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Ndongo atlet bu daanu ci kaw terrain bi: Heatstroke bu metti ('Sedd bu njëkk, dem ak dikk ñaareel') vs Arrest karjaak bu gaaw vs Sickling

Nimero urgence yi wuute nañu ci réew mu nekk. Xët wii dafay jëfandikoo 911, di nimero Etats Unis ak Canada. Yeneen réew yu bari dañuy jëfandikoo 112, 999, wala beneen nimero. Wut nimero sa réew.

Seetaan benn xale bu am 15 at ci liise futbal lineman, ab atlet cross-country collegial, ab waa orkestar marching, wala ab diggi teere football bu ndaw ñu jekki rek daanu ci seen wóom wala ñu daanu ci kaw gason bi ci weeru ut bi ñaari fan ci bis bi ñu koy defaree, bokk na ci paj mi gëna am solo ci wàllu pajum. Ci ndaw ñi ak athletism kolegial, lu ëpp 90% ci dee yu gaaw yi amul trauma ci terrain bi, ñatti mbir yu metti ñoo ko waral: Arrest cardiaque sudden (SCA), Tàngoor wu metti (EHS), ak Sickling bu metti (ES ci atlet yi yor màndarga selil sickle, HbAS). Doonte ñatti jafe-jafe yi mën nañu feeñ ci ay segond yu néew ci tàggat yaram bu metti ci bis bu tàng, jaxasoo benn ak beneen ci 180 segond yu njëkk yi mën na ray nit. Faj ku am arrêt cardiaque ci lu gaaw ni "dafa tàng lool" dafay yeexal defibrillation bi weesu palanteeru mucc bu 3 simili; def ab victime Heatstroke bu metti ci ginaaw ambulance bu waw te am klimaa bi te doo ko njëkka dugal ci ndox mu seddCWI) tub de glace** dafay ñaawlu Association nationale des formateurs athletiques (NATA) ak Korey Stringer Daaray "Li njëkk mooy seddal, dem ak dikk ñaareel" santaane wurus-standard te may seen 41.5 °C (106.7 °F) core tàngoor ngir togg seen yuur ak seen xëtër ci diiru 20 simili tukkib ambulance; ak yuuxu ci atlet bu am ** jafe-jafe sickling bu metti** ngir "jog te dëgëral tànk yi" dafay jur logjamming bu seluli deret yu xonk yu ndaw, rabdomyolyse fulminant, ak arrêt cardiaque hyperkalemique.

Amna chance, antreneur yi, tàggatkat yi (ATCs), ekipu doktër yi, ak waajur yi ci wetu soxla wuñu test deret ci labo ngir ràññee ñatti jafe-jafe yii ci ñax mi. Soo xoolee ñeenti diskriminatëri klinik yu saasi ci 30 segond yu njëkk yi - (1) Tontu ak Noyyi (SCA = amul benn tontu ak noyyig agonal bu amul wala buy xëm), **(2) Gaawaayu daanu (SCA ak Heatstroke daanu ci saasi te kenn yëgul, fekk Sickling atlet yi dañuy daanu ci suuf bi ñuy yewwu, di ñaxtu, ischemik ci suufu ginaaw / gluteal / hamstring) **, ** (3) Palpation sidit (Heatstroke ak Sickling sidit yi dañu melni lu nooy wala lu tàng, waaye dëgg la Heat Cramps tëju ci xeer bu dëgër, spasm yu fës) , ak ** (4) Tàngoor Rectal Core (Exertional Heatstroke dysfonctionnement CNS ak tàngoor rectal bu gëna kawe 40.5 °C / 105 °F, te Sickling ak SCA di am ci tàngoor tàggat yaram bu yéeg wala bu woyof ci suuf 40.0 °C / 104 °F) - mën nga tàmbali protokol biy muccal dundu ci saasi.

(Ngir gëna leeral jéego yi ñuy def ngir dundal xol ak pulmoŋ, xoolal CPR ak AED guide. Soo bëggee am jafe-jafe tàngoor, xoolal Tàngoor ak coono tàngoor ak Gaañ-gaañu yu tar ci rein, rabdomyolyse, ak tànneef ci saw bu ñuul, te wéyal sunu àdduna nimero paj mu jamp répertoire bi mën nañu ci dugg ci wetu liiñ bi.)

Defal lii leegi

  1. Aktiwiseel sa palaŋu jëf ci jafe-jafe yi (EAP) ci 10 seconde yu njëkk yi: nga jox benn nit mu woo 911 (wala 112 / 999), benn nit mu daw ngir AED ci wetu liiñ bi, ak benn nit mu ubbi buntu terrain bi ngir ambulance bi. Bul musa xaar ngir "xool ndax atlet bi daf koy yëngal." Woowal sa nimero paj mu jamp (911 ci Etats Unis ak Canada, 112 ci Europe yépp, 999 ci UK, wala nga xool nimero paj mu jamp) ci saasi su benn atlet daanoo ci terrain bi.
  2. Dugal arrêt cardiaque bu gaaw (SCA) Bi njëkk (Segond 0 ba 30): Sudee atlet bi mënul tontu te noyyiwul nimu waree, tàmbalil CPR ak loxo kese nga def AED ci diir bu weesuwul 3 simili.
  3. Bësal ci mbaggu atlet bi nga yuuxu turam. FIIR BU AM SOLO: Lu tollu ci 50% ci atlet yi am arrêt cardiaque ci lu gaaw dañuy wane myoclonic jerking bu gàtt bu nuru convulsion ci loxo yi/tànk yi (ci diiru 10 ba 20 seconde) ak yuuxu yu am doole, "gasps agonal". Bul musa xalaat ni yëngu-yëngu bu melni convulsion wala gasping ngir noyyi bu jaar yoon, te bul musa xalaat ni atlet bu daanu "dafa tàng lool" ba nga firndeel ni dafa yewwu wala dafay noyyi bu baax ak puls bu dëgër.
  4. Sudee atlet bi tontuwul te noyyiwul nimu waree: dagg seen maillot ak seen mbagg (jëfandikool sizo trauma yu diis ci kanam yi ci pad dënn bi, bàyyi kaska bi/plaque bi ci ginaaw ci barab bi fileek soxlawul ngir mëna dem ci yooni noyyig bi), tàmbalil CPR loxo kese (100 to 120 compressions/min, 5 to 6 cm / 2 to 2.4 in xóot), nga takk AED pads ci dënn bi amul dara ci saasi. Bépp 60-segond retard bu weesu 3 simili dafay wàññi dundu gi 10%.
  5. Sudee atlet bi daa am puls bu dëgër ba noppi di noyyi, xoolal tolluwaayu xel mi (CNS Function) ci saasi: bépp jaxasoo, jeffin ju jaarul yoon, wax ju jaxasoo, mbëggéel, wala koma ci jamonoy tàngoor mooy Exertional Heatstroke (EHS) bañu wane lu wuute.
  6. Laajteel ñeenti laaj yu jëm ci xam-xam: "Luy sa tur? Ban tool lanu nekk? Ban weer la? Ban drill lanu doon def leegi?"
  7. BULEEN MUSAA xalaat ndax atlet bi dafay ñaq am déet (anhidrosis), te BULEEN MUSAA jëfandikoo nopp (tympanic), jaxasoo dëpp (temporal), wala termometre oral. Lu wuute ak mag ñi loru ci tàngoor wu metti, lu ëpp 90% ci atlet ndongo yi ci stroke bu metti, dañuy ñaq bu baax bi ñuy daanu, te termometre jë/nopp yi dañuy jàng **2 ba 4 degre Fahren to **47s Celsi) der bu ñaq, ngelaw li seddal ko. termometre rektal bu am termistor buy soppiku (inserted 15 cm / 6 inches past the anal sphincter) dafay natt tàngoor wi ci biir (> 40.5 °C / 105 °F firndeel EHS).
  8. Sudee tàngoor wu metti (EHS) mingi fi (Core Temp > 40.5 °C / 105 °F WALA delirium CNS bu leer/dagg ci tàngoor wu metti sudee termometre rectal amul): Defal "SEDDAL NJÀKKAL, YÀKKAL ÑAAREEL" ci saasi.
  9. Sooy summi bépp jumtukaay bu lay sol (cask, pad mbagg, maillot, pàntaloŋ, chaussettes, cleats) nga dugal atlet bi ba ci baat bi ci biir 190-ba-570-litre (50-ba-150-galon) ndox mu sedd (CWI) Tub bu fees dell ak glaas ak ndox ci 1.7 °C to 15.0 °C (35 °F to 59 °F).
  10. Deel yëngal ndoxu glaas bi saa yu nekk ci yaram wi ak ci tànk yi, nga tëye seen bopp ak seeni mbagg ci kaw ndox mi, nga jël benn sarbet buñ laxas ci suufu ay lëf.
  11. Sudee amul tub ("TACO Method - Tarp-Assisted Cooling with Oscillation"): Tegal atlet bi ci diggu tarp bu amul ndox, nga wax 4 ba 6 ñi mu àndal ñu yéeg ci catu tarp bi ngir nekk bassin bu nit, nga sànni 3 ba 4 cooler yu glaas ak ndox ci kaw yaramam, nga yëngal tarp bi ci kanam ak ci ginaaw.
  12. BULEEN nangu ambulance bi yab ak dawal ak atlet bi ba seen tàngoor rectal wàcci ba 38.9 °C (102.0 °F) (muy jël 10 ba 18 simili di wéy di dugg ci ndoxu glaas, seddal ko ci 0.20 °C to 0.26 °C / 0.36 °F to 0.47 °F per minute).
  13. Sudee atlet bi yewwu na, tàngoor wi nekk ci suuf 40.0 °C (104 °F), ñu daanu ci suuf ci diiru daw bu metti di ñaxtu "tànk yu néew doole, dee, tàng ak ginaaw" ak sidit yu NOOY: faj ko ni Acute Exertional Sickling (ES) Jafe-jafe.
  14. Dindil atlet bi ci football ci saasi (never order them to run another rep or "walk it off").
  15. Tegal leen ci lëndëm, nga jox leen oxygen bu bari (15 Liters/min via Non-Rebreather Mask)su amee ci wagon bi tàggatkat bi yor athletism, di xool màndarga yi am solo, seddal ko bu baax sudee tàng, ba noppi ** yóbbu ko ci saasi ci ambulance ALS ci Departemaa bi gëna jege ci wàllu paj mu jamp, nga artu doktëru ER ci radio bi ngir waajal ** sickling exertionly, rhabdom, hiperkalemiapeaked T-waves on 12-lead ECG).

Lan moo waral 'Cool bu njëkk, dem ak dikk ñaareel' amna 100 ci teemeer boo jél ci mucc ci stroke bu metti - Ak lu waral yab atlet yu tàng yi jubal ci ambulance di leen ray

  • **30 simili yu tàngoor yi ci selul yi: ** Neuron yuur nit, hepatocyte yi, endothelium vasculaire yi, ak selul sidit yax yi dañu tàmbali dundu protein termik bu dul dellu ginaaw ak Coagulation intravasculaire bu tasaaroo (DIC) su tàngooru yaram wi des ci kaw 40.5 °C (105 °F) lu ëpp 30 simili.
  • Done klinik yu Korey Stringer Institute: Ci ay junniy mbir yuñ bind ci AVC tàngoor bu metti ci marathonist yi, soldaar yi ñuy jël, ak joueur futbal yi fu tàngoor wi yegg ba 42.2 °C to 43.3 °C (108 °F to 110 °F), mucc gi daanaka 100% sudee yaram wi yépp dañu ko dugal ci ndox mu sedd (CWI) ñu ngi koy tàmbali ci barab bi ci diir bu weesuwul 10 simili ginaaw bimu daanoo ba noppi wéyal ba tàngoor wi wàcci ba wàcci 38.9 °C (102 °F) balaa ñuy tàmbali dem ak dikk ci EMS.
  • Li waral dawal ambulance mënu seddal malaad EHS: Bu atlet bi takkoo ci benn stretcher ci biir ambulance buy daw, mënu ñu ko suul ci ndox mu glaas. Teg ay paketu seddal chimik yu ndaw ci seeni lëf te taal AC ambulance bi dafay seddal core bi ci lu néew 0.04 °C (0.07 °F) per minute - loolu dafay tekki atlet bi des ci kaw letal bi 40.5 °C (105 °F) cellule-death threshold ci 25 simili ambulance bi yépp ak 20 simili ER triage toxal, mu jur ñàkka mëna liggéey ci cër yu bari. ** EMS paramedics ak tàggatkat athletic war nañu déggoo suko defee atlet bi des ci biir tub glace ci wet gi 12 ba 18 simili NJÀKK, ñu yab ko ci ambulance bi ginaaw bi tàngoor rectal bi yeggee 38.9 °C (102 °F).**

Garab jël dogal: Triage bu wuute ci wetu benn atlet ndongo bu daanu (180 segond yu njëkk yi)

flowchart TD
    Start["Ndongo atlet dafa daanu wala daanu ci suuf ci diiru tàggat yaram wala match"] --> ActivateEAP["Jéego 1 (0-10 Sec): Defal EAP barab bi, woo 911, jël AED ci wetu, ubbi buntu tool yi"]

    ActivateEAP --> CheckResp{"(10-30 Sec): Ndax atlet bi dafay tontu te dafay noyyi bu baax? (Moytul Jerks yu gàtt ak Agonal Gasps)"}

    CheckResp -->|"Déet: Tontuwul te Noyyiwul / Gasping rek"| SCAProtocol["PROTOKOL ARREST KARDIAK BU GAAW (SCA) (Yaakaar nañu itam ni Commotio Cordis sudee dañu la dóor ci dënn bi): Dagg Jersey/Pads yi, tàmbali CPR ak loxo kese (100-120/min), Defal AED ci diir bu weesuwul 3 simili"]

    CheckResp -->|"WAAW: Noyyi ak Pulse"| CheckCNS{"Xool tolluwaayu xel mi (SNC) ak tàngooru rektal bi: Ndax atlet bi dafa jaxasoo, dafay xeex, ataxic, koma, wala tàngooru > 40.5 C (105 F)?"}

    CheckCNS -->|"WAAW: SNC bi deful liggéey + Tàngoor wu metti (Tàngooru biir bi > 40.5 C / 105 F)"| EHSProtocol["PROTOKOL BU YÀGG TÀNG (EHS): Dindi bépp jumtukaay, dugal ko ci tub bu am ndox mu glaas (1.7-15 C / 35-59 F) wala TACO Tarp ci saasi. COOL BIIR (ba 38.9 C / 102 F), TRANSPORT CI ÑAAREEL"]

    CheckCNS -->|"NO: Yeewu, Leer, Jubluwaay, Temperature < 40.0 C (104 F)"| CheckMuscles{"4ème étape: Nan la atlet bi daanu, ak naka la sidit yi ci tànk yi/ci ginaaw di yëg?"}

    CheckMuscles -->|"Dafa daanu ginaaw Sprints; sidit yi dañu melni lu nooy/laxasu; Ischemik bu metti ci ginaaw/bassin/tànk; Takipnée"| SicklingProtocol["JAFE-JAFE CI TÀGGAT (ES): Dakkal tàggat yaram ci saasi, jox 15 L/min Oxygen, tëdd/am ndox, yóbbu ALS ci saasi ci ambulance ER ngir Rhabdomyolyse & Hyperkalemie ECG"]

    CheckMuscles -->|"Hobbling ci Agony; Sidit yu tëju ci ROCK-HARD spasms yuñuy gis"| CrampProtocol["KRAMP TÀNG BU BAAX: Noppalu ci lëndëm, tàllal sa yaram, masaas ci glaas, solution electrolyte bu xorom (0.5 kuddu kafe xorom ci 500 mL naan sport)"]

Faas 1: Tablo buy méngale 4 yoon ci wetu paj mi (SCA vs. Heatstroke bu metti vs. Sickling bu metti vs. Kramp yu tàng)

Ci ayu-bis bi njëkk ci weeru ut bi ñuy waajal sesoŋ bi, antreneer yi dañuy faral di juum ci Sickling Exertional ngir Kramp yu tàng yu baax, wala ñu juum ci Arrest cardiaque sudden ngir Syncope de tàngoor. Sooy fàttaliku wuute yi am ci klinik yi ci tablo bii, dina tax nga moytu ñu juum ci diagnostic bi ci tool bi:

Diagnostic bu wuute ci daanu bu gaaw ci atlet ndongo yi (NATA / ACSM / AHA Consensus)

Màndarga klinik 1. Xol buy taxaw ci lu gaaw (SCA / Commotio Cordis) 2. Tàngoor wu metti (EHS) 3. Sickling exercitif akut (ES - HbAS Rëdd) 4. Kramp yu baax ci tàngoor
Waxtu ak forage Bépp poñ ci pratique wala jeu; wala luy xew ci saasi (HCM, anomalous coronary artery, Long QT) wala ci diir bu weesuwul 3 seconde ginaaw biñu ko dóore ci dënn bi (Commotio Cordis). Dafay faral di am ginaaw 45+ simili di wéy di liggéey bu baax ci tàngoor/niir gu metti (WBGT > 27.8 °C / 82 °F), lu bari ci Bis 1 ba 5 ci pre-sesoŋ bi laata tàngoor wi di tàmbali ànd ak tàngoor wi. Lu bari ci 10 ba 30 simili yu njëkk yi ci tàggat yaram ci diiru sprinting bu yàgg (gassers, suicides, timed 800-to-1600m conditioning runs, stadium stairs) ak ay noppalu yu gàtt. Bu yagg ci ab tàggat yaram bu yàgg, ak ñaq wala ñaareelu xaaj bu match ginaaw bi sodium ak ndox mi ñàkkee ñaq.
Noo atlet bi wàccee Ci saasi "dagg-ni-xeer" daanu (non-contact wala ginaaw biñu la dóor ci dënn bi); bët yi dellu ginaaw; 50% amnañu 10-20 seconde yuy yëngu tànk yu melni convulsion. Ñu jiitu ko ci mbëggéel, tànk yu jaxasoo (ataxia), ñàkka def liggéey, mer, yuuxu bu amul sabab, wala daanu ci saasi ci delirium / stupor. Dafay wàcci ndànk ci gason bi: Atlet bi dafay bàyyi daw, def ay loxoom ci wóom, daal di wàcci wala tëdd ndax seeni tànk ak seen ginaaw dañuy melni "dee, kawsu, ak ñàkk doole." Atlet dafay tëb wala daanu ci suuf tëye benn calf, hamstring, wala quad bi muy yuuxu wala di grimacing ci spasm sidit bu metti.
Niveau de conscience (CNS) Tontuwul dara ci diir bu gàtt ginaaw bimu daanu. Dysfonctionnement bu xóot ci SNC (100% diagnostic hallmark): Desorienté, xeex, wax bu jaxasoo, xool bu leer, convulsions, wala coma. Wake, Alert, ak Lucid: Mën nañu la wax seen tur, leeral seen metit bu leer, doonte dañu gaaw coono ak jaaxle (can progress to shock/coma if forced to keep running). 100% yeewu, yeewu, ak jubluwaay.
Noyyig & Pulse Pulse bu amul; noyyig amul wala yeex, bruit gasps agonal / snorting. Tachycardie rapide, limitante (140 to 180+ bpm), noyyig gaaw (tachypnea), tension diastolik bu wàññeeku. Noyyi gu gaaw te xóotul (feeling "winded" / unable to catch breath) ak puls bu gaaw bu mëna yàqu ci saasi nekk arritmi hyperkalemique (VFib / PEA). Noyyig yaram ak puls bu jaar yoon (dafay yokk ludul ci tàggat yaram ak metit).
Tonu sidit yi ak kalite metit Flaccid (ginnaaw ab yëngu myoclonic bu gàtt). Flaccid wala rigidité généralisée sudee dafay jàpp. SIDIT YI DAÑUY YÀGG CI SOFT / FLACCID CI LAAL: Metit wi mooy metit bu xóot, bu tëx, bu tàng ci lumbar ci suufu ginaaw, buttocks (gluteals), pelvis, ak hamstrings (buñu nekk bu dëgër). SIDI YI DAÑU DËGËR NI XEER TE DAÑU ÑËW: Mën nga gis gastrocnemius bi wala hamstring bi dajaloo ni baseball ci suufu der bi.
Der bi ak tàngooru rektal bi temperatiir tàggat yaram bu jaadu (37.5 °C to 39.5 °C / 99.5 °F to 103.1 °F); der bi dafay gaawa lewet wala cyanotic. Temperature rectal > 40.5 °C (105.0 °F) (often 41.0 to 43.0 °C / 106 to 109 °F); der bi dafa tàng, te dafay faral di TOW AK ÑÀQ. Temperature rectal < 40.0 °C (104.0 °F); der bi mën na ñaq wala amul benn sikk. Temperature rectal bu mag < 40.0 °C (104.0 °F); der bi dafa bari ñaq ak xorom (white salt crust on jersey).
Jëf ngir muccal dundu ci saasi CPR ak loxo kese + Choc AED ci biir < 3 minutes + 911 ALS dem ak dikk. "Sedd bu njëkk, yóbbu ñaareel": Ci saasi Suytu ci ndoxu glaas (1.7-15 °C / 35-59 °F) ci barab bi ba temp rectal yegg 38.9 °C (102 °F), CI GÀNNAAY yóbbu. Taxaw ci saasi + 15 L/min Oxygen + Noppalu supine + 911 ALS yóbbu ci saasi ci ER (IV normal saline + stat ECG for hyperkalemia). Nooyal ci lëndëm, tàllal sa yaram bu woyof, masaas ci glaas, naan sport bu xorom.

Phase 2: Arrêt cardiaque ci lu gaaw (SCA) ak Commotio Cordis ci terrain bi: sàrtu AED bu 3 simili

Arrest cardiaque ci lu gaaw mooy #1 sabab pajum dee ci atlet yu ndaw yi, di dal lu tollu ci 1 ci 50,000 atlet yu liise ak universite at mu nekk. SCA athletic bu ndaw yi wuute na ak arret karjaak yu màgget yiy bawoo ci arteri coronaire yu fatt, ndax SCA athletic ci ndaw ñi dafay bawoo ci ** ab feebaru xol buñu xamul wala bu am kuuraŋ** wala ab dóor bu dëgër ci dënn bi (Commotio Cordis).

1. 5 sabab yu njëkk yi waral xol bi di tëju ci atlet yu ndaw yi

  1. Kardiyomiyopati hipertrofik (HCM): Yaatuwaayu genetik bu sidit xol bu cammoy biy indi fibrilasioŋ ventrikular (VFib)** su adrenaline bi di yokk ci daw.
  2. Anomalie artérielle coronaire congénitale (CAA): Arterie coronaire biy joge ci sinus aortique bu baaxul bi dafay gëna xëcc diggante aorte bi ak arterie pulmonaire bi ci diiru génnug tàggat yaram bu gëna mag.
  3. Ion-kanalopati genetik ak feebaru kuuraŋ (Long QT, Brugada, CPVT, ak Wolff-Parkinson-White / WPW): Xol yu jaar yoon, yu am kuuraŋ bu gàtt ci suufu adrenaline buy jameet.
  4. Myocardite viral bu metti: Inflamasioŋ bu noppi ci sidit xol bi ci diir bi wala ci diir bu weesuwul 1 wala 2 ayu-bis ginaaw feebar bu bawoo ci virus (Coxsackievirus, Influenza, COVID-19, Adenovirus) su atlet bi delloo ci kondisioneer bu dëgër bi muy wér.
  5. Kommosio Kordis (Blunt Chest-Impact Arrest): Dafay am ci xol bu wér 100% sudee ab baseball, bal lacrosse, puck hockey, softball, wala kask daanu ci kuuru dënn bi ci cammoy bi (precordium) ci diir bi 20 ba 40 milisegond di yéeg ci vague T (ventricular repolarization), sànni xol ci fibrilasioŋ ventrikular.

2. Lu tax antreneer yi waru ñu musa nax "Jerks yuy jàpp" wala "Agonal Gasping"

Ci jàngat wideo yu liise ak universite athletic arrêt cardiaque, #1 sabab bi antreneer yi yeexal CPR ak jël AED mooy ** loxo ak tànki atlet bi daanu dañuy yëngu ni epileptik ci diiru 15 seconde, seen xol diis ak yuuxu, ronko gasps **. - Fisioloji bi: Su fibrillation ventriculaire bi daggee deret jiy daw ci yuur gi, hypoxie bu metti dafay indi convulsion myoclonique bu 10 ba 20 seconde, daal di topp ci tronc yuur gi reflexes gasping agonal. - Regle bu Sideline (Inter-Association Task Force Mandate): Bépp atlet bu daanu ci anam wu amul benn metit (wala ginaaw biñu ko dóore ci dënn bi) te mënul def dara, dañu koy tëj ci saasi ba keroog ñu koy firndeel. Bul dugal dara ci gémmiñ, bul xaar ba "convulsion" bi jeex, te bul toog 60 seconde di rëbb pulse. Yonneel AED ci saasi, nga wane dënn bi, nga tàmbali def compressions dënn bi. Su AED joxee shock ci diir bu weesuwul 1 ba 3 simili ginaaw bimu daanoo ci tool bi, limu nit ñi mucc dafay weesu 85% ba 90%.

3ème étape: stroke tàngoor bu metti (EHS): def jéego par jéego "Cool njëkk, Transport ñaareel"

Accident de chaleur exercitif (EHS) dafay gëna yokk bu baax ci weeru sulet ak weeru ut ci futbal bi njëkk ci sesoŋ bi, cross-country, ak tàggat yaram** su Tàngooru Globe Wet-Bulb (WBGT) weesu 27.8 °C to 32.2 °C (82 °F to 90 °F).

1. Lu tax nga wara jëfandikoo termometre rectal (ak lu tax ñaq du tere am tàngoor)

Ba leegi ñaari gëm-gëm ñooy ray atlet ndonngo yi seen bakkan ci weeru ut bu nekk: - Njàngale #1 ("Sudee ba leegi dañuy ñaq, coono tàngoor rekk la, du tàngoor"): Njuumte. Der bu wow (anhidrosis) dafay am ci Classic passif heatstroke ci mag ñi ci diiru fan yu bari. Ci Heatstroke, atlet bu ndaw buy defar 1,000+ watt ci tàngoor metabolik ci biir pad yi dafay dawal seen tàngoor core ci 37 °C (98.6 °F) ngir 41.5 °C (106.7 °F) ci 45 simili, fekk mingi ñaq bu baax. - Njàngale #2 ("Jëfandikool ab scanner infrarouge ci jë wala termometre nopp"): NJUUMTE. Jàngat yi Korey Stringer Institute amal dañu wane ni jë, nopp (tympanic), ak termometre oral 36.5 °C to 38.0 °C (97.7 °F to 100.4 °F) ci kaw atlet bu tàngoor wi ci biir rectal bi nekk luy ray nit 41.8 °C (107.2 °F), ndax evaporation ñaq dafay seddal der bi. - Waa sudee sa daara amul termometre rectal ci terrain bi? Japp ci Regle Presumption Clinique: Bépp atlet buy tàggat sa yaram ci anam wu tàng, te dafay wane Sistem Nerveux Central bu wóor (CNS) dysfonctionnement (jaxasoo, jaxasoo, fitna, mbëggéel, daanu, wala coma ginaaw biñu bañee SCA) DAFA wara faj ci saasi ak dugal yaram wi yépp ci ndox mu sedd, muy luñu yaakaar ni Heatstroke Exertional.

2. Ni ñuy doxalee ci ndox mu sedd (CWI) Tub wala TACO Protocolu tarp ci wetu

  1. Pre-Stage tub bi balaa ngay pratique WBGT > 25 °C (77 °F): Feesal 380 ba 570 litir (100 ba 150 galon) ci reservoir Rubbermaid ci wetu tente tàggat yaram bu am lëndëm ak ndox (10 °C to 15 °C / 50 °F to 59 °F), ak 3 ba 4 cooler yu def glaas buñ dagg ñu toog ci wetu tub bi ñuy waaja sànni ci biir.
  2. Dindil jumtukaay yi ci diir bu weesuwul 60 segond: Dindil kaska bi, pad mbagg yi, maillot bi, pàntaloŋ bi, tànk yi ak soset yi (wet uniforms trap heat).
  3. Duy dugg ci baat bi bamu xóot te wéy di yëngal: Yéegal atlet bi ci biir tub bi suko defee seen bakkan, pelvis, pooj ak loxo dugg ci ndox mi 1.7 °C to 15.0 °C (35 °F to 59 °F) ndox mu glaas. Teg ab sarbet buñu laxas ci suufu ñaari pooj yi nga tëye ci ñaari spotters ngir tëye yoonu respiraasioŋ bi ci kaw ndox mi. 30 seconde yu nekk dangay yëngal ndox mi bu baax suko defee der bi du am lu tàng.
  4. Xeexal Delirium Combatif: Tàngooru yuur gi dafay faral di tax atlet bi di xeex. Waxal 4 spotter ñu jàpp mbagg yi ak wóom atlet bi ci biir tub bi (wala nga jëfandikoo **TACO tarp ** ci kaw ñax mi). Ci diir bu weesuwul 3 ba 5 simili ginaaw biñu ko dugalee ci ndoxu glaas, delirium combatif bi dafay jeex ginaaw bi deretu yuur gi seddee.
  5. Tamperatiiru dindi biñ bëgga (38.9 °C / 102.0 °F): Dindil atlet bi ci bànxaasu glaas bi nga yóbbu ko ci cimu ambulance biy xaar su sonde rectal bi jàngee 38.9 °C (102.0 °F) (prevents afterdrop hypothermia). Soo amul termometre rectal, dangay dugal ko ci ndox mi 12 ba 15 simili (wala ba ngay lox ba noppi leer ci sa xel) balaa nga koy yab ci ambulance bi.

4ème étape: Sickling exercitif (HbAS) jafe-jafe: lu tax yuuxu "Toxal ci Kramp yi" waral hyperkalemie fatal

Lu tollu ci 1 ci 12 doomi Amerique yu ñuul (8%), 1 ci 100 Hispanik yu Amerique, ak ay junni atlet yu bawoo Mediteraane, Moyen Orient, Inde, ak ndono Caraïbe yor Jikkoo Sickle Cell (HbAS) - loolu dafay tekki ni dañu jël benn gène hemoglobine bu jaar yoon (HbA) ak benn gen hemoglobine (HbS). Ci dundu bu jaar yoon, nit ñi am Sickle Cell Trait dañu wér bu baax te amul feebaru Sickle Cell (HbSS).

Waaye, ci diiru coono anaerobic bu tar, bu yàgg - rawatina sprint yu bari (gassers, suicides, mat drills), test fitness yu 1-mile/2-mile ci bis bi njëkk, wala conditionnement bu amul-huddle te du am noppalu - ñeenti trigger physiologique yu boole ci biir tànki atlet biy liggéey ak sidit yi ci ginaaw: 1. Hypoxie bu tar ci tisu (oxygen dafay wàcci ci biir quadriceps/hamstring yiy liggéey); 2. Acidose lactique bu tar (pH sidit yi wàcci ci suuf 7.0); 3. Dédrataasioŋ selulaar (hyperosmolité ci biir kapilaar sidit yi); ak 4. Tàngoor sidit yu yéeg.

Tetrad bii dafay tax seluli deret yu xonk yi ci saasi joge ci disk yu nooy te neexa laxasu dem ba nekk "sickles" yu dëgër, yuy kole. Ci diiru 2 ba 5 simili, seluli deret yu xonk yooyu dañuy tëju ba noppi tëj kapilaar yu ndaw yiy dundal sidit yu mag yi ci gënn gi, ci bassin bi, ci pooj yi ak ci suufu ginaaw gi (acute ischemic rhabdomyolysis)**. Xiif deret ak oxygen, selul sidit yax yi dañuy toj bu baax, sànni limu bari ci biir selul yi Potassium (K+) ak Myoglobine dañuy dugg ci deret ji. Sudee antreneer bi dafa forse atlet bu sickle mu dellu ci liiñ bi, dawaat benn sprint, potassium serum bi dafay yéeg ba romb 7.0 to 9.0 mEq/L, di indi arrêt cardiaque hyperkalemique buy ray nit (sine-wave ventricular fibrillation or PEA) ci kaw tool bi.

Ni ñuy xàmmee sickling bu metti ak kramp yu tàng ci 10 seconde

  • Kramp yu tàng: Atlet bi dafay joge ci terrain bi di yuuxu, jàpp sidit bu dëgër ni xeer, di nuru luñu laxas ci tànk wala sidit hamstring; tàllal dafay jàppale ndànk-ndànk.
  • Exertional Sickling: Atlet bi slumps ci turf nuru ku sonn ak tiit, di ñaxtu, ñakk kattan gu tàng ci seen ci suufu ginaaw, buttocks, ak ñaari pooj yi, te sooy fëgg seeni pooj wala calves ak say loxo, **sidit yi normally ak ft. Bul musa tàllal wala dàmp sidit bu sickle, te bul musa wax atlet bu sickle mu jog jeexal drill bi.

Nimero paj mu jamp ak protokolu agence

Réew / Région Yonnee ci jafe-jafe Athletic Tàngoor, Xol & Sickling Standard yiy Yorandi Jumtukaay yiñ wara jëfandikoo ak sàrti ànd ak klimaa bi
Etats Unis 911 Association nationale des formateurs athletiques (NATA) + Daaray Korey Stringer (KSI, UConn) + Daaray Siyaas ci wàllu tàggat yaram bu NCAA + NFHS (National Federation of State High School Associations) NCAA dafa wara saytu jikko selil sickle/sàrti firnde; liise bu etaa bi ** WBGT Yooni tàngoor ** (lu melni, * Zach Martin Act * ci FL, * Jordan McNair * tegtali ci MD, Georgia GHSA sàrti WBGT) di santaane ci barab bi ** Tubs yu sedd-ndox ** ak ** AEDs ci wet ** simili 1-3.
Kanaada 911 Komite buy xelal pajum tàggat yaram (SMAC) + Association Canadienne des Terapeutes Atlétiques (CATA) + Fondation xol ak AVC bu Canada Tablo coppite tàngoor/WBGT ci diggante daara yi (OFSAA ci Ontario, BC School Sports) ak protocolu jëfandikoo AED ci barab bi war.
Royaume-Uni 999 wala 112 Daaray tàggat yaram bu UK (UKSI) + Konselu dekkal UK + Daara bu mag biy jàngale tàggat yaram ak pajum tàggat yaram (FSEM) + Risku xol ci ndaw ñi (CRY) FA (Football Association) ak RFU Pitchside Toppatoo ci saasi (PHICIS) tegtal yiy wax defibrillation ci saasi ci wetu terrain bi ak seddal buy jaar yoon.
Mbootaayu Ëroop 112 Conseil européen de resuscitation (ERC) + **Société européenne de cardiologie (ESC ** + Reglemaasioŋu pajum UEFA Protocolu depistaasu ECG bu 12 njiit laata ñuy bokk (lu melni, yoonu depistaasu tàggat yaram bu Italie) ak AED / gaaraasu seddal bi ci wetu estaad bi.
Ostralie ak Nouvelle-Zélande 000 (AU) / 111 (Nouvelle-Zélande) Pajum tàggat yaram Australie (SMA Politigu tàngoor wu metti) + Konselu dekki bu Australie (ARC) + Konselu dundal bu NZ SMA Sport-Specific Thermical Risk Charts (temperature ambiant vs. humidité relatif cutoffs) ak waajal dugg ci ndox mu sedd ngir muñ / xew-xew yi ci tool.
Inde ak Asie-Pacifique 112 (Inde) / 119 (Japon/Corée) / 995 (SG) Njiitu tàggat yaram ci Inde (SAI) + Association sportive japonaise (JSPO WBGT tegtal) + Daaray tàggat yaram bu Singapore Wareef WBGT meter xool ci terrain athletic daara yi (halting all strenuous youth outdoor exercise at WBGT >= 31 °C / 87.8 °F ci Japon).

Laaj yi ñuy faral di laaj

Lan ngay def sudee fajkat EMS yi ñëw nañu ci terrain bi ba noppi ni dañu wara yab sunu atlet bu Exertional Heatstroke ci ambulance bi ci saasi balaa seen tàngoor di sedd?

Bépp daara ju am sertifikaa di tàggat yaram (ATC) ak doktëru ekip bi dañu wara defar déggoob bind balaa sesoŋ bi ak kilifa pajum Pompier/EMS bi ci dëkk bi. Ci wàllu Association Nationale des Médecins EMS (NAEMSP), College des Médecins d'Urgence américaine (ACEP), ak NATA, dañu sant fajkat yi ñu jàppale ci seddal tub bi ci ndox mu sedd (CWI) (bi ñuy tàmbali liiñ IV ak di xool tàngoor wi ci wetu tub bi) wàcci ba 38,9 degre Celsius (102,0 degre Fahrenheit) LAATA ñuy yóbbu malaad bi ci ambulance bi**. Sudee EMS bi yor wàllu pajum dëkk bi dafa santaane ñu yóbbu ko ci saasi balaa tub bi di waajal, jëfandikoo ** TACO anam (def ay darab yu tooy, yu fees dell ak glaas / tarps ci atlet bu amul dara) ** te nga yëgal Departemaa biy jël paj mu jamp mu am ndoxu glaas buy xaar ci ambulance bi.

Lan moo waral 5 fan yu njëkk ci weeru ut bi futbal mbaa jeego cross-country mooy palanteer bi gëna faat bakkan ci Heatstroke ak Sickling bu metti yepp?

Lu ëppu **75% ci liise yi ak collège yi dañuy am ci 4 fan yu njëkk yi ñuy waajal sesoŋ bi**. Ci wàllu physiologie, yaram wi dafay soxla **10 ba 14 fan yu toppalante ci exposition tàngoor bu bari ("Acclimatisation Heat")** ngir yaatal volume deret plasma ci 12% ba 15%, wàññi tàngoor wi ci biir ñaq, yokk tàngoor conservdium ñaq, ak ñaq conservdium. Su ndonngo bu xamul klimaa bi génnee ci kër gu am klimaa bi ci bis 1 bi, ñu defal ko 3 waxtu ci tàggat yaram ci pads yu mat wala sprint yu am klimaa bi ("gasser yu bari"), seen sistem kardiyovaskulaar mënul dindi tàngoor wala tëye oxygenasioŋ sidit yi. Lii moo tax sàrti NATA ak NFHS tere ñaari jëf ci bis bi ci bis yu toppalante, tere yéere kaaraange yu mat sëkk ci bis 1 ba 5, ak tere test conditionnement ci bis 1.

naka lañuy jëfandikoo tàngooru glob bu ampoule bu tooy (WBGT) meter ci wetu liiñ bi, te lu tax mu gëna baax ci aplikaasioŋu meteo bi ci "Index Heat" bi ci telefon bi?

"Index de chaleur" biñ miin ci aplikaasioŋu meteo bi dañu koy xayma sudee danga toog ci **100% lëndëm ak ngelaw lu woyof** - du bàyyi xel ci **radiasioŋ jant bu direct buy tàngal gazon artifisiyel bu ñuul** ak **ngelaw luy tëju ci estaad bi**. **Temperature Globe Wet Bulb portable (`WBGT`) meter** dafay boole ñatti kaptër yu wuute: **(1) Tàngooru Ampoule bu waw** (`10%`), **(2) Tàngooru ampoule bu tooy (`70%`)** natt kàttanu seddal ñaq ci evaporaasioŋ ci humidite ak gaawaayu ngelaw li, ak **(3) Tàngooru Globe bu ñuul (`20%`)** natt tàngoor radiant jant bi ci kaw gason bi. Su liiñ bu wet `WBGT` yegg **`27.8 °C to 30.0 °C (82 °F to 86 °F)`**, waxtu bu nekk dañu wara noppalu 15 simili ngir seddal seen yaram; kañ `WBGT` lu ëpp **`32.2 °C (90.0 °F)`** (wala gëna suufe ci klimaa yi gëna sedd ci nord bi), bépp jëf ci biti bu padded ak conditioning bu tar dañu ko wara fomm wala ñu toxal ko ci biir kër.

Sudee ndongo atlet xamna ni amna jikko Sickle Cell (HbAS), ndax dañu leen tere def sport varsity?

Déedet - **amul atlet bu am màndarga selil sickle (`HbAS`) musu ñu ko dàq ci bépp tàggat yaram**. Ay junni atlet NCAA ak profesionel ñu ngi joŋante ak Sickle Cell Trait bis bu nekk ci jàmm. lu moy loolu, xam atlet `HbAS` status dafay may antreneer yi ak tàggatkat yi ñu mëna jëfandikoo **Sickle Cell Trait Precautions**: **(1)** May atlet bi mu tabax kondisioneer ndànk-ndànk moo gën daw bis-1 timed mile / gasser test; **(2)** Yokk ñaari yoon diggante noppalu ak defaraat ci diggante baamtu sprint yi; **(3)** Jéggalu atlet bi ci daw yu mat sëkk ci tàngoor wu metti wala ci altitude bu kawe (`above 1,500 meters / 5,000 feet`); **(4)** Fexe ba sa yaram di wéy di am ndox; ak **(5)** May atlet bi doole génn ci bépp drill ci saa si mu yëg ni tànk, gënn, wala ginaaw gu néew doole te du ragal ñu koy yar.

Ndax war nanu dindi kasku joueur football wala lacrosse ci biir terrain ci jamonoy arrêt cardiaque ci lu gaaw wala stroke exercitif?

Waaw. Ci **Tàngoor bu metti (`EHS`)**, amul benn trauma ci collu cervical, te kaska bi ak pads mbagg yi dañuy jàpp tàngoor wi: **dindil kaska bi ak pads mbagg yi ci saasi** balaa ngay wàcce atlet bi ci biir ndox mu sedd. Ci **Arrêt cardiaque bu gaaw (`SCA`)**, sudee atlet bi dafa daanu te dara dalu ko ci baat bi/bopp bi, **dagg jersey bi ak buum yi ci kanam ci pads mbagg yi ci saasi ngir wane dënn bi amul dara ngir CPR ak AED pad placement**, nga dindi masku kanam bi (`or helmet/pads`) ngir ventilation ci yooni respirasioŋ yi **musul yeexal tàmbali compressions ci dënn bi wala joxe shock AED**.

Tàggat biñu lay digal: Bépp ndaw, liise, ak antreneer collegial, arbit, ak waajur yi ci wetu dañu wara def CPR, AED, ak njàngum sertifikaasioŋ ci Sports First Aid jaaraleko ci Croix Rouge bu Amerique, Mbootaayu xol bu Amerique, St John Ambulance, wala Federasioŋ Nasionaal bu Mbootaayu Liise yu Etat (NFHS Learn), ñu jàngat seen Plaŋu Jëf ci Jafe-jafe (EAP) ak chronomètre balaa ñuy tàmbali tàggat yaram ci sesoŋ bu nekk.

Gid yu jëm ci loolu

Boroom yi ak tegtali ofisel

  • Association nationale des formateurs athletiques (NATA, Etats-Unis): Bataaxelu Position: Feebaru Tàngoor Exercitif (Standard Thermometry Rectal ak Immersion ci Ndox Sedd ci Site "Sedd bu njëkk, Transport Ñaareelu" Mandat) ak Bataaxelu Bokk: Doxal bu metti ci Injull Triage de sickling exercitif).
  • **Korey Stringer Institute (KSI, Daara bu kawe bu Connecticut) & Daara bu kawe bu Amerique buy jàngale pajum tàggat yaram (ACSM) **: *Bataaxelu deggoo ci wàllu faj tàngoor wu metti balaa lopitaal, seddal bu ànd ak oscillation (TACO), ak tàngooru globe bu daara ju kawe (WBGT)
  • ** Kuréel giy liggéey ci diggante kuréel yi ngir moytu dee yu gaaw ci daara yu kawe yi ak ci sesioŋ yi ñuy amal ci daara yu kawe yi (NCAA / NATA / NSCA / kuréel gi yor xol ci Amerique) **: Njàngale ngir xàmmee ak jëflante ak xol bu gaaw (3 simili AED Target, Myoclonic Gagnitioner Seizure) Rabdomyolyse / Sickle ci atlet yu am màndarga selil sickle (HbAS).
  • Collège américain des médecins d'urgence (ACEP) & Association nationale des médecins EMS (NAEMSP): Kàddub Politik buñ Bokk ak Këyitu Njàngale: Njàngale mu am AVC bu tàngoor bu metti balaa lopitaal (Jëfandikoo ndox mu sedd ci barab bi laataa ñuy yóbbu EMS Ambulance).
  • Centre yiy saytu ak fàggu feebar yi (CDC, Etats Unis): Feebaru tàngoor ci atlet yu liise yi ak Sickle Cell Trait (HbAS) Moytu yi ci wàllu tàggat yaram.