Atleet almuudo ɓuuɓɗo e nder ladde : Ɓuuɓri ɓuuɓndi (‘Cool ko adii, yah-ngartaa ɗiɗaɓo’) vs Ɓuuɓri ɓernde ɓuuɓndi vs Sickling¶

Laartude suka jahroowo e duuɓi 15, lineman fuku koyɗe duɗal jaaɓi haaɗtirde, dognoowo cross-country kolees, tergal e fedde marching, walla sukaaɓe fuku koyɗe hakkundeejo, ɗoon e ɗoon ina njippoo e koppi mum en walla ina njippoo e dow turf e nder lewru Aout balɗe ɗiɗi e nder balɗe ɗiɗi, ina jeyaa e ko ɓuri teeŋtude e sahaaji e nder safaaraaji safaara emergen. E nder sukaaɓe e atletik kolees, ko ina ɓura 90% e maayɓe ɓe ngalaa caɗeele e nder dingiral fijirde, ko ngonkaaji tati tan njiylotoo : Sudden Cardiac Arrest (SCA), Ɓoornugol nguleeki (EHS), e Sikkil (ES e nder atletee en jogiiɓe sifaa Sickle Cell, HbAS). So tawii emergency tati ɗii fof ina mbaawi feeñde e nder leƴƴanɗe seeɗa e golle tiiɗɗe e ñalawma ngulɗo, jiiɓru gooto e goɗɗo e nder 180 leƴƴannde gadane ina waawi warde. Safrude ñawɗo mo ɓernde mum ɓuuɓnata no feewi ko "ɓuuɓɗo tan" ina leeltina defibrillaasiyoŋ caggal windo nguurndam hojomaaji 3 ; waɗde ñawɗo Exertional Heatstroke feewde e caggal ambulance yoorɗo, mo henndu mum ɓuuɓnata tawa aɗa adii ɓuuɓnude ɗum en e nokku ɓurtugol ndiyam ngulɗam (CWI) ice tub ina bonna Fedde ngenndiire jannginooɓe atletik (NATA) e Duɗal Korey Stringer "Cool ko adii, yah-ngartaa ɗiɗaɓo" mandat kaŋŋe-standard e accude maɓɓe 41.5 °C (106.7 °F) nguleeki core ngam defde ngaandi mum en e heeñere mum en e nder hojomaaji 20 e nder yahdu ambulance ; e wullude e atletee mo Exertional Sickling crisis ɓuuɓɗo ngam « ummaade e tiiɗtinde ɓuuɓri koyɗe » ina addana ƴiiƴam mboɗejam ɓuuɓɗam, rabdomiyolisi fulminant, e ɓuuɓri ɓernde hiperkalemik.

Ko moƴƴi tan, coftal ɓalli, jannginooɓe atletik (ATCs), safrooɓe ekipaaji, e jibnaaɓe banngeeji ɗii ngalaa haaju e ƴeewndo ƴiiƴam laboratuwaar ngam anndude ɗeeɗoo caɗeele tati ceertuɗe e dow huɗo. E ƴeewtaade diisnondiral kilinik nayi jooni jooni e nder leƴƴanɗe 30 gadane - (1) Jaabawol e Fooftere (SCA = jaabaaki haa laaɓi tawa foofaango agonal ngo alaa walla ngo gasataa), (2) Jaawgol ɓuuɓol (SCA e Heatstroke toɓɓere ɗoon e ɗoon tawa jeertinaani, tawi Sickling atletee en ina njuuroo e leydi tawa ina ngulla haa jooni ina ngulla ina ɓuuɓna, ina ɓuuɓna ɓalndu les/gluteal/hamstring), (3) Palpation musculaire (Heatstroke e Sickling ƴiye ina nanndi e softugol walla ɓuuɓngol, kono ko goonga Heat Cramps coktirgal e nder ɓuuɓri tiiɗndi no haayre nii, ina yiyee ina ɓuuɓna), e (4) Temperature Rectal Core (Exertional Heatstroke ina siforee no feewi e ŋakkeende golle CNS e nguleeki ɓalndu core dow 40.5 °C / 105 °F, tawi noon Sickling e SCA ina waɗa e nguleeki ekkorde no woorunoo walla toownde seeɗa les 40.0 °C / 104 °F) - aɗa waawi udditde porotokol hisnugol nguurndam laaɓtungol ɗoon e ɗoon.

(Ngam humpitaade no feewi laabi nguurndam ɓernde e ƴiiƴam, ƴeew CPR e AED ina njiyloo. Ngam caɗeele nguleeki kuuɓtodinɗe, ƴeew Ɓoornugol nguleeki vs ɓuuɓri ɓuuɓri e Gaññeeje ƴiiƴam tiiɗɗe, rabdomiolisis, e triage eɓɓoore ƴiiƴam ɓalejam, e jogaade aduna men limooje caɗtuɗe regginorde heɓotoonde e bannge.)

Waɗde ɗum jooni¶

1. Softina Peeje Golle Emergency nokku maa (EAP) e nder leƴƴanɗe 10 gadane ɗee : toɗɗaa neɗɗo gooto nodda 911 (walla 112 / 999), neɗɗo gooto doga ngam AED bannge, e neɗɗo gooto uddita dame ladde ngam ambulance. Woto meeɗ ɗaminaade "ƴeewde so tawii atletee oo ina diwta ɗum." Noddu limoore emergency nokkuure maa (911 to Amerik e Kanadaa, 112 to Orop fof, 999 to Angalteer, walla ƴeew limooje caɗtuɗe) ɗoon e ɗoon kala nde kala atletee yani e ladde.
2. Ittugol Ɓooygol Ɓernde (SCA) Ko adii fof (Leƴƴanɗe 0 haa 30): So tawii atletee oo JAABAAƊO, foofaani no haanirta nii, fuɗɗoo CPR juuɗe tan, mbaɗtaa AED e nder hojomaaji 3.
3. Tappu e junngo atletee oo, wulla innde maɓɓe. TRAPP SIDELINE CRITIQUE: Ko ina wona 50% e atletee en wonɓe e Sudden Cardiac Arrest ina kollita ɓuuɓri juutndi nanndundi e ɓuuɓri mioklonik e juuɗe/koyɗe (fotde leƴƴanɗe 10 haa 20) e "gasps agonal", ɓuuɓɗi, ɓuuɓɗi. Hoto meeɗ juumde dimmbagol walla ɓuuɓgol nanndungol e seppooji ngam foofde no haanirta nii, kadi hoto meeɗ sikkude atletee mo ɓuuɓɗo ina "ɓuuɓi tan" haa nde tabitintaa ɓe ina ngummii walla ina foofa no haanirta nii e ɓuuɓri tiiɗndi.
4. So tawii daɗndoowo oo jaabaaki, foofaani no haanirta nii : taƴon jersey mum en e paɗe mum en (kuutoragol taƴe trauma teeŋtuɗe les ɓuuɓri yeeso paɗe ɓalndu, accu kaski/caggal mum e nokku mum so wonaa tawa ina haani ngam naatde e laawol henndu), fuɗɗoo CPR juuɗe tan (100 to 120 compressions/min, 5 to 6 cm / 2 to 2.4 in deep), e jokkondirde pads AED e ɓanndu ɓuuɓndu ɗoon e ɗoon. Kala 60-leƴƴannde ko ɓuri hojomaaji 3 ina usta nguurndam 10%.
5. So tawii defoowo oo ina jogii pulse tiiɗɗo, ina foofa, ƴeewto Mental Status (CNS Function) ɗoon e ɗoon : kala ko ina ustoo miijo, jikku mo alaa hakkille, haala ɓuuɓka, ɓuuɓka, walla komaa e nder nguleeki ko Exertional Heatstroke (EHS) haa nde hollitaama ko wonaa ɗuum.
6. Naamndo naamne orientation nayi: "Hol innde maa? Hol fannu mo ngon-ɗen? Hol lewru woni? Hol drill mo mbaɗno-ɗen jooni oo?"
7. WOTO MEƊƊI tuugnaade e so tawii atletee oo ina ɓuuɓtoo walla alaa (anhidrosis), e WOTO huutoro noppi (tympanic), tiinde (temporal), walla termometre hunduko. Ina wayi no mawɓe wonduɓe e nguleeki kiiɗki, ko ɓuri 90% e almudɓe daɗɓe e nguleeki kiiɗki ina ɓuuɓtoo e ɓuuɓri keewndi e sahaa nde ɓe njippii ndee, e termometreeji tiinde/noppi ina njannga 2 haa 4 degereeji Fahels tooheel7us) ɓalndu ɓuuɓndu, ɓuuɓndu henndu. Ko termometre rectal termistor flexible tan (inserted 15 cm / 6 inches past the anal sphincter) ina fota no feewi nguleeki core ( ).> 40.5 °C / 105 °F ina tabitina EHS).
8. So tawii ko ɓuuɓri tiiɗndi (EHS) ina woodi ( ).Core Temp > 40.5 °C / 105 °F WALLA delirium/collapse CNS laaɓtuɗo e nguleeki mawki so termometre rectal alaa): Waɗde "COOL FIRST, TRANSPORT SECOND" ɗoon e ɗoon.
9. Ƴeewee denndaangal kaɓirɗe uniforme (kaski, paɗe, jersey, pantalon, soseeji, cleats) e ɓuuɓnude atletee oo haa e wutte e nder 190 haa 570 liiteer (50 haa 150 gallon) Cold-Water Immersion (CWI) Tub keewɗo ice e ndiyam at 1.7 °C to 15.0 °C (35 °F to 59 °F).
10. Ƴeewee ndiyam ɓuuɓɗam ɗam jokkude e saraaji ɓalndu e terɗe atleteer oo tawa ina njogii hoore e koyɗe mum en dow ndiyam e ɓuuɓri ɓuuɓndi les ɓuuɓri.
11. So tawii alaa tubbo ina woodi ("TACO Method - Tarp-Assisted Cooling with Oscillation"): Lelnude atletee oo e hakkunde tarp ladde mo ndiyam waawataa, waɗde 4 haa 6 wondiiɓe mum ƴetta ŋoral tarp oo ngam waɗde heen ɓuuɓri neɗɗo, ɓuuɓna cooyngal 3 haa 4 ice e ndiyam to bannge ɓanndu atletee oo, ɓuuɓna tarp oo yeeso e caggal tawa ina jokki.
12. WOTO ɗaccu ambulance oo ina jolna e ina diwa e atletee oo haa nguleeki mum en core rectal ustoo to 38.9 °C (102.0 °F) (ko heewi ƴettude 10 haa 18 minit e nder ndiyam ɓuuɓɗam jokkondirɗam, coofgol e tolno... 0.20 °C to 0.26 °C / 0.36 °F to 0.47 °F per minute).
13. So tawii atletee oo ina AWAKE, jeertina, nguleeki core ina les 40.0 °C (104 °F), eɓe njuumta e leydi e nder dogdu tiiɗndu ina ngulla « koyɗe ɓutte, maayɗe, ɓuuɓɗe e les ɓalndu » e ƴiye SOFT : safree no Acute Exertional Sickling (ES) Kiriis.
14. Ittu atletee o e fijirde ɗoon e ɗoon (never order them to run another rep or "walk it off").
15. Lelnu ɗe e nder ɓuuɓri, ndokku oksijen ɓeydiiɗo toowɗo (15 Liters/min via Non-Rebreather Mask) so tawii ina woodi e oto gonɗo e bannge jannginoowo atletik, ƴeewto maale nguurndam ko juuti, cooyna no feewi so tawii ina wuli, e naatde ɗoon e ɗoon e ambulance ALS to Departemaa Emergency ɓurɗo ɓadaade, jeertina cafroowo ER e rajo ngam waawde feewnude sickling exertional rhabdomsis, hiperkalemiya (peaked T-waves on 12-lead ECG).

Lekki kuulal : Triage différentiel banngeeji ɗi atletee almuudo ɓuuɓɗo (180 leƴƴannde adannde)¶

flowchart TD
    Start["Atleet almuudo ina fadi walla ina fadi haa leydi e nder golle walla e nder pijirlooji"] --> ActivateEAP["Ɗatal 1 (0-10 Sec): Softinde EAP nokku, Noddu 911, Ƴettu AED bannge, Uddit Dame Ladde"]

    ActivateEAP --> CheckResp{"Ɗatal 2 (10-30 Sec): Mbele Atletee oo ina jaaboo e foofde no haanirta nii? (Reentoɗee Jerks & Gasps Agonal)"}

    CheckResp -->|"NO: Jaabaaki e Foofaani / Gasping tan"| SCAProtocol["POROTOKOOL ƁURƊO ƁURDE ƁURDE (SCA) (Kañum ne ina tuuma Commotio Cordis so tawii ko e nder reedu): Taƴu Jersey/Pads, Fuɗɗoo CPR juuɗe tan (100-120/min), Waɗde AED e nder hojomaaji 3"]

    CheckResp -->|"EEY: Fooftere E Pulse"| CheckCNS{"Ɗatal 3: Ƴeewto ngonka hakkille (SNC) e nguleeki ɓalndu : Mbele atletee oo ina jiiɓii, ina haɓa, ina ataksi, ina wondi e koma, walla nguleeki > 40,5 C (105 F) ?"}

    CheckCNS -->|"EEY: Ɓooygol CNS + Nguleeki mawki (Temperature > 40,5 C / 105 F)"| EHSProtocol["ƊEƊƊE ƊEƊƊE ƊEƊƊE ƊEƊƊE (EHS) : Kaɓirɗe ɓutte, ɓuuɓnee e nder ɓuuɓri ndiyam (1,7-15 C / 35-59 F) walla TACO Tarp ɗoon e ɗoon. COOL ADDI (to 38,9 C / 102 F), JOKKOL ƊIƊAƁOL"]

    CheckCNS -->|"NO: Ƴeewto, Lucid, Ƴeewndo, Tempere < 40.0 C (104 F)"| CheckMuscles{"Ɗatal 4: Hol no Atlete yaniri, e hol no ƴiye koyngal/ɓaawo njiyrata?"}

    CheckMuscles -->|"Slumped Caggal Doggol; Musɗe ina njiya SOFT/Flaccid; Dull Iskemik Ɓaawo/Pelvis/Koyɗe Naafigaagal; Takipnee"| SicklingProtocol["KIRIIS ƁURƊO WOƊƊUDE (ES) : Woppu golle ɗoon e ɗoon, Hokku oksijen 15 L/min, Jokku Supine/Hiddrate, Ambulance ALS ɗoon e ɗoon to ER ngam Rabdomiolyse & Hiperkalemia ECG"]

    CheckMuscles -->|"Hobbo e nder Agoni; Muscles Cokaaɗo e ROCK-HARD Yiyeede Ɓoornugol Spasms"| CrampProtocol["ƁURI ƁURDE ƁURDE ƁURDE ƁURDE : Fooftude e nder ɓuuɓri, ɓuuɓri gonndi e ɓuuɓri, ɓuuɓri ɓuuɓri, ɓuuɓri elektorolit ɓuuɓndi e hunuko (0,5 tsp ɓuuɓri e nder 500 mL njaram dingiral)"]

Faandaare 1 : Taƴre ƴeewndo safaara bannge 4 (SCA e ɓuuɓri gonndi e ɓuuɓri e ɓuuɓri gonndi e ɓuuɓri)¶

E nder yontere adannde e lewru ut, ko adii nde coftal ɓalli waɗata, coftal ɓalli ina heewi majjere Exertional Sickling ngam Cramps de chaleur moƴƴo, walla majjere Arrest cardiaque sudden ngam Syncope de chaleur. Siftorde ceertugol kilinik e nder ndeeɗoo alluwal ina haɗa ñawbuuli bonɗi e nder ladde :

Diagnostic feere-feere e ɓuuɓri banngeeji ɗii ɗoon e ɗoon e nder atletee en almudɓe (NATA / ACSM / AHA Consensus)¶

Faandaare 2: Ɓoornugol ɓernde ɗoon e ɗoon (SCA) e Commotio Cordis e nder ladde : kuulal AED ngal hojomaaji 3¶

Sudden Cardiac Arrest ko #1 sabaabu safaara maayde e sukaaɓe atletee en, ina fiyra fotde 1 e nder 50,000 atletee en duɗe hakkundeeje e kolees hitaande kala. Nanduɗo e ɓuuɓri ɓernde mawɓe saabaade ɓuuɓri ƴiiƴam, SCA atletik sukaaɓe ina ummoo e caɗeele ɓernde structural walla electricité ɗe nganndaaka walla e fiyde ɓuuɓnde e ɓalndu (Commotio Cordis).

1. Sabaabuuji 5 gadani gonɗi e ɓuuɓri ɓernde e nder sukaaɓe atletee en¶

1. Kardiyomiyopati hipertrofik (HCM): Tekkeendi genetik e ɓalndu ɓernde ɓalndu nano ina addana ɗum warde Fibrillation ventriculaire (VFib) nde adrenalin ina ɓeydoo e nder dogdu.
2. Anomaliiji ƴiiƴam koronaawiris jibinannde (CAA): Ɓoornugol koronaawiris ummoriingol e sinus aorta mo moƴƴaani ina heɓa ɓuuɓde hakkunde aorta e ƴiiƴam pulmonaari e nder yaltugol ekkorse ɓurngol mawnude.
3. Ion-Kanalopaatiiji e Sindromuuji Elektrik (Long QT, Brugada, CPVT, e Wolff-Parkinson-White / WPW): Ɓerɗe gonɗe e mbaydi mbaylaandi, ɗe njuumtata ko e kuuraa les ɓuuɓri adrenalin.
4. Miyokarditis viral akut: Ɓuuɓri silsil e nder ɓalndu ɓernde e nder yontere walla e nder yontere 1 haa 2 caggal ñawu viral (Coxsackievirus, Influenza, COVID-19, Adenovirus) nde atletee artirta e ngonka tiiɗka tawa ina selli.
5. Kommosiyo Kordis (Blunt Chest-Impact Arrest): Ina waɗa e ɓernde cellunde 100% so tawii bal beysbol, bal lacrosse, bal hockey, bal softball, walla kaski ina fiyra ɓalndu nano (precordium) e nder 20 haa 40 milisekon gonɗo e dow ŋorol T (ventricular repolarization), werlaade ɓernde e nder Fibrillaasiyoŋ Ventrikel.

2. Ko waɗi coftal ɓalli fotaani foolde "Jerks Seizure" walla "Gasping Agonal".¶

E nder ƴeewndooji wideyooji ko faati e ɓuuɓri ɓernde atletik e nder duɗe hakkundeeje e kolees, #1 sabaabu coftal ɓalli leeltini CPR e ƴettude AED ko wonde juuɗe e koyɗe atletee mo yani oo ina ɓuuɓtoo no ɓuuɓri epilepsi nii fotde leƴƴanɗe 15, e ɓernde maɓɓe ina ɓuuɓtoo e ɓuuɓri mawndi, ɓuuɓndi. - Fisiyoloji: So Fibrillation Ventriculaire taƴii ƴiiƴam e nder ngaandi, hipoksiiji ɓuuɓɗi ina addana seƴƴere mioklonik 10 haa 20 leƴƴannde, rewi heen ko refleksuuji gasping agonal. - Kuulal Sideline (Inter-Association Task Force Mandate): Kala atletee mo yani e ko aldaa e mboros (walla caggal nde fiyi e ɓalndu) tawa jaabaaki, ina woni e Sudden Cardiac Arrest haa nde selli ko wonaa ɗuum. Woto waɗ heen hay huunde e hunuko mum, woto ɗaɓɓu "seizure" haa joofna, kadi woto 60 sekon e fiyde pulse. Neldu AED ɗoon e ɗoon, feeñnina ɓalndu nduu, fuɗɗoo ɓuuɓnude ɓalndu nduu. So AED rokkii ɓuuɓri e nder hojomaaji 1 haa 3 caggal nde yani e ladde, keewal nguurndam ina ɓura 85% haa 90%.

Faandaare 3: Ɓooygol nguleeki (EHS): njuɓɓudi "Cool ko adii, Transport ko ɗiɗaɓo".¶

Ɓooygol nguleeki (EHS) ina ɓeydoo heewde e nder Lewru Siilo e Lewru Aout ko adii nde fuku koyɗe, e nder leydi, e nder golle fuku koyɗe nde Wet-Bulb Globe Temperature (WBGT) ɓuri 27.8 °C to 32.2 °C (82 °F to 90 °F).

1. Ko waɗi aɗa foti huutoraade termometre rectal (e ko waɗi ɓuuɓri WAƊATAA ɓuuɓri)¶

Miijooji ɗiɗi ina njokki e ustude nguurndam atletee en janngooɓe kala lewru ut : - Miijo #1 ("So ɓe ngoni ko e ɓuuɓde haa jooni, ko ɓuuɓri tan, wonaa ɓuuɓri"): FEENAARE. Laral yoorngal (anhidrosis) ina waɗa e ɓuuɓri nguleeki kiiɗɗi e ñawɓe mawɓe e nder balɗe keewɗe. E nder Exertional Heatstroke, suka jahroowo e duuɓi 100 ina heɓa 1 000+ watt nguleeki mbaylaandi nder pads ina riiwta nguleeki mum en core gila e... 37 °C (98.6 °F) to 41.5 °C (106.7 °F) e nder hojomaaji 45 tawa ina ɓuuɓtoo haa jooni. - Miijo #2 ("Kuutoragol ƴulɓe tiinde walla termometre noppi"): FEENAARE. Wiɗtooji ɗi Duɗal Korey Stringer waɗi ina kollita wonde tiinde, noppi (tympanic), e termometreeji hunduko ina njannga ** .36.5 °C to 38.0 °C (97.7 °F to 100.4 °F)** e dow atletee mo nguleeki mum nder reedu ina waawi warde 41.8 °C (107.2 °F), sabu ɓuuɓri ɓuuɓri ina cooyna ɓalndu. - Hol ko woni so duɗal maa alaa termometre rectal e nder ladde? Tuugno e Kuulal teskinngal e nder safaara: **Kala atletee mo waɗata ekkorse e nder ngonkaaji ngulɗi, mo hollirta ko Sistem Nervous Central (CNS).

2. No dognirten ɓuuɓri ndiyam ngulɗam (CWI) Tuubaako walla TACO Porotokol Tarp e dow bannge¶

1. Pre-Stage Tub Ko adii Kuugal Nde WBGT > 25 °C (77 °F): Hebbinde tanki Rubbermaid mo 380 haa 570 liiteer (100 haa 150 gallon) sara laylaytol janngirgol ɓuuɓngol ngol e ndiyam (10 °C to 15 °C / 50 °F to 59 °F), e cooyngal 3 haa 4 ɓuuɓngal jooɗngal sara tuuba ina heddorii duppude.
2. Strip Kaɓirɗe e nder Leƴƴanɗe 60: Ittude kaski, paɗe juuɗe, jersey, pantalon, cleats, e soseeji (wet uniforms trap heat).
3. Submerge Neck-Deep e Stir Continuously: Ƴettu atletee oo e nder ɓuuɓri ndii ngam ɓalndu maɓɓe, pelɓi maɓɓe, koyɗe maɓɓe, e juuɗe maɓɓe ina ɓuuɓtoo e nder 1.7 °C to 15.0 °C (35 °F to 59 °F) ndiyam ɓuuɓɗam. Fiilde towel ɓuuɓngel les ɓuuɓri ɗiɗi ndi spotters ɗiɗi njogii ngam reentaade laawol henndu dow ndiyam. Ƴeewee ndiyam ɗam e semmbe kala leƴƴanɗe 30 mbele laral keeriwal ngulngal ina waasa feeñde e ɓalndu nduu.
4. Njuɓɓudi Delirium Combatif: Ɓooygol ngaandi ina heewi waɗde atletee hare. Haa 4 spotters ina njogoo no feewi juuɗe e koppi atletee oo e nder tub (walla kuutoroo TACO tarp feere dow huɗo). E nder hojomaaji 3 haa 5 e nder ndiyam ɓuuɓɗam, delirium combatif ina ustoo nde ƴiiƴam ngaandi cooynata.
5. Tempere ittugol target (38.9 °C / 102.0 °F): Ittude atleteer oo e nder ɓuuɓri ice, nawtu ɗum en e ɓuuɓri ambulance fadndotoondi so sonde rectal janngi 38.9 °C (102.0 °F) (prevents afterdrop hypothermia). So a alaa termometre rectal, ɓuuɓna ɗum fotde 12 haa 15 minit (walla haa ɓuuɓol e laaɓal hakkille ngarta) hade maa naatde e ambulance.

Faandaare 4: Sifaa tiiɗɗo (HbAS) kiris : hol ko waɗi wullude "Push Through the Cramps" ina addana neɗɗo hiperkalemiya bonɗo¶

Ko ina wona 1 e nder 12 Ameriknaajo ɓaleejo (8%), 1 e nder 100 Hispanik Ameriknaajo, e ujunnaaje ujunnaaje atletee en ummoriiɓe Mediteraane, Fuɗnaange hakkundeejo, Inndo, e Kariibi ina njogii Sickle Cell Trait (HbAS) - firti ko ɓe ndoni taƴre hemoglobin wootere no woorunoo (HbA) e taƴre wootere hemoglobin sickle ( ).HbS). E nder nguurndam ñalnde kala, yimɓe wonduɓe e Sickle Cell Trait ina celli no feewi, ɓe ngalaa ñawu Sickle Cell (HbSS).

Kono, e nder eɓɓoore anaerobiik ɓurnde tiiɗde, duumiinde - teeŋti noon e doggol waktuuji keewɗi (gassers, suicides, mat drills), jarribooji fitinaaji ñalnde adannde 1-mile/2-mile waktuuji, walla up-tempo no-huddle conditioning tawa fooftere alaa heen - joljole fijirde nay ina kawra e nder ɓalndu atletee oo golloowo e koyngal mum e ɓalndu mum : 1. Hypoxia Tissue Severe (toɓɓe oksijen nder ƴiye/ɓalndu golloowo); 2. Asidosis laktik tiiɗɗo (pH ɓalndu ina ustoo les 7.0); 3. Ɓuuɓri cellal (hiperosmoliteer nder kapilaaruuji ɓalndu); e 4. Temperatur Muscle Toowɗo.

Ndeeɗoo tetrad ina addana ƴiiƴam boɗejam atletee oo ɓuuɓde no feewi gila e diskiiji ɓutti, ɓutti, haa "sickles" lewru tiiɗndu, ɓutti. E nder hojomaaji 2 haa 5, ɗeen ƴiye boɗeeje sickled logjam e ɓuuɓna kapilaaruuji mikroskopiiji ñamlooji ƴiye mawɗe gonɗe e nder reedu, e nder reedu, e nder reedu, e les ɓalndu (acute ischemic rhabdomyolysis). Heege ƴiiƴam e oksijen, ƴiye ɓalndu ina ɓuuɓtoo en masse, ina ɓuuɓna ƴiye keewɗe Potassium (K+) e Miyoglobin ina njuuti e nder ƴiiƴam. So tawii coftal ɓalli doolii atletee sickling ngam artirde e dogdu wooturu, potaasiyom serum ina ummoo 7.0 to 9.0 mEq/L, ina addana ɓernde ɓuuɓde hiperkalemik (sine-wave ventricular fibrillation or PEA) dow ladde.

Limooje emergency diiwaan e porotokolle agence¶

Naamne keewɗe naamneede¶

Hol ko woni so tawii safrooɓe EMS nokkuuji ɗii ngarii e ladde, ɓe ndartinii jolnude atletee men Exertional Heatstroke e nder ambulance ɗoon e ɗoon hade nguleeki maɓɓe core cooynaade ?¶

Kala jannginoowo fijirde (ATC) e cafroowo ekipaaji ina foti waɗde nanondiral binndital ko adii nde dumunna oo fuɗɗotoo e gardiiɗo safaara Fire/EMS nokku oo. E nder jooni, Fedde Ngenndiije Dentuɗe ngam Cafrooɓe EMS (NAEMSP), Koldaa Ameriknaajo Cafrooɓe Emergency (ACEP), e bayyinaango nanondiral NATA, safrooɓe ina njamiraa **wallitde e nokku coofgol ndiyam ngulɗam (CWI) (nde fuɗɗotoo laylaytol IV e ƴeewndo ɓernde e nguleeki ɓalndu ina ustoo haa 38,9 degere Celsius (102,0 degere Fahrenheit) HADE mum nawde ñawɗo oo e nder ambulance**. So tawii toppitiiɗo safaara EMS nokku oo yamirii yah-ngartaa ko yaawi hade tuub oo hesɗitaade, huutoroo **feere TACO (ɓurtinde leppi/tarpeeji ɓuuɓɗi, ɓuuɓɗi e nder geec)** e humpitaade Departemaa Emergency jaɓɓotooɗo oo ngam jogaade lootorde ɓuuɓnde e ndiyam geec ina fadi to door ambulance.

Hol ko waɗi balɗe 5 gadane e lewru ut ko fuku koyɗe walla golle hakkunde leyɗeele ɓuri maayde e Heatstroke e Exertional Sickling fof ?¶

Ko ɓuri **75% e denndaangal maayɓe e duɗe hakkundeeje e duɗe jaaɓi haaɗtirde e nder balɗe 4 gadane ɗe mboros oo yani e mum**. To bannge fijirde, ɓanndu neɗɗo ina ɗaɓɓi **balɗe 10 haa 14 jokkondirɗe e ɓuuɓri gonndi e nguleeki ("Heat Acclimatization")** ngam ɓeydude ɓuuɓri ƴiiƴam plasma fotde 12% haa 15%, ustude tolno nguleeki core ɗo ɓuuɓri fuɗɗotoo, ɓeydude ɓuuɓri soservdium yaltugol ɓuuɓri, e ɓeydude ɓuuɓri soservdium yaltugol ɓuuɓri. So almuudo mo anndaaka yaltii e galle mo henndu mum woni e mum ñalnde 1, o waɗtaa e golle waktuuji 3 e nder paddorɗe timmuɗe walla e nder dogdu ("serial gassers"), njuɓɓudi ɓernde maɓɓe waawaa ittude nguleeki walla jogaade oksijen e nder ɓalndu. Ko ɗum waɗi kuule NATA e NFHS ina kaɗa golle balɗe ɗiɗi e nder balɗe jokkondirɗe, ina kaɗa kaɓirɗe ndeenka timmuɗe e nder balɗe 1 haa 5, ina kaɗa jarribooji baɗeteeɗi e sahaa kala e nder balɗe 1.

Hol no kuutortoɗen nguleeki tagofeere Wet-Bulb (WBGT) meeteer e bannge, kadi hol ko waɗi ɗum ɓuri "Index de chaleur" applique weeyo smartphone ?¶

"Index de chaleur" gonɗo e app weeyo ina hiisee tawa aɗa jooɗii e **100% ɓuuɓol e henndu ɓuuɓndu** - ina yejjita **radiation solaire radiant directement chauffage de noir artificiel turf** e **blocage de l'énergie local de stade**. A junngo **Wet-Bulb Globe nguleeki (`WBGT`) meeteer** ina hawra e sensorji tati ceertuɗi: **(1) Tempere Dry-Bulb** (`10%`), **(2) Nguleeki ɓuuɓki (`70%`)** fotde mbaawka coofgol ɓuuɓri e nder nguleeki e njaaweeki henndu, e **(3) Temperature Black-Globe (`20%`)** fotde nguleeki naange toowki e dow turf. Nde bannge `WBGT` yetti **`27.8 °C to 30.0 °C (82 °F to 86 °F)`**, balɗe 15 coofgol doole ina poti waɗde waktu kala ; nde `WBGT` ɓuri **`32.2 °C (90.0 °F)`** (walla les e nder nokkuuji cooyɗi to bannge worgo), denndaangal golle paddorde yaajnde e conditioning tiiɗɗo ina poti woppeede walla diwteede e nder galle.

So tawii janngoowo daɗndoowo ina anndi ina jogii Sickle Cell Trait (HbAS), mbele ɓe ngoppaama waɗde dingiral varsity?¶

Alaa - **alaa atletee mo sifaa Sickle Cell (`HbAS`) ina meeɗi woppeede e kala dingiral**. Ujunaaje ujunnaaje NCAA e atletee en karallaagal ina kaɓa e Sickle Cell Trait ñalnde kala e kisal. E nder heen, anndude ko atletee `HbAS` status ina addana coftal ɓalli e jannginooɓe fijooji huutoraade **Reento Sickle Cell Trait** : **(1)** Accude fijoowo oo mahde conditioning seeɗa seeɗa tawa ina doga jarribooji mile/gasser ñalnde-1 ; **(2)** Softinde waktuuji fooftere e cellal hakkunde njuuteendi dogdu ; **(3)** Yaafnaade atletee oo e dogdu timmundu all-out e nder nguleeki mawki walla tooweeki (`above 1,500 meters / 5,000 feet`); **(4)** Tabitingol jokkude ndiyam ; e **(5)** Doole atleteer ngam yaltude e kala drill e sahaa nde ɓe njiyata koyngal, buttuli, walla les ɓuuɓri tawa ɓe kulaani jukkungo.

Mbele eɗen poti meeɗde ittude kaski fuku koyɗe walla lacrosse e nder ladde e nder sahaa nde ɓernde mum ɓuuɓnata walla nde ɓuuɓnata nguleeki ?¶

Oho. E nder **Ɓuuɓri nguleeki (`EHS`)**, alaa ko bonnata ɓalndu nduu, kadi kaski e paɗe ɓalndu ina nannga nguleeki : **ittu kaski e paɗe ɓalndu fof ɗoon e ɗoon** hade maa jippinde atletee oo e nder ɓuuɓri ndiyam ngulɗam. E nder **Arrest ɓernde ɗoon e ɗoon (`SCA`)**, so tawii atletee o yanii tawa alaa ko bonnata wutte/hoore, **taƴon udditde jersey e laabi yeeso paddorɗe ɓalndu ɗoon e ɗoon ngam feeñninde ɓalndu nduu tawa ina waɗi CPR e paddorɗe AED**, e ittude mask yeeso (`or helmet/pads`) ngam ɓuuɓnude ƴiiƴam so tawii **meeɗaani leeltinde fuɗɗoraade ɓuuɓri ɓalndu walla rokkude ɓuuɓri AED**.

Jaŋde wasiyaade: Kala suka, duɗal hakkundeewal, e jannginoowo kolees, referee, e jibinannde bannge ina foti timminde CPR, AED, e kursus seedantaagal ballal gadanal e nder dingiral rewrude e Croix-Rouge Amerik, Fedde Ɓernde Amerik, Ambulance St John, walla Fedde Ngenndiije Dentuɗe Fedde Duɗe Toownde Dowlaaji (NFHS Learn), e janngude nokku maɓɓe Peeje Golle Emergency (EAP) e limto (stopwatch) hade gollal gadanal kala sahaa.

Ardiiɓe jokkondirɓe¶

• CPR e AED ko doggol doggol
• Ɓoornugol nguleeki vs ɓuuɓri ɓuuɓri
• Gaññeeje ƴiiƴam tiiɗɗe, rabdomiolisis, e triage eɓɓoore ƴiiƴam ɓalejam
• Gaññeeje hoore e concussion ballal gadanal
• Limooje emergency e neldugol hakkunde leyɗeele

Fuɗɗoode e ardorde laawɗunde¶

• Fedde ngenndiire jannginooɓe fijooji (NATA, leyɗeele dentuɗe Amerik): Haala darnde: Ñawuuji nguleeki kuuɓtodinɗi (Standard Termometrie rektal e ɓuuɓri ndiyam ngulɗam e nokku "Cool First, Transport Second" Mandat) e Haala nanondiral: Njuɓɓudi ɓuuɓndi, e IHSCollp Triage Sickling eɓɓoore).
• Duɗal Korey Stringer (KSI, Duɗal jaaɓi-haaɗtirde Connecticut) & Duɗal jaaɓi-haaɗtirde Ameriknaajo to bannge safaara (ACSM): *Haala nanondiral ko faati e toppitagol nguleeki ɓurtuki, coofgol e ballal tarp e ɓuuɓri (TACO), e ɓuuɓri aduna (WBGT)
• Goomu hakkunde-leyɗe ngam haɗde maayde e nder duɗe hakkundeeje e duɗe jaaɓi-haaɗtirde (NCAA / NATA / NSCA / Fedde Ameriknaare ɓernde): Wasiyaaji ngam anndude e jogaade jokkere enɗam (Target AED 3-minit, Seizure Acgnite Myoclonic/ Rabdomiolisis / Sikki e nder atletee en wonduɓe e sifaa sikki (HbAS).
• Koldaa Ameriknaajo Cafrooɓe Emergency (ACEP) & Fedde Ngenndiije Dentuɗe Cafrooɓe EMS (NAEMSP): Kaayitaaji jokkondire politik e jaŋde: Njuɓɓudi gonndi e ɓuuɓri gonndi e ɓuuɓri (Timminde ɓuuɓri ndiyam ngulɗam e nokku ko adii nde EMS naatata e ambulance).
• Nokkuuji toppitiiɗi haɓaade ñawuuji (CDC, leyɗeele dentuɗe Amerik): Njaɓɓugol nguleeki e nder atletee en duɗe hakkundeeje e Sickle Cell Trait (HbAS) ngam haɓaade ñawuuji kisal.