or stunned
Is confused about assignments
Is unsure of game, score, opponent
Answers questions slowly
Can’t recall events prior to or after a hit
Concussion symptoms are made worse by exertion, both physical and cognitive (mental). The most important treatment for a concussion is rest. The athlete should not exercise or do any activities that may make the symptoms worse, like driving a car, reading, working/playing on the computer, playing video games, cutting the lawn, or other cognitively or physically taxing activities. If cognitive activities (e.g., reading, concentrating, using the computer) cause symptoms to worsen, the athlete may have to stay home from school. If athletes return to activities before they are completely better, they are more likely to get worse and their symptoms are more likely to last longer.
Return to school or work should occur gradually and not until the athlete feels better and school/work activities do not aggravate symptoms.
If an athlete is suspected of having sustained a concussion, implement the CDC’s recommended 4-step action plan:
Remove the athlete from play. When in doubt, keep the athlete out of play.
Ensure the athlete is evaluated by a health care professional experienced in evaluating for a concussion.
Inform the athlete’s parents or guardians about the possible concussion and give them a fact sheet on concussion.
Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for a concussion, says they are symptom-free and it’s okay to return to play.
According to the CDC, in 2009, an estimated 248,418 children (age 19 or younger) that were treated in emergency departments for sports and recreation-related injuries were diagnosed with a concussion or TBI. The rate of emergency department visits for sports and recreation-related injuries with a diagnosis of concussion or TBI rose 57% among children from 2001 to 2009.
Among children and youth ages 5-18 years, the five leading sports or recreational activities which account for concussions include bicycling, football, basketball, playground activities, and soccer.
Collegiate and high school football players who have had at least one concussion are at an increased risk for another concussion.
A repeat concussion that occurs before the brain recovers from the first—usually within a short period of time (hours, days, or weeks)—reportedly can result in brain swelling, permanent brain damage, and even death. This condition is called second impact syndrome.
For males, the leading cause of high school sports concussion is football; for females, the leading cause of high school sports concussion is soccer.
High school athletes’ recovery times for a sports concussion are longer than college athletes’ recovery times.
High school athletes who sustain a concussion are three times more likely to sustain a second concussion.
Lack of proper diagnosis and management of concussion may result in serious long-term consequences, or risk of coma or death.
For more information on sports concussion, prevention, or what to do if you suspect someone has sustained a concussion, complete our Resource Request Form or call our office at 1-800-444-6443 or 804-355-5748. The following links also provide additional information.
SUDDEN CARDIAC ARREST
What It Is – and What It Isn’t
Sudden cardiac arrest (SCA) is a sudden, abrupt loss of heart function. Most sudden cardiac arrest episodes are caused by the rapid and/or chaotic activity of the heart known as ventricular tachycardia (VT) or ventricular fibrillation (VF). These are diseases of the heart’s electrical conduction system that should not be confused with a heart attack (myocardial infarction), which is caused by a blocked blood vessel leading to loss of blood supply to a portion of the heart muscle. However, some people may experience SCA during a heart attack.
Incidence of Sudden Cardiac Arrest
Sudden cardiac arrest is a major health problem. According to the American Heart Association, SCA affects approximately 450,000 people each year in the United States.
SCA kills more Americans than lung cancer, breast cancer and AIDS combined.
Of the 450,000 Americans who suffer SCA each year, an estimated 95 percent die before reaching the hospital.
Rapid defibrillation is the only definitive treatment for SCA, and survival decreases 7-10 percent for every minute without it.
SCA victims range from young children to the elderly.
The average response time to an emergency call is six to 12 minutes.
What Makes Someone Susceptible to Sudden Cardiac Arrest?
People with heart disease are at varying risks for dying suddenly, but there are ways to markedly decrease that risk. Anyone with heart disease should discuss the risk of sudden cardiac arrest with their physician and talk about whether or not a referral to a heart rhythm specialist is appropriate for them. SCA risk factors include:
Survival of a previous SCA episode
Previous heart attack
Family history of SCA or other heart disease
Fast rhythm in the lower chambers of the heart (ventricles)
Dealing With Sudden Cardiac Arrest – Treatment Options
Cardiac arrest is reversible in most victims if it’s treated within minutes, but the only effective treatment is the delivery of an electrical shock. With the development of hospital coronary care units in the 1960s, it was found that electrical devices that shocked the heart could turn an abnormally rapid rhythm into a normal one. Later, it also became clear that cardiac arrest could be reversed outside the hospital if specially trained emergency rescue teams reached the person quickly Chances of survival are reduced by 7-10 percent with every passing minute. However, even after survival the prognosis continued to be dismal. The first-year recurrence rate was 20-40 percent.
In the mid-1980s, the implantable cardioverter-defibrillator (ICD) was designed and quickly called “an emergency room in the chest.” It monitored the heart’s electrical conduction system and administered electrical shocks directly to the heart to stop ventricular fibrillation. Today, ICDs do much more and have been proven to be 99 percent effective in treating ventricular arrhythmias.
A modern ICD is about the size of a small stopwatch and is implanted in the upper chest. It continuously monitors the electrical conduction system of the heart, watching for dangerous patterns and delivering electrical impulses when needed that may range from a tiny pulse like a cardiac pacemaker’s to a full, life-saving shock that can return the heart to normal rhythm. Dangerous patterns may indicate ventricular fibrillation, ventricular tachycardia or less problematic supraventricular tachycardias that arise in the upper chambers of the heart. ICDs now also collect information for the physician to use in diagnosis and programming the device to the exact needs of the patient. For patients with ICDs, the first-year recurrence rate of sudden cardiac arrest has been reduced to 1 to 2 percent.
External defibrillators are being more widely used by emergency medical technicians, firefighters and policemen. Thanks to new legislation, they also have become commonplace in many public buildings and airports, as well as at schools, shopping malls, stadiums, golf courses and other places where large groups of people congregate. External defibrillators for non-medical operators are called AEDs, or automated external defibrillators, and are extremely easy to use by trained laypersons, with voice-activated instructions.