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By Alecia Good, MEd, ATC
Athletic Trainer
MUSC Health Sports Medicine

A young athlete collapses to the ground in front of you. No trained emergency personnel are present on the scene. Would you know what to do?

As the athletic trainer at Pinewood Preparatory School, I have posted Emergency Action Plans in every sports venue. The plans include what to do, who to call, and exact locations for dispatch if there is a need to call for emergency personnel. The hope is that if an emergency should ever occur and I am not there the first responders (usually coaches), will know how to respond. Two weeks ago, these plans were put into place and the first responders were able to save a young man’s life.

One evening a few weeks ago, several alumni gathered to play pick up basketball in our gym. Around 8 pm one of the players crashed to the ground and was unresponsive with sudden cardiac arrest. The other players quickly acted to find two coaches that were in the other gym, send someone for an automated external defibrillator (AED), and call 911. Within minutes, one coach performed hands-only CPR while the other quickly attached and turned on the AED. They continued their rescue efforts until the paramedics arrived. 

Once at the ER it was reported that emergency personnel were able to regain a pulse after at least 10 to 20 minutes of the young man’s heart being stopped. The question the doctors then began to ask was what the brain function would be like because his heart was stopped for such a long duration. The doctors were comforted by the fact that early CPR and defibrillation was performed. 

After only 2 minutes without oxygen-rich blood from the heart, brain cells can start to die. After 6 minutes, brain death occurs. According to the American Heart Association, “Sudden Cardiac Arrest is a leading cause of death in the U.S.—but when ordinary people, not just doctors and EMTs, are equipped with the skills to perform CPR, the survival rate can double, or even triple.”

The young man was placed in a medically-induced coma with a cooling therapy for a few days. After his body was brought back up to temperature and the paralytic drugs were discontinued, the young man woke and returned to normal function. He was talking and moving around and has since been discharged from the hospital. 

Early CPR to manually pump the blood to the brain and early defibrillation to shock the heart back into rhythm is without a doubt what saved this young man’s life. Had the coaches and students not acted quickly to enact the emergency action plan, this story would not have had the same happy ending. To reiterate my colleague’s blog on the importance of knowing CPR, please take the time to learn CPR and how to use an AED. Here is a link for hands-only CPR from the American Heart Association. Even if you don’t have time to take a full course, this compression only technique can save a life as it did in this situation. More importantly, know your surroundings and be willing to act in the event of an emergency. Take note of where there may be emergency equipment (AED, first aid kit) and know your location to be able to give accurate directions. Any delay in action can be the difference in the outcome of the emergency.

Sun Salutation in Moderation: How to protect your skin in sunny Charleston

The sun salutation which means “to adore” is a signature Yoga pose that pays homage to the sun. Throughout the summer many of us will become “sun worshippers,” offering up our own salutations on the beaches of Charleston, South Carolina. Making sure we protect our skin from sun damage while we enjoy the beach (or any outdoor activity) is the key to maintaining healthy skin.

 

According to the Centers for Disease Control there are a number of rituals we can adopt to protect ourselves from the sun’s damaging rays.

Sun Safety Rituals

Sun Safety Rituals: Shade, Hat, Clothing, Sunscreen

Shade – Stay out of the sun by finding or creating a shady spot. Shade offers shelter from the harmful UV rays. It also reduces your risk of skin damage and skin cancer.

Hat – Block the sun from areas we often forget by covering your ears, face and neck with a wide-brim hat! Remember dark colors offer more UV protection.

Clothing – covering your skin with clothing that covers your arms and legs can block some of the UVA and UVB radiation. Look for long sleeve shirts and long pants with UPF (Ultraviolet Protection Factor).

And of course – sunscreen. Sunscreen, or sunblock, is one of the simplest ways to reduce your risk for skin cancer, burns, and wrinkles. Be sure that you pay attention the SPF level and the expiration date for your sunscreen. An SPF of 15 or above is recommended. And expired sunscreen may not offer optimal protection.

Finally, be sure to practice your sun worship in moderation.

MUSC Health Dermatology in Charleston, SC

If you are interested in protecting your skin, getting your annual checkup, or improving your skin health and appearance, MUSC Health offers both cosmetic dermatology  and medical dermatology in 8 locations throughout the Lowcountry. Learn more about your skin health options by visiting MUSC Health Dermatology online or by calling 843-792-8282.

MUSC Health is committed to building healthy communities throughout the Lowcounty. This Fourth of July, keep yourself, your family, and your community healthy by staying safe around fireworks. Fireworks are a beautiful way to celebrate the season, but can be very dangerous. 

Did you know?

  • The hand is the most common site of injury caused by fireworks and accounts for approximately 36% of all injuries.*
  • The face and eyes each account for almost 20% of injuries.*
  • And more than 50% of all firework injuries are from burns exclusively or burns combined with blast injuries.*
  • Children under five using sparklers and other “safer” options accounted for more than 40% of the fireworks-related injuries in 2013.*
  • In 2015, U.S. hospital emergency rooms treated an estimated 11,900 people for fireworks related injuries; 51% of those injuries were to the extremities and 41% were to the head. Children younger than 15 years of age accounted for one-quarter (26%) of the estimated 2015 injuries.**

*Data attributed to The Huffington Post (July 2, 2017) https://www.huffingtonpost.com/amy-kontrick/july-fourth-holiday-is-one-of-the-deadliest-holiday-weekends----but-it-doesnt-have-to-be_b_10761002.html

**Consumer Product Safety Commission’s 2015 Fireworks Annual Report by Yongling Tu.

Tips on How to Reduce Fireworks Injury

  • Always make sure to have a bucket of water or a fire extinguisher in close proximity of fireworks.
  • If a firework does not go off or will not light, do not investigate the problem or stand close to it. Dose the firework with water immediately. Do not pick it up or stand over it. NEVER relight a dud.
  • Always stand several feet away from lit fireworks and never light fireworks indoors.
  • Avoid lighting fireworks near dry grass and always point them away from homes, other people, brush, leaves, etc.
  • Never hold a lit firework in your hand or attempt to set a firework off while holding it.
  • When handling fireworks, do not wear flammable materials or loose clothing.
  • Do not smoke or use flammable gases near fireworks.
  • Do not drink alcohol or be under the influence while lighting fireworks.
  • Wear safety glasses or goggles when shooting fireworks.
  • Children should be closely supervised around fireworks at all times. Even sparklers can pose a danger to young children if not handled properly.
  • If you do handle fireworks, make sure that you use only legal fireworks. A good deal of today’s injuries is still caused by fireworks that have been outlawed. Check the labels and make sure to store all fireworks in a cool, dry place.
  • The best way to prevent firework injuries this Fourth of July is to leave it to the professionals. Take your family to a public fireworks display and just enjoy the show!

If you receive an injury while handling fireworks this Fourth of July season, please remember the following:

  • Go immediately to the doctor or a hospital.
  • If there is an eye injury, do not rub or touch the eye area in order to minimize additional damage. Do not flush the eye out with water.
  • If there is a serious burn, call your doctor immediately and remove any clothing from the burned area.
  • For bleeding, apply pressure to control and go to your nearest emergency room or call 911.
  • For minor burns:
    • Cool the burn by running it under cool tap water or apply a cool compress
    • Remove rings or other tight jewelry from the injured extremity
    • Apply antibiotic ointment to any open wounds or ruptured blisters
    • Apply a loose nonstick sterile bandage or band aid.
    • Wash the wound with mild soap daily, and reapply antibiotic ointment and bandage
    • Take over the counter anti-inflammatory medications as directed until pain subsides, but consult with your doctor before starting any new medication
    • Seek medical attention for large burns, worsening swelling or pain, signs of inflection or any other concerns

Schedule Your Appointment at MUSC Health

For non-emergency appointments, talk with one of our many providers, including at the Musculoskeletal Institute and the Storm Eye Institute, to learn more about how to protect yourself and your family. Find a doctor near you with multiple locations throughout the Lowcountry!
 

By Michael J. Barr, PT, DPT, MSR
Sports Medicine Manager
MUSC Health Sports Medicine

MUSC Health Stadium

Major League Lacrosse is coming to Charleston and MUSC Health Stadium! MLL announced in April that the Charleston Battery will host the 2018 MLL Championship at MUSC Health Stadium on August 18. Luckily, we do not have to wait until August to see Major League Lacrosse in action, as the first-ever MLL game in the state of South Carolina is right around the corner on June 30 at MUSC Health Stadium. This inaugural game is a match between the Charlotte Hounds and the Atlanta Blaze.

The buzz around the Charleston lacrosse community is the excitement about the upcoming matches. Over the past 10 years, lacrosse has been one of the fastest-growing sports in the Lowcountry and throughout the United States. According to USA lacrosse’s 2016 survey, there are over 825,000 players participating in organized lacrosse throughout the country, which is an increase of over 225 percent compared to their first survey completed in 2001.

As the game grows in popularity and participation, the topic of injuries always comes up. Parents are concerned for their children’s well being, as they are with participation in all sports. A study completed by Xiang et al., and published in the American Journal of Sports Medicine in 2014, examined the number of high school lacrosse injuries (male and female) from 2008 to 2012. The top injury type was sprains/strains (38.3 percent) followed by concussions (22.2 percent) and abrasions/contusions (12.2 percent). The majority of the injuries were to the lower extremities (foot/ankle, knee, and thigh). In approximately 40 percent of the injuries that occurred, the players were able to return to play within 1 to 6 days and only 6.6 percent of the total injuries were serious enough to require surgical intervention.

So just like in all sports, injuries can occur in lacrosse, but there are also ways to minimize this risk through injury prevention techniques. Stop Sports Injuries has a full list of injury prevention guidelines for lacrosse players.

To prevent most prevalent injuries, sprains/strains, and concussions, here are my suggestions:

Sprains/Strains:

  1. Proper warm-up prior to play: This should include active movement in addition to both dynamic and static stretching.
  2. In season strengthening program: Focus on balance, dynamic stability, and core strengthening.
  3. Offseason training: Fitness training in the offseason can be the most important step to injury prevention. This should include a combination of cardiovascular training, strengthening and flexibility programs, plyometric training, and agility training.

Concussions:

  1. Know the rules and follow the rules: In boys’ lacrosse, when played correctly, unprotected hits should not occur, and in girls’ lacrosse there should be no head/face contact. Unfortunately, rules are not always followed or taught to players, so this is where experienced coaching comes into play.
  2. Wear the proper equipment: Lacrosse equipment is designed to be protective, but if helmets, facial equipment, and mouth guards are worn out or the wrong size, they may not be doing their job, which can lead to increased injuries.
  3. Know the signs and symptoms: If a hit occurs and there is a suspicion of a concussion, players should be held out of play until assessed by a health care professional trained in concussion management. Athletic trainers are your best resource for on-field management. If a concussion does occur, follow return-to-play guidelines to minimize the risk for escalated symptoms or future issues.

In lacrosse, just like in all other sports, there is a risk for injury, but the overall benefits of sports participation significantly outweigh the risks.

If you have read this far, you must be interested in the game, see how the elite do it, and come out to the game on June 30 and all of the festivities surrounding the Major League Lacrosse Championship at MUSC Health Stadium in August.

By Brittney Lang MS, ATC
Athletic Trainer
MUSC Health Sports Medicine
www.MUSCHealth.org/sports

Summer workouts for athletes have started and with temperatures and humidity rising daily as we get closer to summer we have to be aware of making sure our athletes are properly hydrated. Athletes should have access to water during any weights and conditioning sessions and given breaks during sessions as needed. It is also necessary to educate athletes on the importance of hydrating well before and after physical activity to maintain good health.

An athlete needs to be properly hydrated if they want to be able to perform at their highest level. Physical activity, heat, and humidity increase the amount of fluid your body needs to stay hydrated.  Below are recommendations for how much fluid one should be drinking to maintain adequate levels.

Everyday
Drink adequate fluids. Roughly 1 ml for every calorie consumed. For example, if you eat 4000 calories, drink 4000 ml of fluids (4 L).

2 to 3 hours before training/competition
7 oz of fluid

Immediately prior to training/competition
6 to 12 oz of fluid

Every 15 to 20 minutes during training/competition
6 to 12 oz of fluid

Exercise longer than one hour
Be sure to include a carbohydrate source in the form of solid, gel or sports drinks. Consume roughly 30 to 60 grams of carbohydrate per hour. 600 to 1200 ml of a sports drink will fulfill this need.

After exercise 
16 to 24 oz for every pound lost from the training session or competition.

It is good practice to do a pre and post workout weight check to make sure the athlete has been consuming enough during the workout; and to see if they have lost any weight and determine how much extra they may have to replenish.

Staying well hydrated will help decrease the risk of heat illnesses such as muscle cramps, heat exhaustion and heat stroke by helping with body temperature regulation and cooling efficiently.

Dehydration

The body loses fluid through the skin as sweat, through the lungs while breathing, and through urination. When the body loses more fluids than is being taken in to replace what is lost we have dehydration. There are some common signs and symptoms of dehydration to look out for during training:

  • Headache
  • Nausea
  • Dizziness
  • Thirst
  • Fatigue
  • Muscle cramping
  • Low output of urine/dark coloration

If an athlete is experiencing any of these symptoms, they should stop what they are doing and drink fluids. An athlete should not completely rely on their thirst mechanism to tell them to drink. If the athlete feels thirsty, it is too late. The body has begun to feel the effects from dehydration and their performance will suffer along with their body. One should not wait that long.

Over hydration

While dehydration is more common in athletes, there is a very real possibility of over hydration. This is when the athlete intakes more water than the body has released i.e through sweat. This can lead to low sodium levels also known as hyponatremia and cause very severe health problems if the athlete does not seek the necessary help right away. Drinking some sport drinks during longer or intense workout sessions can help with keeping sodium levels up and eliminate the possibility of hyponatremia during training.

Hydration is one of the most important things an athlete can do to maintain mental and physical performance. Educating the athlete on proper hydration techniques is the best way for them to stay healthy.

 

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