School Nurses on the Front Lines of Healthcare: Emergencies Associated With Sport and Physical Activities (Part 3): Shortness of Breath in a Pediatric Athlete During a Track Event.

Sport participation is an important part of the development, both physically and mentally, of children and adolescents in the United States. Illness and injury associated with sport and physical activities may occur in the school setting. Although most sport-related illness and injury in students are considered minor emergencies, life-threatening illnesses or injuries may occur. It is important for the school nurse to recognize potential life-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow-up at their primary healthcare provider's office, or directly to the closest emergency department [ED] via Emergency Medical Services [EMS]). This article specifically describes the initial assessment and management of shortness of breath in an adolescent athlete during a track event.

School Nurses on the Front Lines of Healthcare: Emergencies Associated With Sport and Physical Activities (Part 2): Sudden Cardiac Arrest, Hypovolemic Shock, and Spinal Cord Injury.

Sport participation is an important part of the development, both physically and mentally, of children and adolescents in the United States. Illness and injury associated with sport and physical activities may occur in the school setting. Although most sport-related illness and injury in students are considered minor emergencies, life-threatening illnesses or injuries may occur. It is important for the school nurse to recognize potential life-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary healthcare provider's office, or directly to the closest emergency department via Emergency Medical Services). This article specifically describes the initial assessment and management of three potentially life-threatening conditions associated with sport and physical activity, namely sudden cardiac arrest, hypovolemic shock, and spinal cord injury.

Cannabinoid Hyperemesis Syndrome and Hypophosphatemia in Adolescents.

We report 3 adolescents with cannabis hyperemesis syndrome and recurrent hypophosphatemia complicating their clinical course with potential for significant consequences. They serve as reminders for providers to consider the diagnosis of cannabis hyperemesis syndrome and to monitor serum electrolytes closely in the setting of adolescent hyperemesis.

Fracture Risk in Spaceflight and Potential Treatment Options.

INTRODUCTION: Understanding the effects of microgravity on bone is essential, since humans are now considering long-distance spaceflight missions. It is well known that bone mineral density (BMD) decreases during long-duration spaceflight. While the risk of fracture in a microgravity environment is believed to be low, the potential risk for fracture increases upon re-entering a gravity environment. The objective of this study was to determine skeletal regions of high-risk for fracture after long-duration spaceflight and identify management protocols for those fractures.METHODS: A literature search was conducted on current fracture risk predictive models and suggestions for treatment.RESULTS: Exercise with the Advanced Resistance Exercise Device (ARED), T2 treadmill, and cycle ergometer with vibration isolation and stabilization (CEVIS) on the International Space Station (ISS) is part of a fundamental long-duration spaceflight strategy to mitigate BMD loss. Additionally, studies have shown that bisphosphonates have an additive effect for preventing bone loss. However, if a fracture were to occur, treatments that improve bone healing in space (in addition to standard management modalities such as splinting) include the use of low-intensity pulsed ultrasound, electromagnetic field therapy, and intermittent subcutaneous injections of parathyroid hormone. In the event of a complicated fracture, surgical intervention with a universal external fixation device could be a viable option for management.CONCLUSION: In conclusion, the best strategy for mitigating musculoskeletal injuries for deep-space missions will be a combination of BMD loss reduction coupled with improvements in management protocols for potential fractures.Swaffield TP, Neviaser AS, Lehnhardt K. Fracture risk in spaceflight and potential treatment options. Aerosp Med Hum Perform. 2018; 89(12):1060-1067.