Semathi sa Seithuti se Oeleng Lebaleng: Heatstroke ea Boipheliso ('Cool First, Transport Second') vs Sudden Cardiac Arrest vs Sickling¶

Ho shebella 'mathi oa bolo ea maoto ea lilemo li 15, semathi se pota-potileng naha, setho sa sehlopha se tsamaeang, kapa sebapali sa bacha sa bolo ea maoto ka tšohanyetso ba oela fatše ka mangole kapa ba oela fatše nakong ea boitlhakiso ba ho lokisa maemo a mabeli ka letsatsi ka Phato ke e 'ngoe ea maemo a tšohanyetso a bohlokoa ka ho fetesisa a bongaka lipapaling. Bocheng le liatleletiki tse kopaneng, kaholimo ho 90% ea mafu ohle a tšohanyetso a sa sithabetsang lebaleng a bakoa ke maemo a mararo feela a hlobaetsang: Ho tšoaroa ha pelo ka tšohanyetso (SCA), Sefuba sa Heatstroke se Ikemetseng (EHS), le Ho kula ka Boiketlo (ES ho baatlelete ba jereng Sickle Cell Trait, HbAS). Le hoja maemo a mararo a tšohanyetso a ka hlaha ka mor'a metsotsoana ea ho sebetsa ka matla ha 'mele letsatsing le chesang, ho ferekanya e mong ka nako ea pele **metsotsoana e 180 ** ho ka bolaea. Ho tšoara motho ea ts'oeroeng ka tšohanyetso ea lefu la pelo e le "ho futhumala feela" ho liehisa defibrillation ho feta fensetere ea ho pholoha ea metsotso e 3; ho kenya mohlaseluoa oa Exertional Heatstroke ka morao ka morao ho ambulense e omeletseng, e nang le moea o pholileng ntle le ho e qoelisa ka setšeng ** ho qoelisoa metsing a batang (CWI) ice tub ** e tlola **National Athletic Trainers' Association (NATA) le Korey Stringer Institute "Cool First, Transport Second" taelo e tloaelehileng ea khauta ** mme e lumella 41.5 °C (106.7 °F) mocheso oa mantlha ho pheha boko le sebete sa bona nakong ea leeto la ambulense la metsotso e 20; le ho hoeletsa moatlelete ea nang le bothata bo matla ba Exertional Sickling crisis ho "tsoha le ho ntša mahlaba a leoto" ho baka koluoa ​​​​ea microvascular red-blood-cell logjamming, fulminant rhabdomyolysis, le hyperkalemic cardiac arrest.

Ka lehlohonolo, bakoetlisi, bakoetlisi ba liatleletiki (ATCs), lingaka tsa sehlopha, le batsoali ba ka thōko ha ba hloke liteko tsa mali tsa laboratori ho arola maemo ana a mararo a tšohanyetso joang. Ka ho hlahloba bakhethoa ba bane ba hanghang ba tleliniking nakong ea metsotsoana e 30 ea pele - (1) Karabelo le Phefumoloho (SCA = ho se arabele ka ho felletseng ka moea o le sieo kapa o phefumolohang oa agonal), (2) Collapse Velocity (SCA le Heatstroke oela ka tšohanyetso ntle le temoso, athe Sickling baatlelete ba oela fatše ba ntse ba falimehile 'me ba tletleba ka bofokoli bo lerootho, bo tlaase ba ischemic / gluteal/hamstring), (3) Palpation ea mesifa (3)Heatstroke le Sickling mesifa e ikutloa e le bonolo kapa e fokola, athe ke 'nete Heat Cramps notlela ka har'a mafika a thata, a bonahalang a koaletsoe), le (4) Core Rectal Temperature (Exertional Heatstroke e hlalosoa ka thata ke ho se sebetse ha CNS hammoho le mocheso oa mokokotlo oa mokokotlo o ka holimo 40.5 °C / 105 °F, athe Sickling le SCA li etsahala ka mocheso o tloaelehileng kapa o fokolang oa boikoetliso ka tlase 40.0 °C / 104 °F) - o ka qala mokhoa o nepahetseng oa ho pholosa bophelo hang hang.

(Bakeng sa mehato e qaqileng ea ho tsosolosa pelo ea pelo, bona CPR le tataiso ea AED. Bakeng sa maemo a tšohanyetso a mocheso ka kakaretso, bona Ho otloa ke mocheso khahlano le ho felloa ke matla ha mocheso le Kotsi e mpe ea liphio, rhabdomyolysis, le tlhahlobo ea moroto o lefifi, le ho boloka lefatše la rona dinomoro tsa tshohanyetso bukana e fumanehang ka thoko.)

Etsa sena hona joale¶

1. ** Kenya tšebetsong Morero oa Ts'ebetso ea Tšohanyetso oa sebaka sa hau (EAP) ka metsotsoana e 10 ea pele: abela motho a le mong ho letsetsa 911 (kapa 112 / 999), motho a le mong ho matha bakeng sa AED e ka thōko, le motho a le mong ho bula liheke tsa lebaleng bakeng sa ambulense.** Le ka mohla u se ke ua emela ho "bona hore na moatlelete o tla e sisinya." Letsetsa nomoro ea hau ea tšohanyetso ea lehae (911 US le Canada, 112 ho pholletsa le Europe, 999 UK, kapa bona dinomoro tsa tshohanyetso) hang-hang ha moatlelete ofe kapa ofe a oela lebaleng.
2. Laola ho Tšoaroa ha pelo ka tšohanyetso (SCA) Ea pele (Metsotsoana ea 0 ho ea ho 30): Haeba moatlelete a SA ARABELLE 'me a sa phefumolohe ka tsela e tloaelehileng, qala Hands-Only CPR 'me u sebelise AED nakong ea metsotso ea 3.
3. Tlanya lehetleng la moatlelete mme o hoeletse lebitso la bona. SEFELO SE BOHLOKOA SA TLHOKOMELISO: Hoo e ka bang 50% ea baatlelete ba Sudden Cardiac Arrest ba bonts'a ho ts'oara ho se hokae joalo ka myoclonic ea matsoho/maoto (bakeng sa metsotsoana e 10 ho isa ho e 20) le lentsoe le phahameng, le kurutla "agonal gasps". Le ka mohla u se ke ua etsa phoso ea ho tsikitlanya kapa ho hema ka tsela e tloaelehileng, 'me ** le ka mohla u se ke ua nka hore moatlelete ea oeleng o "chesehile haholo" ho fihlela u tiisa hore ba falimehile kapa ba phefumoloha ka tloaelo ka ho otla ho matla **.
4. Haeba moatlelete a sa arabele 'me a sa phefumolohe ka mokhoa o tloaelehileng: khaola jeresi ea bona le liphahlo tsa mahetla (ho sebelisa lithapo tse boima tsa trauma ho theosa le marapo a ka pele a sefuba sa sefuba, ho siea helmete / letlapa la mokokotlo ntle le haeba ho hlokahala bakeng sa ho kena moeeng), qala ** CPR ea Matsoho feela (100 to 120 compressions/min, 5 to 6 cm / 2 to 2.4 in tebileng) **, 'me u kopanye lipampiri tsa **AED ** sefubeng se se nang letho hang-hang. Nako e 'ngoe le e 'ngoe **5-metsotsoana e 60 ** ho feta metsotso e 3 e theola ho pholoha ka 10%.
5. Haeba moatlelete a e-na le ho otla ho matla 'me a phefumoloha, hlahloba Boemo ba Kelello (CNS Function) hang-hang: pherekano leha e le efe, boitšoaro bo sa utloahaleng, puo e sa hlakang, ho khoptjoa kapa ho akheha nakong ea mocheso oa leholimo ke Exertional Heatstroke (EHS) ho fihlela ho pakoa ka tsela e fapaneng.
6. Botsa lipotso tse 'nè tsa boithuto: "Lebitso la hau u mang? Re tšimong efe? Ke khoeli efe? Re ne re qeta ho etsa boro efe?"
7. ** LE KA mohla u se ke ua itšetleha ka hore na moatlelete o fufuleloa kapa che (anhidrosis), 'me U SE KE UA sebelisa tsebe (tympanic), phatla (temporal), kapa thermometer ea molomo.** Ho fapana le batho ba hōlileng ba hlasetsoeng ke mocheso oa khale, ka holimo ho 90% ea baatlelete ba liithuti ba Exertional Heatstroke e bolaeang ba rotha mofufutso o mongata nakong eo ba oa, 'me lithemomethara tsa phatla/tsebe li bala *2 ho isa ho 4 degrees Celsius (4 to 7 degrees Fahrenheit) letlalo le fufuleloa haholo Feela ** thermistor rectal thermometer e feto-fetohang ** (inserted 15 cm / 6 inches past the anal sphincter) e lekanya mocheso oa mantlha ka nepo (> 40.5 °C / 105 °F e tiisa EHS).
8. Haeba ho na le Heatstroke e Ikemetseng (EHS) e teng (Core Temp > 40.5 °C / 105 °F KAPA CNS delirium/ho putlama ha mocheso o phahameng ha thermometer ea rectal e le sieo): Phetha "COOL FIRST, TRANSPORT SECOND" hang-hang.
9. Amoha lisebelisoa tsohle tsa junifomo (helmete, liphaephe tsa mahetla, jeresi, borikhoe, likausi, li-cleats) 'me u tšele moatlelete ho fihla molaleng ka ho qoelisoa ka metsi a batang a 190 ho isa ho 570 (50-to-150-gallon)CWI) Tub e tletseng leqhoa le metsi ka 1.7 °C to 15.0 °C (35 °F to 59 °F)**.
10. Hlohlelletsa metsi a leqhoa u sa khaotse ho pota-potile 'mele oa moatlelete le lipheletsong ha ba ntse ba tšoere hlooho le mahetla holim'a metsi ka thaole e phuthoang ka tlas'a maphaka.
11. Haeba ho se na bate e teng ("TACO Method - Tarp-Assisted Cooling with Oscillation"): Beha moatlelete bohareng ba lebala le sa keneleng metsi, etsa hore basebetsi-'moho le uena ba 4 ho isa ho ba 6 ba phahamise mathōko a terepe ho etsa beisine ea motho, ba lahlele li- cooler tse 3 ho isa ho tse 4 tsa leqhoa le metsi ka ho toba holim'a 'mele oa moatlelete, 'me u tsokotse terepe pele le morao.
12. ** U SE KE UA lumella ambulense ho laela le ho khanna le moatlelete ho fihlela mocheso oa bona oa mokokotlo o theoha ho 38.9 °C (102.0 °F)** (eo hangata e nkang metsotso e 10 ho isa ho e 18 ea ho qoelisoa ka metsi a leqhoa, ho pholile ka sekhahla sa 0.20 °C to 0.26 °C / 0.36 °F to 0.47 °F per minute).
13. Haeba moatlelete a TSOHA, o falimehile, mocheso oa mantlha o ka tlase 40.0 °C (104 °F), 'me ba oela fatše nakong ea ho matha ka lebelo le matla ba tletleba ka "maoto a fokolang, a shoeleng, a tukang le mokokotlo o ka tlaase" ka mesifa e SOFT: tšoara joaloka Acute Exertional Sickling (ES) Mathata.
14. Tlosa moatlelete papaling hang-hang (never order them to run another rep or "walk it off").
15. Li behe moriting, u fane ka oksijene ea tlatsetso e phahameng 15 Liters/min via Non-Rebreather Mask) haeba e fumaneha ka kariking ea mokoetlisi oa liatleletiki, hlokomela matšoao a bohlokoa ka ho tsoelang pele, pholile ka bonolo haeba ho futhumetse, le palama hang-hang ka ambulense ea ALS ho ea Lefapheng la Emergency le haufi le teng, ho lemosa ngaka ea ER seea-le-moeeng ho itokisetsa acute exertional sickling, fulminant rhabdomyolysis, le hyperkalemia e sokelang bophelo.peaked T-waves on 12-lead ECG).

Sefate sa ho etsa qeto: Lekhetlo le ka thoko la moatlelete oa moithuti ea oeleng (Metsotsoana e 180 ea pele)¶

flowchart TD
    Start["Moatlelete oa Seithuti o oa oela fatše kapa oa oela fatše nakong ea boikoetliso kapa papali"] --> ActivateEAP["Mohato oa 1 (0-10 Sec): Kenya Sebaka EAP, Letsetsa 911, Lata Sideline AED, Open Field Gates"]

    ActivateEAP --> CheckResp{"Mohato oa 2 (10-30 Sec): Na Moatlelete oa Arabela le ho Phefumoloha ka tloaelo? (Hlokomela Li-Jerks tse Khutšoanyane tsa ho Sebetsa le li-Agonal Gasps)"}

    CheckResp -->|"CHE: Ha a arabele ebile ha a phefumolohe / Ho hema Feela"| SCAProtocol["PROTOCOL EA SUDDEN CARDIAC ARREST (SCA) (Hape e belaelloa Commotio Cordis haeba e Otloa Sefubeng): Seha Jersey / Pads, Qala Hands-Only CPR (100-120 / min), Sebelisa AED Nakong ea Metsotso ea 3"]

    CheckResp -->|"EE: Ho phefumoloha ka Pulse"| CheckCNS{"Mohato oa 3: Hlahloba Boemo ba Kelello (CNS) le Core Rectal Temp: Na Moatlelete o Ferekane, O Loantša, Ataxic, Comatose, kapa Temp > 40.5 C (105 F)?"}

    CheckCNS -->|"EE: Ho se sebetse ha CNS + Mocheso o Phahameng (Core Temp> 40.5 C / 105 F)"| EHSProtocol["EXERTIONAL HEATSTROKE (EHS) PROTOCOL: Lisebelisoa tsa Strip, Koahela ka Ice-Water Tub (1.7-15 C / 35-59 F) kapa TACO Tarp hang-hang. COOL FIRST (ho ea ho 38.9 C / 102 F), TRANSPORT SECOND"]

    CheckCNS -->|"NO: Tsoha, Lucid, Oriented, Core Temp <40.0 C (104 F)"| CheckMuscles{"Mohato oa 4: Moatlelete O Oetse Joang, 'me Mesifa ea Leoto / Morao e Ikutloa Joang?"}

    CheckMuscles -->|"Slumped Ka mor'a Sprints; Mesifa e Ikutloa E BONOLO/E FUMANEHARE; Bohloko bo Lerootho ba Ischemic Back / Pelvis / Leoto; Tachypnea"| SicklingProtocol["EXERTIONAL SICKLING (ES) CRISIS: Emisa Boikoetliso Hang-hang, Fana ka 15 L/min Oxygen, Boloka Supine / Hydrated, Hang-hang Ambulance ea ALS ho ER bakeng sa Rhabdomyolysis & Hyperkalemia ECG"]

    CheckMuscles -->|"Hobbling in Agony; Lisifa tse Koaletsoeng ka har'a ROCK-HARD Li-Spasms tse Bonahalang tsa Knotted"| CrampProtocol["BENIGN EXERTIONAL HEAT CRAMPS: Phomola ka Moriting, Ho Otlolla ho sa Feleng, Ho Sila Leqhoeng, Tharollo ea Molomo oa Letsoai la Electrolyte (0.5 tsp letsoai ho seno sa lipapali sa 500 ml)"]

Mokhahlelo oa 1: Tafole ea papiso ea kliniki ea litsela tse 4 (SCA vs. Exertional Heatstroke vs. Exertional Sickling vs. Heat Cramps)¶

Bekeng ea pele ea August pre-season conditioning, bakoetlisi hangata ba etsa phoso Exertional Sickling ka benign **Heat Cramps **, kapa phoso Sudden Cardiac Arrest bakeng sa Heat Syncope. Ho tšoara ka hlooho liphapang tsa kliniki tse tafoleng ena ho thibela tlhahlobo e fosahetseng e bolaeang lebaleng:

Tlhahlobo e Ikemetseng ea Ho putlama ha Lehlakore ka Tšohanyetso ho Baatlelete ba Baithuti (NATA / ACSM / AHA Consensus)¶

Mokhahlelo oa 2: Ho Tšoaroa ha Pelo ka Tšohanyetso (SCA) le Commotio Cordis lebaleng: molao oa AED oa metsotso ea 3¶

Sudden Cardiac Arrest ke #1 sesosa sa bongaka sa lefu ho baatlelete ba bacha , e hlaselang hoo e ka bang a le mong ho ba 50,000 ba sekolo se phahameng le baatlelete ba koleche selemo se seng le se seng. Ho fapana le tlhaselo ea pelo ea batho ba baholo e bakoang ke methapo e koalehileng ea methapo ea mali, SCA ea baatlelete ea bacha e bakoa ke ** boemo bo sa lemohuoang ba sebopeho kapa pelo ea motlakase ** kapa ka ho otla ha sefuba ha sefuba (Commotio Cordis).

1. Lisosa tse 5 tse ka sehloohong tsa ho tšoaroa ha pelo ka tšohanyetso ho baatlelete ba bacha¶

1. ** Hypertrophic Cardiomyopathy (HCM):** Botenya ba liphatsa tsa lefutso tsa mosifa oa pelo oa ventricular le letšehali bo bakang lefu Ventricular Fibrillation (VFib) ha adrenaline e phahama nakong ea lebelo la lebelo.
2. Congenital Coronary Artery Anomalies (CAA): Mothapo oa pelo o tsoang ho sinus e fosahetseng ea aorta o hatelloa pakeng tsa aorta le pulmonary artery nakong ea boikoetliso bo phahameng ka ho fetisisa.
3. Genetic Ion-Channelopathies & Electrical Syndromes (Long QT, Brugada, CPVT, le Wolff-Parkinson-White / WPW): Lipelo tse tloaelehileng tse tsamaeang ka nako e khutšoanyane ka lebaka la ho phatloha ha adrenaline.
4. Acute Viral Myocarditis: Ho ruruha ho khutsitseng ha mesifa ea pelo nakong ea libeke tse 1 ho isa ho tse 2 ka mor'a lefu la vaerase.Coxsackievirus, Influenza, COVID-19, Adenovirus) ha moatlelete a khutlela boemong bo thata ha a ntse a hlaphoheloa.
5. Commotio CordisBlunt Chest-Impact Arrest): E etsahala 100% pelong e phetseng hantle ha baseball, bolo ea lacrosse, hockey puck, softball, kapa helmete li otla lebota le letšehali la sefuba (precordium) nakong e nepahetseng 20-to-40-millisecond upslope ea T-wave (ventricular repolarization), ho lahlela pelo ho Ventricular Fibrillation.

2. Hobaneng ha Bakoetlisi ba sa Lokela ho Thetsoa ke "Seizure Jerks" kapa "Agonal Gasping"¶

Litlhahlobong tsa video tse mabapi le ho ts'oaroa ha pelo sekolong se phahameng le kolecheng, lebaka la # 1 leo ka lona bakoetlisi ba ileng ba liehisa CPR le ho lata AED ke hore **matsoho le maoto a moatlelete ea oeleng a ile a sisinyeha joalo ka lefu la sethoathoa ka metsotsoana e 15, 'me sefuba sa bona se tlala moea o matla, o korotla *. - The Physiology: Ha Ventricular Fibrillation e fokotsa phallo ea mali ho ea bokong, hypoxia e matla e etsa hore ho be le 10-to-20-second myoclonic seizure, e lateloe ke brainstem agonal gasping reflexes. - The Sideline Rule (Inter-Association Task Force Mandate): Moatlelete leha e le ofe ea oelang ka mokhoa o sa utloiseng bohloko (kapa ka mor'a ho otla sefuba) 'me a sa arabele, o tšoeroe ke Sudden Cardiac Arrest ho fihlela ho pakoa ka tsela e fapaneng. U se ke ua kenya letho ka hanong, u se ke ua emela hore "ts'ollo" e fele, 'me u se ke ua qeta metsotsoana e 60 u tsoma pulse. Romela bakeng sa AED hang-hang, pepesa sefuba, 'me u qale ho hatella sefuba. Ha AED e fana ka ts'oaetso nakong ea 1 ho metsoo e 3 ** ea ho oa lebaleng, litekanyetso tsa ho pholoha li feta 85% ho 90%.

Mokhahlelo oa 3: Sefuba sa Heatstroke (EHS): ts'ebetso ea mohato ka mohato ea "Cool First, Transport Second"¶

Sefuba sa Heatstroke (EHS) e phahame haholo nakong ea Phupu le Phato pele ho nako ea bolo ea maoto, ho tšela linaha, le litloaelo tsa bolo ea maoto ha Wet-Bulb Globe Temperature (WBGT) feta 27.8 °C to 32.2 °C (82 °F to 90 °F).

1. Lebaka Leo U Lokelang ho Sebelisa Rectal Thermometer (Le Hobaneng ho fufuleloa ho sa Laole Heatstroke)¶

Litšōmo tse peli li ntse li lefella baatlelete ba liithuti bophelo ba bona ka August: - Khopolo-taba ea #1 ("Haeba ba ntse ba fufuleloa, ke mokhathala feela oa mocheso, eseng mocheso oa mocheso"): BOHATA. Letlalo le omileng (anhidrosis) e etsahala ho classic passive heatstroke ho bakuli ba tsofetseng ka matsatsi a 'maloa. Ho Exertional Heatstroke, moatlelete e monyane ea hlahisang li-watts tse 1,000+ tsa mocheso oa metabolism ka har'a li-pads o tsamaisa mocheso oa mantlha ho tloha. 37 °C (98.6 °F) ho 41.5 °C (106.7 °F) ka metsotso e 45 ke ntse ke fufuleloa haholo. - Khopolo-taba ea #2 ("Sebelisa sekena sa infrared se phatleng kapa thermometer ea tsebe"): BOHATA. Liphuputso tse entsoeng ke Korey Stringer Institute li bontša hore phatla, tsebe (tympanic), 'me li-thermometer tsa molomo li bala 36.5 °C to 38.0 °C (97.7 °F to 100.4 °F) ho moatlelete eo mocheso oa hae oa ka hare oa rectal o bolaeang 41.8 °C (107.2 °F), hobane mofufutso oa mofufutso o pholisa letlalo. - Ho Etsa'ng Haeba Sekolo sa Hao se se na Thermometer ea Rectal lebaleng? Itšetlehe ka Molao oa Boikutlo ba Tleliniki: Moatlelete ofe kapa ofe ea ikoetlisang maemong a futhumetseng a bonts'ang Sistimi ea Bohareng ea Ts'oaetso e sa tsitsang (CNS) ho se sebetse hantle (pherekano, ho ferekana kelellong, ho ba mabifi, ho khoptjoa, ho putlama, kapa ho akheha ka mor'a ho laola SCA) E TLAMEHA ho phekoloa hang-hang ka ho Iqoelisoa ka Metsi a Cold ka 'mele e le ntho eo ho nahanoang hore ke E Eketsehileng Heatstroke.

2. Mokhoa oa ho Qoba ka Metsing a Batsoang (CWI) Tub kapa TACO Tarp Protocol ka lehlakoreng le ka thoko¶

1. Beha Tub Pele Pele U Itloaetsa Neng WBGT > 25 °C (77 °F): Tlatsa 380-to-570-liter (100-to-150-gallon) Rubbermaid stock tank haufi le tente ea koetliso e nang le moriti ka metsi (10 °C to 15 °C / 50 °F to 59 °F), e nang le li- cooler tse 3 ho isa ho tse 4 tsa leqhoa le pshatlehileng tse lutseng pela bate e seng e loketse ho lahleloa.
2. Thepa e Hlollang ka Metsotsoana e ka Tlas'a 60: Tlosa helmete, liphaephe tsa mahetla, jeresi, borikhoe, lipekere le likausi (wet uniforms trap heat).
3. Suthela Molala 'me U Tsoele Pele: Phahamisa moatlelete ka har'a bate hore kutu ea hae, letheka, lirope le matsoho a qoele ka 1.7 °C to 15.0 °C (35 °F to 59 °F) metsi a leqhoa. Kopanya thaole ka tlas'a maphaka ka bobeli a tšoeroeng ke li-spoters tse peli ho boloka tsela ea moea e ka holim'a metsi. Sutha metsi ka matla metsotsoana e meng le e meng e 30 kahoo moeli o futhumetseng o ke ke oa theha khahlano le letlalo.
4. Ho Laola Combative Delirium: Ho futhumala ho feteletseng ha boko hangata ho etsa hore moatlelete a loane. E-ba le li-spotters tse 4 ka bonolo ho tšoara mahetla le mangole a moatlelete ka har'a tub (kapa sebelisa TACO mokhoa oa sekontiri holim'a joang). Ka nako ea metsotso e 3 ho isa ho e 5 ea ho qoelisoa metsing a leqhoa, delirium ea ntoa e kokobela ha mali a boko a kokobela.
5. Mocheso oa ho Tlosa o Lebeletsoeng (38.9 °C / 102.0 °F): Tlosa moatlelete ho tloha ka har'a leqhoa ebe u li fetisetsa setulong sa ambulense se emetseng ** ha probe ea rectal e bala 38.9 °C (102.0 °F)**(prevents afterdrop hypothermia). Ntle le thermometer ea rectal, qoelisa ** 12 ho metsotso ea 15 ** (kapa ho fihlela ho thothomela le ho hlaka kelellong ho khutla) pele o kenya ambulense.

Mokhahlelo oa 4: Ho Ikitlaetsa ho Sickling (HbAS) tsietsi: ke hobane'ng ha ho hoeletsa "Push Through the Cramps" ho baka hyperkalemia e bolaeang¶

Hoo e ka bang ** 1 ho 12 MaAmerika a Batšo (8%)**, Moamerika a le 1 ho a le 100 a Ma-Hispanic, le baatlelete ba likete ba Mediterranean, Bochabela bo Hare, Maindia le Caribbean ba nkile Sickle Cell Trait (HbAS) - ho bolelang hore ba futsitse phatsa e le 'ngoe e tloaelehileng ea hemoglobin (HbA) le mofuta o le mong oa hemoglobin ea sekele (HbS). Tlas'a bophelo bo tloaelehileng ba letsatsi le letsatsi, batho ba nang le Sickle Cell Trait ba phetse hantle 'me ha ba na Sickle Cell Disease.HbSS).

Leha ho le joalo, nakong ea **matla a feteletseng, a tsitsitseng a anaerobic ** - haholo-holo **mabelo a nako e phetoang khafetsa (gassers, suicides, mat drills), liteko tsa boikoetliso ba letsatsi la pele la 1-mile/2-mile, kapa up-tempo no-huddle conditioning ntle le khefu ea ho phomola ** - lintho tse 'nè tse susumetsang tsa 'mele li kopanya ka hare ho leoto le sebetsang la moatlelete le mesifa ea morao: 1. Severe Tissue Hypoxia (oksijene e theohela ka hare ho quadriceps/hamstrings e sebetsang); 2. Lactic Acidosis e Matla (pH ea mesifa e theohela ka tlase 7.0); 3. Cellular Dehydration ** (hypesmolality ka hare ho mesifa ea capillaries); le 4. Mocheso o Phahameng oa mesifa.

Tetrad ena e etsa hore lisele tse khubelu tsa mali tsa moatlelete li tsoe ka tšohanyetso ho tloha ho li-disk tse boreleli, tse tenyetsehang ho ea ho "lisekele" tse thata, tse khomarelang. Ka nako ea metsotso e 2 ho isa ho e 5, lisele tsena tse khubelu tsa mali logjam le ho koala li-capillaries tse nyane tse fepang mesifa e meholo ea marao, pelvis, lirope le mokokotlo o tlase.acute ischemic rhabdomyolysis). Ho lapa mali le oksijene, lisele tsa mesifa ea masapo li phatloha ka bongata, li lahla bongata bo boholo ba intracellular Potassium (K+) le Myoglobin ka ho toba mading. Haeba mokoetlisi a qobella moatlelete ea kulang hore a khutlele moleng ebe a matha lebelo le leng hape, serum potasiamo e phahama nakong e fetileng. 7.0 to 9.0 mEq/L, ho baka lefu la hyperkalemic ho tšoaroa ha pelo (sine-wave ventricular fibrillation or PEA) lebaleng.

Linomoro tsa libaka tsa tšohanyetso le liprothokholo tsa mekhatlo¶

Lipotso tse botsoang khafetsa¶

Ho thoe'ng haeba baoki ba EMS ba sebakeng sa heno ba fihla lebaleng 'me ba tsitlella ho kenya moatlelete oa rona oa Exertional Heatstroke ka ambulense hang pele mocheso oa bona oa mantlha o theoha?¶

Sekolo se seng le se seng sa Sekolo se Pakiloeng sa Liatleletiki (ATC) le Ngaka ea Sehlopha se lokela ho theha tumellano e ngotsoeng pele ho nako ea selemo le Mookameli oa Bongaka oa Mollo / EMS oa moo. Tlas'a Mokhatlo oa Hona joale oa Sechaba oa Lingaka tsa EMS (NAEMSP), American College of Emergency Physicians (ACEP), le lipolelo tsa tumellano tse kopanetsoeng tsa NATA, baoki ba thuso ea bongaka bo botle ba laeloa ho ** thusa ka sebaka sa ho futhumatsa metsi a Cold-Water Immersion (CWI) sebakeng sa marang-rang (ha ho qala mohala oa IV le leihlo la pelo ka thōko ho tub) ho fihlela mocheso oa mocheso oa "Celsius" o theoha. (102.0 degrees Fahrenheit) PELE ho isa mokuli ka ambulense**. Haeba taolo ea bongaka ea EMS ea lehae e laela lipalangoang hang-hang pele bate e se e lokile, sebelisa mokhoa oa **TACO (ho phuthela maqephe a metsi, a tletseng leqhoa / lithapa ho pota-pota moatlelete ea hlobotseng)** 'me u tsebise Lefapha la Tšohanyetso le amohelang hore ho be le bate ea ho qoelisoa ka metsi a leqhoa e emetseng monyako oa bay ea ambulense.

Hobaneng matsatsi a 5 a pele a bolo ea maoto a Phato kapa a naha e fapaneng e le fensetere e bolaeang ka ho fetesisa bakeng sa Heatstroke le Exertional Sickling?¶

Ho feta **75% ea likotsi tsohle tsa likolo tse phahameng le tse kopaneng tsa Exertional Heatstroke le Exertional Sickling li etsahala matsatsing a pele a 4 a pre-season condition**. Physiologically, 'mele oa motho o hloka **10 ho matsatsi a 14 a latellanang a ho pepesehela mocheso ("Heat Acclimatization")** ho atolosa plasma ea mali ka 12% ho ea ho 15%, ho theola moeli oa mocheso oa mantlha moo ho fufuleloa ho qalang, ho eketsa sekhahla sa mofufutso, le ho boloka sodium ea mofufutso. Ha seithuti se sa tloaelehang se tsoa ka tlung e nang le moea o pholileng ka Letsatsi la 1 'me se etsoa ka mokhoa oa lihora tsa 3 ka liphaephe tse feletseng kapa li-sprints tsa nako ("serial gassers"), tsamaiso ea bona ea pelo e ke ke ea senya mocheso kapa ea boloka oksijene ea mesifa. Ke ka lebaka lena NATA le NFHS melao e thibelang mekhoa ea matsatsi a mabeli ka matsatsi a latellanang, e thibelang lisebelisoa tse felletseng tsa ts'ireletso nakong ea Matsatsi a 1 ho isa ho a 5, le ho thibela liteko tsa maemo a felletseng ka Letsatsi la 1.

Re sebelisa Temperature ea Wet-Bulb Globe joang?WBGT) mitha ka thōko, hona ke hobane'ng ha e le molemo ho feta "Heat Index" ea "Heat Index" ea app ea smartphone?¶

"Heat Index" e tloaelehileng ho app ea boemo ba leholimo e baloa ho nkoa hore u lutse **100% moriting o nang le moea o fokang hasesaane ** - e hlokomoloha **mahlaseli a mahlaseli a letsatsi a chesang a futhumatsang lesela le lefifi la maiketsetso ** le **thibelo ea moea ea lebala la lehae**. E tšoaroa ka letsoho **Wet-Bulb Globe Temperature (`WBGT`) mitha** e kopanya li-sensor tse tharo tse ikhethileng: **(1) Mocheso o omileng oa Bulb** (`10%`), **(2) Mocheso oa Tlhaho oa Mocheso oa Bulb (`70%`)** e lekanya mofufutso wa mofufutso o tsidifatsang ho phatlalla le mongobo le lebelo la moya, le **(3) Mocheso wa Black-Globe (`20%`)** ho lekanya mocheso o otlolohileng oa mahlaseli a letsatsi holim'a phula. Ha e le ka thoko `WBGT` e fihla **`27.8 °C to 30.0 °C (82 °F to 86 °F)`**, khefu e tlamang ea metsotso e 15 e tlameha ho etsahala hora e 'ngoe le e 'ngoe; neng `WBGT` feta **`32.2 °C (90.0 °F)`** (kapa tlase maemong a leholimo a pholileng a leboea), litloaelo tsohle tse katiloeng ka ntle le boemo bo matla bo tlameha ho hlakoloa kapa ho fallisetsoa ka matlung.

Haeba moatlelete oa moithuti a tseba hore o na le Sickle Cell Trait (HbAS), na ba thibetsoe ho bapala lipapali tsa varsity?¶

Che - **ha ho moatlelete ea nang le Sickle Cell Trait (`HbAS`) ha a na tokelo ya ho kena papading efe kapa efe**. Liketekete tsa NCAA le baatlelete ba litsebi ba qothisana lehlokoa le Sickle Cell Trait letsatsi le leng le le leng. Ho e-na le hoo, ho tseba tsa moatlelete `HbAS` boemo bo lumella bakoetlisi le barupeli ba liatleletiki ho kenya ts'ebetsong tse lebisitsoeng **Sickle Cell Trait Precautions **: **(1)** Ho lumella moatlelete hore a hahe boemo butle-butle ho e-na le ho matha liteko tsa Letsatsi-1 nako ea mile / gasser; **(2)** Nako ea ho phomola le ho hlaphoheloa habeli pakeng tsa ho pheta-pheta ha lebelo; **(3)** Ho kopa moatlelete hore a se ke a matha ka nako eohle a matha ka mocheso o phahameng kapa bophahamong bo phahameng (`above 1,500 meters / 5,000 feet`); **(4)** Ho netefatsa hore ho na le metsi a sa khaotseng; le **(5)** Ho matlafatsa moatlelete hore a tsoe ho phunya leha e le efe hang ha a ikutloa a sa tloaeleha leoto, marako, kapa bokooa bo ka tlase ntle le tšabo ea kotlo.

Na re lokela ho tlosa helmete ea bolo ea maoto kapa lacrosse lebaleng nakong ea Sudden Cardiac Arrest kapa Exertional Heatstroke?¶

Ee. Ho **Sefuba sa Mocheso se Ikemetseng (`EHS`)**, ha ho na ts'oaetso ea mokokotlo oa mokokotlo, 'me helmete le liphahlo tsa mahetla li tšoara mocheso o tsamaisang: ** tlosa helmete le liphahlo tsa mahetla hang-hang ** pele u theola moatlelete ka har'a bateng ea ho qoelisoa ka metsing a batang. Ka **Ho Tšoaroa ha pelo ka tšohanyetso (`SCA`)**, haeba moatlelete a ne a oela ntle le molala / hlooho, ** khaola jeresi le lithapo tse ka pele tsa mahetla hang-hang ho pepesa sefuba se se nang letho bakeng sa CPR le AED pad placement **, 'me u tlose sefahleho sa sefahleho (`or helmet/pads`) bakeng sa moea o kenang moeeng hafeela ** e se ke ea lieha ho qala ho hatella sefuba kapa ho fana ka ts'oaetso ea AED **.

*NFHS Learn), le ho itlhakisetsa sebaka sa bona Emergency Action Plan (EAP) ka stopwatch pele ho boikoetliso ba pele ba sehla se seng le se seng.

Litataiso tse amanang¶

• CPR le AED tataiso ea mohato ka mohato
• Ho otloa ke mocheso khahlano le ho felloa ke matla ha mocheso
• Kotsi e mpe ea liphio, rhabdomyolysis, le tlhahlobo ea moroto o lefifi
• Maqeba a hlooho le thuso ea pele ea moferefere
• Linomoro tsa maemo a tšohanyetso le thomello ea machaba

Mehloli le tataiso ea semmuso¶

• National Athletic Trainers' Association (NATA, United States): Position Statement: Exertional Heat Illnesses (Rectal Thermometry Standard and On-Site Cold-Water Immersion "Cool First, Transport Second" Mandate) le *Polelo ea Tumellano: Acute Management of Injured or Ill-Collapsed Athling, Ethling Triage, Ethling Triage
• Korey Stringer Institute (KSI, University of Connecticut) & American College of Sports Medicine (ACSM): Consensus Statement on Exertional Heatstroke Prehospital Care, Tarp-Assisted Cooling with Oscillation (TACO), le State High School Wet-Bulb Globe Temperature (WBGT) Acclimatization Policies.
• Inter-Association Task Force bakeng sa ho Thibela Lefu la Tšohanyetso Sekolong sa Sekondari & Collegiate Conditioning Sessions (NCAA / NATA / NSCA / American Heart Association): * Likhothaletso tsa ho Lemoha le ho Laola ho Tšoaroa ha Lefu la Ka tšohanyetso (3-Metsotso ea AED Target, Myoclonic Seisping le Acoglonic Seizure/Acognical Recognition) Rhabdomyolysis / Sickling ho Baatlelete ba nang le Sickle Cell Trait (HbAS)*.
• ** American College of Emergency Physicians (ACEP) & National Association of EMS Physicians (NAEMSP)**: * Joint Policy Resource and Education Paper: Prehospital Management of Exertional Heat Stroke (Ho Tlatsa ho Inela ka Metsing a Cold-Metsi Pele ho Lipalangoang tsa Ambulense tsa EMS)*.
• Litsi tsa Taolo le Thibelo ea Mafu (CDC, United States): Boloetse ba Mocheso Har'a Baatlelete ba Sekolo se Phahameng le Sickle Cell Trait (HbAS) Litlhokomelo tse Sireletsehileng tsa Boikoetliso.