By: William M. Adams, PhD, LAT, ATC; Vice President of Sport Safety
Every year, we are plagued with the news of young athletes dying or suffering catastrophic injuries while playing the sports that they love. While being multi-causal, the most likely culprits are sudden cardiac arrest, head injuries and exertional heat stroke. While death during sport (or physical activity) cannot be 100% prevented, there are some key strategies that can be taken to ensure that these risks are mitigated. Factors such as appropriate healthcare coverage during training and competition, venue-specific emergency action plans, access to an automated external defibrillator and heat acclimatization for preseason practices are effective means to mitigate risk. Below is an explanation of these fundamental policies and procedures that should be implemented at all levels of sport to ensure the health and safety of our athletes on the playing field.
1. Access to appropriate healthcare. Having access to appropriate healthcare (i.e. athletic trainers, sports medicine physician or other healthcare providers trained in sports medicine), is a vital aspect for any athletics program. These individuals are trained in the recognition, evaluation, treatment and return to activity of sport related emergencies. Having these individuals onsite for all sanctioned practices and competitions where the risk of sudden death is high ensures that, in the event of an emergency, prompt care can be given, which helps optimize the outcomes for the athlete.
2. Emergency Preparedness. In addition to having access to appropriate healthcare for all sanctioned training and competition, having a regularly rehearsed, venue-specific emergency action plan (EAP) allows all members associated with any athletics program to have a plan in place in the event of an emergency from occurring. Having a well-established EAP dictates the roles and responsibilities of each member of the athletics team and minimizes the time to point of care services during emergency situations.
3. Immediate Access to an Automated External Defibrillator (AED). Sudden cardiac arrest is the number one medical condition resulting in death during participation in sport or physical activity. The utilization of an AED during a cardiac event is an effective method to ensure survival; however, the chances of survival decrease roughly 10% for every minute defibrillation is delayed. With sudden cardiac arrest being the number 1 reason causing athletes to die during sport, having this life-saving device within 1-3 minutes of any venue hosting training or competition minimizes the time from defibrillation. Evidence shows that when an AED is utilized within one-minute of sudden cardiac arrest, survival is as high as 90%, thus justifying the need to have an adequate number of AEDs to service an athletics program at any and all institutions.
4. Heat Acclimatization. Exercise in hot environmental conditions not only adds additional stress on the body (both cardiovascular thermoregulatory strain), but exercise in the head can greatly increase the risk of exertional heat stroke if an individual is not accustomed to exercising in such conditions. Heat acclimatization, the physiological adaptations that occur following repeated bouts of exercise improves ones ability to exercise in the heat. Adaptations such as increased sweat rate, decrease exercising body temperature and heart rate and earlier onset of sweating allow for a greater ability to mitigate the risk of exertional heat stroke. The method of becoming heat acclimatized is a gradual progression of exercise duration, intensity and the wearing of protective equipment (i.e. football equipment, field hockey goalie equipment, etc.). This method has proved effective at both the NCAA and high school levels especially for football with only 2 football players dying from exertional heat stroke during August preseason practices since the 2003 implementation of the policy (saving 25-30 lives in the process). At the high school level, there have been zero exertional heat stroke deaths since any state athletics association has mandated this policy.
Source: Training and Conditioning