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MUSC Health Blog

Date: 2017

Guest Post by:

Kathleen Choate, ATC
Athletic Trainer
MUSC Health Sports Medicine

If you found a loved one in cardiac arrest, what would you do? Sure, you know to call 911, but what do you do until EMS arrives? In these scenarios, every second counts. With every minute of no heart beat and no CPR, the chance of survival plummets. Action on your part greatly increases the chances of survival.

Often times, people who give CPR outside of the hospital do not have a medical background, and are considered laypeople. Laypeople are often teachers, coaches, and childcare providers who obtain CPR certification for their jobs.

In a perfect world, every able-bodied person would know CPR and be mentally prepared to use it. It’s important to know that delaying CPR by even a minute greatly reduces the chance of survival. The sooner you can recognize the need for CPR and start effective compressions, the greater chance the victim has to survive. If your loved one needs help at home, this means that YOU are their greatest chance of survival. This is where we are the least prepared and even unwilling to take the necessary action to save our loved one's life. Unfortunately, individuals are only 15.5 percent likely to give CPR to someone they know. (Casper, MD, Murphy, EMT-P, Weinstein, EMT-P, & Brinsfield, MD, MPH, 2003)

There are many reasons that could account for a layperson's unwillingness to initiate CPR — most of which are emotional or psychological in nature. Some reasons people don't initiate CPR are due to panic, fear of performing CPR incorrectly, fear of causing harm, fear of litigation, and fear of contracting a disease. (Coons & Guy, 2009)

With all this being said, I implore you to do two things. First, get certified in CPR and second, do some soul-searching about what might prevent you from performing CPR. This is especially important if you are alone and the victim is a loved one. Bring these concerns with you to class to discuss with the instructor, and mentally prepare yourself for these worst-case scenarios in advance.

The following are reputable sites where you can search for classes near you:

American Heart Association

American Red Cross

Works Cited:

Casper, MD, K., Murphy, EMT-P, G., Weinstein, EMT-P, C., & Brinsfield, MD, MPH, K. (2003). A Comparison of Cardiopulmonary Resuscitation Rates of Strangers Versus Known Bystanders. Prehospital Emergency Care, 299-302. doi:10.1080/10903120390936455

Coons, S. J., & Guy, M. C. (2009). Performing Bystander CPR for Sudden Cardiac Arrest: Behavioral Intentions Among the General Adult Population in Arizona. Resuscitation, 334-340.

Guest Post by:
Stephanie Davey
Certified Athletic Trainer
MUSC Health Sports Medicine

It is often said that if you want something to last, you must take care of it. For example, regularly changing the oil in your car, you do not want to continue running dirty oil through your engine or it won’t last, the same can be said for your tires, rotate them or they wear out! The body is no different. Athletes, mainly pitchers and quarterbacks, need to take care of their arms, so their arms will take care of them. So why do athletes assume it’s best to not take care of their bodies? Good question, for whatever reason, high school athletes have a bevy of reasons as to why they are not consistent in keeping up with the routine maintenance of their body. Time, lack of knowledge and resources to complete the maintenance, or a lack of accountability are a few of the reasons why athletes do not keep up with their body maintenance.

A lot of time and resources has been spent researching and alerting of the dangers of overthrowing for a baseball player.  However, it seems that many people neglect the arm of a quarterback.  All the hype is on the overuse of arms in baseball players that lead to Tommy John surgery, but there isn’t a lot of talk about overuse of the quarterback arm, which endures large amounts of stress throughout grueling summer camp practices.

In order to limit the excuses or reasons for poor shoulder health of athletes at our high school, we prepare all of our throwers with a routine known as “Thrower’s Ten Exercise Program”. Our baseball program has incorporated this routine into most of their pitchers’ routines, while our football quarterbacks began working through the program during spring practice when shoulder fatigue and tightness became a problem.

The “Thrower’s Ten Exercise Program” is designed to strengthen and stabilize many of the muscles surrounding the shoulder complex, while also serving as a stretching aide to all throwers. The Thrower’s Ten program can be adapted to fit the needs of each athlete in terms of resistance and weight being utilized. We utilize Jaeger Bands, two and a half pound and five pound dumbbells, and Therabands. While the Thrower’s Ten isn’t a new phenomenon in the arm care research, it is an effective time management piece to improving athlete arm care and it is cost effective.

The Thrower’s Ten and other shoulder strengthening plans should be used to help prevent injury and at the direction of someone familiar with arm care. If you or your athlete already have shoulder pain or an injury, it’s best to consult an orthopedic or sports specialized doctor.

What we have noticed at our school is that our throwing athletes have begun to feel better in their shoulders, enhanced their range of motion, increased their arm endurance, and improved their arm strength. Once a routine is established, the athlete needs minimal supervision to ensure the completion of the exercises.

Guest post by:
Marty Travis
Athletic Trainer
MUSC Health Sports Medicine


You would think the notion of proper sleep benefiting one’s overall health, academic performance, and athletic performance is common sense. You will be surprised to find many young student athletes do not believe in the value of sleep. I have not seen any research on athletes’ attitudes on sleep, but in my daily duties as an athletic trainer it seems like many just do not care about proper sleep. I am always hearing stories from both the athletes and their parents about athletes staying up late only to get a few hours of sleep before going to class the next day. My pre-season talks to athletes in the past few years included discussions on sleep along with proper nutrition, hydration, and concussion awareness.

Teenager napping in library with notebooks

From our past experiences we all know that the lack of quality sleep has negative effects on both athletic and academic performance. It hinders our ability to make quick and correct decisions, whether it is answering a test’s question or making the correct pass on a basketball fast break. If you stayed up all night “cramming“ for a test you will most likely do poorly. It is the same way for a big game. If the athlete stays up late playing video games, the following day the athlete will most likely play poorly in the game. Also poor sleeping habits can have emotional effects. I know from personal experience that if I do not get enough sleep over a period of days I can get very grouchy and irritable. I have seen this with many other people and athletes.

How much sleep do you need? I do not think there is an answer that fits all. There are studies that say anywhere between seven and ten hours nightly but I believe it is based on the individual. Some perform well with only five hours of sleep and some need ten hours. I believe consistency is the key. First find out what your optimal sleep time is. Then during the school year and sports season get into a habit of going to sleep and waking at the same time. This, with proper nutrition and good conditioning, will only help your athletic performance and daily living.

Lastly, what about naps? More and more college football coaches encourage their players to take naps before late afternoon and evening games. The coaches are seeing better performances from players who nap before games. The National Sleep Foundation recommends a 30 minute nap before games. The Foundation does not recommend naps longer than 30 minutes because that may hinder sleep that night.

There are other negative effects of improper sleep such as hindering energy recovery, slowing injury recovery, and increasing cortisol levels. We must continue to stress proper sleep and hope the student athletes finally buy into it.

Guest Post by:
Brittany Darling, MS, ATC
Athletic Trainer
MUSC Health Sports Medicine

This past week, high schools across the state stepped onto the football field looking to begin their season strong. Jumping into a new season can be a difficult transition for many high school aged athletes, especially at this time of the year. With the summer season come longer, hotter days of staying up late and eating unhealthy foods. This pre-season time period can make or break an athlete fighting for a starting position, and there are some simple tips to help you feel better prepared for the rough days ahead.

Rest

One of the biggest issues I see with the high school athletes is that all summer they have been staying up unreasonably late, and once football practice begins they fail to change and adjust their sleeping patterns. It is ideal to get eight to nine hours of sleep every night, and in order to accomplish this social outings may need to be put on hold for the time being. Both the body and brain require this rest to function properly, and if it is receiving significantly less then it can result in difficulty concentrating, poor decision-making, and even injury. A coach will know the difference between a well-rested and focused player versus a tired and inattentive one. Additionally, when given that rare day off- make sure you take it. A light stretch and relaxation is better to utilize than a heavy lift or hard run on your only off day of the week.

Hydrate

Hydration does not just take place during practice, but before and after it as well. Drinking water to hydrate all day long is more beneficial than chugging an entire water bottle in the middle of practice. It is actually dangerous to consume an excess of water at one time, and can lead to a condition called hyponatremia, which is a medical emergency. It is best to carry a water bottle around with you throughout the day because it will remind you to drink it. When having a meal, chose water over sweet tea or sodas, which can actually dehydrate you further. Try and limit Gatorade intake to one to two a day during activity because it also contains excess sugar, which is not needed all day long. For coaches, I like to recommend built-in water breaks at practice every 10 to15 minutes, but a player should always have water available to them if it is needed sooner. As the heat index climbs during these late August weeks, water breaks should be even more frequent and excess equipment removed when necessary per NATA standards.

Food

Food is the fuel for your body, and what you provide your body with for fuel will have a direct effect on how your body feels. Greasy, heavy food will make your body feel just that- heavy and difficult to move. Try to avoid fast food during pre-season, and make a strong attempt to get in a solid 3 meals per day with snacks in-between. Some good snack options before or during practice include pretzels, fruits and vegetables, or simple sandwiches without condiments on it. A post-practice meal should contain proteins and replenish you after a hard practice. Skipping meals or not eating enough can result in low energy at practice, and in the heat of summer possibly even lead to syncope or fainting.

Equipment Check

It is extremely important to make sure all of your equipment fits the way it is supposed to. Helmets should not be too big or too small or they can cause serious injury. Although many like smaller shoulder pads for better mobility, these must come down to cover the entire shoulder and kneepads also must be worn. Additional equipment such as a back plate or a horse collar is personal preference, but can be very useful in preventing injury. Mouth guards are another must have that at least one player always seems to be missing. If you are unsure about whether your equipment is fitting correctly, your coach and athletic trainer should be able to help you.

MUSC Children’s Hospital is once again the only such institution in South Carolina to be ranked among U.S. News & World Report’s 2017-18 edition of “America’s Best Children’s Hospitals.”

The latest rankings are published online by U.S. News & World Report.

The leading specialties for MUSC Children’s Hospital are: No. 11 for cardiology and heart surgery; No. 28 for nephrology; No. 37 for urology; No. 36 for cancer; No. 47 for gastroenterology and GI surgery; and No. 45 for neurology and neurosurgery.

Newcomers to the list this year, although known throughout the state for their unparalleled, specialized care, neurology and neurosurgery were recognized for quality of care, strong clinical outcomes and survival rates. In addition, the cardiology and heart surgery programs now sit one spot away from the top 10 programs in the country. Cancer, gastroenterology and GI surgery, urology, and nephrology continued strong showings for this ranking period.

“These rankings represent a steadfast commitment by our entire children’s hospital staff to delivering the highest quality pediatric care in the region. Although each of these programs should be proud of these specific achievements, they truly reflect the collective hard work of all our teams,” said Mark A. Scheurer, M.D., MUSC Children’s Health chief of clinical services. “As we look to the opening of the new hospital in 2019 and continue developing our outpatient subspecialty care services within communities, we feel confident that we are striking the appropriate balance that puts the needs of our patients and their families first.”

The 11th annual rankings highlight the top 50 U.S. pediatric hospitals in each of 10 specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology and GI surgery, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology, and urology. In the 2017-18 rankings, 81 of the 187 hospitals surveyed were ranked in at least one of the 10 specialties.

The current methodology combines clinical and operational data, results from a reputational survey of board-certified pediatric specialists, and supplemental information from resources such as the National Cancer Institute. RTI International collects and analyzes the data for the rankings. The methodology reflects the level and quality of hospital resources directly related to patient care, such as staffing, technology and special services; delivery of health care, such as reputation among pediatric specialists, programs that prevent infections and adherence to best practices; and clinical outcomes, such as patient survival, infection rates and complications. Survival rates, adequacy of nurse staffing and procedure volume are among the many kinds of information about each ranked hospital that can be viewed on the U.S. News website.

"Once again, our care team members at the Children’s Hospital have another source of validation for the excellent care they are delivering to our patients and their families every day,” said Patrick J. Cawley, M.D., MUSC Health CEO and university vice president for health affairs. “Clearly, the biggest validation they receive comes from those they serve, but these annual rankings certainly confirm that collectively we are leading health innovation for all the lives we touch at our Children’s Hospital. We can’t wait to see how the new MUSC Shawn Jenkins Children’s Hospital will take the state’s comprehensive care of children and their families to new and unprecedented heights for our state."

 

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