School Nurses on the Front Lines of Medicine: Emergencies Associated With Sport and Physical Activities: Part 1.

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- and limb-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus, catastrophic brain or cervical spine injuries, hypoglycemia, blunt chest/abdominal injuries, or extremity fractures requiring surgery. It is important for the school nurse to recognize potential life- and limb-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life- and limb-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 describes the initial assessment and management of three common emergencies associated with sport and physical activities.

Exertional heat stroke in navy and marine personnel: a hot topic.

Although exertional heat stroke is considered a preventable condition, this life-threatening emergency affects hundreds of military personnel annually. Because heat stroke is preventable, it is important that Navy critical care nurses rapidly recognize and treat heat stroke casualties. Combined intrinsic and extrinsic risk factors can quickly lead to heat stroke if not recognized by deployed critical care nurses and other first responders. In addition to initial critical care nursing interventions, such as establishing intravenous access, determining body core temperature, and assessing hemodynamic status, aggressive cooling measures should be initiated immediately. The most important determinant in heat stroke outcome is the amount of time that patients sustain hyperthermia. Heat stroke survival approaches 100% when evidence-based cooling guidelines are followed, but mortality from heat stroke is a significant risk when care is delayed. Navy critical care and other military nurses should be aware of targeted assessments and cooling interventions when heat stroke is suspected during military operations.

When the heat is on.

While most people would welcome a warm, sunny summer, the heat can prove life-threatening for some vulnerable groups.

[Heat stroke. Standarized treatment plan]. / Golpe de calor. Plan de cuidados estandarizado.

Heat stroke, or sun stroke, is defined as an emergency situation characterized by an increase in central body temperature above 40 degrees C and alterations in the central nervous system where encephalopathy predominates and coma is typical. A precocious diagnosis is essential and if the initial opportune measures are not taken, the death rate is very high, up to 70%. Due to climate changes, the number of heat stroke cases has increased since the 2003 heat wave. Although at first symptoms these cases are treated in hospital emergency wards or outpatient wards, when the severity of a person stricken by heat stroke becomes life-threatening or advanced medical care is warranted, patients are placed in Intensive Medical Care Wards. Even though cases of heat stroke are low, its lethalness converts it to a serious life-threatening circumstance due to thermal regulation deterioration, adverse neurological effects, and secondary multi-organ dysfunction.