#CoolFirstTransportSecond

Seamless triage saves a life of an athlete

Yuri Hosokawa, PhD, ATC

Vice President of Communication, Vice President of Education

 

 

Earlier this summer, when everyone was relieved to have completed the spring sport season, we were invited to give a lecture and hands-on training for exertional heat stroke emergency at CoxHealth Sports Medical Conference in Springfield, MO. This was their second annual gathering to review and practice updated policy and procedures for athlete health and safety. Physicians, athletic trainers, emergency medical technicians, athletic directors and coaches of local high schools attended this meeting. During the hands-on training, multiple scenarios were practiced. For example, what do you do when the first responder was an individual who was not medically licensed? What is the chain of command when an athletic trainer is present and not present? What cooling modalities are acceptable? What precautions must be taken during cooling? This lab also reiterated the importance of cool first, transport second. I am happy to say that their updated policy specifically states to cool first and then transport after the patient’s rectal temperature is down to 102 degrees Fahrenheit and that no other measures of body temperature assessment is acceptable. Throughout the meeting, I was very impressed to see their collaboration and understanding of each other’s role and I know their athletes are in good hands.

A month and half after the meeting, I received an email from CoxHealth stating that their emergency preparedness was put to a test– where an athlete was successfully recognized and treated for exertional heat stroke.

Sarah Bankhead (ATC, athletic trainer at CoxHealth), who treated the athlete, recalls the day as follows: When our athletes were putting away the blocking bags after practice, a coach noticed one of the athletes closing his eyes and beginning to fall over in the shed. The coach caught him and immediately called for help. The first coach to reach him checked his pulse and noticed shallow rapid breathing­­. The head coach called 911 and the other two coaches started putting ice in the groin, neck, and armpit areas. I, the athletic trainer, soon came over with a rectal thermometer, inserted it, and got an initial temperature of 108 degrees Fahrenheit. After confirmation of exertional heat stroke, a tarp was immediately place underneath the athlete and began to be filled with ice and water to start the cooling process before the emergency medical service arrived. We ensured that the athlete’s temperature was cooled to 102 degrees Fahrenheit, and then the athlete was transported via ambulance for follow up evaluation. The athlete has made a full recovery with no deficits thanks to the quick actions of those above, an effective policy in place, and the Sports Safety Summit which prepared my coaches to respond

Many teams have now begun their fall pre-season training. Do you know the chain of command and procedures when a heat emergency occurs on your practice field? It is never too late to review and build a consensus among the stakeholders of your sports medicine team. Take a “time out” and go over your emergency action plan. #Strive2Protect

 

Preventing Sudden Death in Sport– CoxHealth Sports Safety Conference

Brad Endres, ATC, CSCS

Assistant Director of Sports Safety Policies

The prevention of sudden death in sports begins well before a catastrophic injury occurs.

It may be true that heroes are made in how they respond when they are needed most. Many stories throughout the country give testament to the life-saving nature of an appropriate and timely response to medical emergencies in sport. While these stories are indeed uplifting, they are often the result of a great amount of effort dedicated to being prepared in the event of an emergency. During their 2017 Sports Medicine Conference, the Sports Medicine team at CoxHealth exemplified the old adage that “practice makes perfect”, and it was truly a sight to behold. This team, led by Dr. Shannon Woods, was a shining example of how to collaborate with multiple health care providers in order to create, implement, and practice “best-practice” policies and procedures intended to promote athlete safety. KSI was invited to travel to Springfield, MO to take part in the Conference, and it was inspiring to witness the rubber meet the road in regards to the practical application of research.

Throughout the two days of the conference, KSI staff led evidence-based educational sessions on exertional heat illnesses. KSI Vice-President of Communication and Education Dr. Yuri Hosokawa started off the conference on Friday morning with an evidence-based presentation about the prevention, recognition, and treatment of exertional heat illnesses. After the presentation, she led the participants through a practical lab session on the “best-practices” of responding to an individual suffering from exertional heat stroke (EHS).  The participants attending the Friday session of the conference included athletic trainers, coaches, sports medicine physicians, EMS personnel, and school administrators from local area high schools, given that these practical skills would be vital for treating one of their athletes in the event they developed EHS while participating in sports. On Friday afternoon, CoxHealth staff led mock emergency scenarios where participants  were able to gain hands-on practice of what they had learned in the morning. The participants took the scenarios seriously, which led to great discussions during the scenario debriefings. Additionally, the local Springfield news station recorded a news segment about the Conference in order to spread the word about emergency preparedness and athlete safety.

On the final day of the conference, the participants included physical therapists, physicians from other specialties, parents of young athletes, and other interested members of the community. Yuri and I geared our presentations to a slightly different audience, but the message was largely the same: evidence-based policies and procedures can indeed save lives.

Yuri and I were thankful to be invited to the 2017 CoxHealth Sports Medicine Conference, and proud to represent KSI at such an impressive collaborative event. Being in compliance with “best practice” emergency response policies is not always the easiest thing to do, but networks like CoxHealth Sports Medicine are proving that it can be done. Because of their efforts, the athletes they serve will undoubtedly be safe and well cared for.

Collaborative Solutions for Safety in Florida High School Sports

William Adams, PhD, LAT, ATC

 

On March 9-10, 2017, Drs. Douglas Casa, PhD, ATC, FACSM, FNATA, FNAK and William Adams, PhD, ATC along with KSI staff member Courteney Benjamin, MS, CSCS traveled to the University of Florida to attend their Collaborative Solutions for Safety in Florida High School Sports meeting. Organized by the University of Florida and the Florida Association of Sports Medicine, the aim of the meeting was to begin the steps of health and safety policies for the Florida’s high school student-athletes.

 

The meeting was attended by representatives from various regions within the state of Florida and included sports medicine physicians, athletic trainers, high school administrators, coaches and the Florida High School Athletics Association. Dr. Casa spoke on the importance of implementing evidence-based best practice policies focused on the leading causes of death in sport and provided numerous case examples as to how these policies have been effective at reducing the number of sport-related deaths. Dr. Adams followed by discussing the current standing of health and safety policies mandated for high school athletics in Florida.

 

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Following these initial talks, the rest of the meeting consisted of various break out sessions specifically designed to stimulate discussion amongst the group and discuss strategies for how to implement changes to current policies related to emergency action plans, environmental monitoring and activity modification guidelines, concussion, AEDs and coaching education. Discussing the current barriers for implementing the aforementioned policies and strategies to overcome these barriers with the attendees, who many are the state leaders in their respective professions, allowed everyone in the room to participate to assist in developing a plan going forward to present to the Florida High School Athletics Association to further protect their student-athletes.

 

Overall, this meeting was a tremendous success and we are truly thankful for the University of Florida and FASmed for organizing this meeting and for the University of Florida for hosting the meeting at their facilities.  Having a group of highly motivated individuals from across the state of Florida come together to discuss how they can improve high school student-athlete health and safety is a model example of ways other states can have similar successes. The coordinated efforts of sports medicine professionals, high school and state high school athletics association administrators and coaches is instrumental for preventing sudden death in our young athletes who have a full life to live in front of them.

 

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KSI at the Vermont City Marathon & Relay

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By Andrea Fortunati, Assistant Director of Elite Athlete Health and Performance

Korea Stringer Institute was represented for the first time at the 27th annual People’s United Bank Vermont City Marathon & Relay that was held on May 24th, 2015 in Burlington, VT. The race included 8,000 participants and began promptly at 8:00am with the Wheelchair participants, followed by the runners at 8:03am.

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Members of the KSI, William Adams, Yuri Hosokawa, Luke Belval, and Andrea Fortunati worked in the main medical tent located at the finish line as well as at medical tents located at the midpoint of the race.

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This year, there were approximately 150 medical visits seen throughout the day with a total of six athletes transported to the University of Vermont Medical Center.

Four cases of exertional heat stroke were seen and treated at the marathon. During all of these cases at least one member of KSI was present and aided in the treatment process. One case was treated at the medical tent located at mile 13 and the other three cases were treated in the main medical tent at the finish line. In the critical care tent there were two cold-water immersion tubs and members of KSI ready to implement proper protocols and procedures that have been profoundly researched to treat EHS. Treatment for the cases in the critical care tent where done with cold water immersion, which is found to be the quickest and most effective way to cool the body, and rectal thermometers were used for the body temperatures assessment, which is critical in assessing the body temperature in people who are suffering from exertional heat stroke. Once the athletes had been properly cooled, all EHS cases were transported to the UVMMC following the medical organizer’s protocol for a follow-up examination.

This is the second of several marathons KSI will be involved with this year, the first being at the Boston Marathon. Other road races KSI are attending include the Lake Placid Ironman, the Falmouth Road Race, New Haven Road Race, the Marine Corps Marathon, and more.

This is the second of several marathons KSI will be involved with this year, the first being at the Boston Marathon. Other road races KSI are attending include the Lake Placid Ironman, the Falmouth Road Race, New Haven Road Race, the Marine Corps Marathon, and more.