290 lessons learnt from a heatstroke death

1
101 Monday 15 October Just who is ‘being active’? Profiles of Masters competitors and assessment of injury risk. G. Winter 1 & G. Thompson 2 * 1 Tropical Institute Of Sports Medicine And Exercise Science 2 Territory Sportsmedicine The institutional encouragement for society at all levels to increase their exercise participation often does not give adequate consideration of who takes up this message, the “burden of injury” or health problems the individual may carry, and the risk of injury with exercise and in competitive events. This research considers the profile of masters’ competitors at the Alice Springs Masters Games (an event held biennially since 1982), their pre existing medical and orthopaedic conditions, and their in- competition risk of injury. The implication of these findings allow guidelines to be offered to government and event organizers for safe masters’ competitions It’s Not A Torch! : Medical care on the Australian sector of The Queen’s Baton relay – a unique experience S. Mejak 1,2,3,4 * 1 Melbourne 2006 2 Alphington Sports Medicine Clinic 3 Victorian Institute Of Sport 4 Northern Knights AFL This abstract was not available at the time of printing. Lessons learnt from a heatstroke death S. Rudzki 1 * 1 Australian Army Introduction : Following the death of a young soldier from Heatstroke in October 2005 , the Australian Army embarked on a thorough review of it’s policies, training and clinical management of Heat Injury. A number of deficiencies were identified and corrective action instituted. Methodology: A thorough review of the literature on heat injury was conducted and comprehensive policy was produced that was evidence based. This policy was peer reviewed by a panel of international experts in November 2006. In addition an educational DVD was produced and made a part of mandatory annual training. Lessons Learnt: Prevention of heat injury was considered to be the most important lesson and this must be based on risk management principles. Commanders were educated on the important interaction between external heat stress (WBGT) and exercise intensity. Comprehensive work-rest tables were introduced and mandatory levels of medical support required when risk levels were high or extreme. It became apparent that there was no appreciation of the difference between self-limiting heat illnesses such as heat exhaustion and life threatening heat injuries such as heatstroke. Strong cultural resistance led to rectal temperatures not being taken as a routine. There was an overwhelming belief that adequate fluid replacement would prevent heat injury, and all preventative efforts were focused on encouraging maximum water intake, rather than effective cooling. The importance of salt replacement was neither understood nor applied. The effectiveness of different cooling methods were not understood. The use of ice packs applied to the groin, axilla and neck were utilised as standard practice despite the literature showing that this produces the slowest rate of core temperature reduction of all methods reported. Conclusion: The confusion identified within Army members is likely to be replicated in the broader community. A clear understanding of appropriate preventative measures, accurate diagnostic approaches and effective treatment methods is essential to prevent further deaths from heatstroke in the exercising community. Musculoskeletal and medical issues in world class sprinters: a twelve month prospective cohort study B. Hamilton 1,2 *, P. McCourt 1,2 & N. Black 1 1 UK Athletics 2 English Institute of Sport World class sprinting places demands on both the athletes’ bodies and medical staff. There are limited epidemiological studies into either the injury profile of such athletes or the medical demands placed upon practitioners to keep them injury and illness free. It is our observation that British track athletes have expectations of high levels of therapeutic input. As part of a wider prospective clinical audit, UK Athletics monitored both the injury and illness profile, and any therapeutic interventions in six world class (Olympic and World Championship medallists and finalists) 100/200 metre sprinters, for a twelve-month period. On a weekly basis athletes were contacted directly or by phone and the week assessed using a variety of directed questions. Training weeks were divided into fourteen sessions, with the quality of each session assessed, injuries or impediments to training noted and all medical or therapeutic interventions recorded. In addition, all investigations undertaken for the period were documented. One athlete retired from the sport and was not included in the data analysis. The results revealed a high rate and broad range of musculoskeletal injuries, with a variable impact on training quality and quantity. There was a high level of therapeutic input noted, with marked individual variability. We conclude that elite British sprinters train with a large number of musculoskeletal concerns and require a high level of therapeutic input. This data will be of interest to those involved in the provision of medical services to elite athletes. 288 289 290 291

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Page 1: 290 Lessons learnt from a heatstroke death

101

Mon

day

15 O

ctob

er

Just who is ‘being active’? Profiles of Masters competitors and assessment of injury risk.G. Winter1 & G. Thompson2*1Tropical Institute Of Sports Medicine And Exercise Science2Territory Sportsmedicine

The institutional encouragement for society at all levels to increase their exercise participation often does not give adequate consideration of who takes up this message, the “burden of injury” or health problems the individual may carry, and the risk of injury with exercise and in competitive events. This research considers the profile of masters’ competitors at the Alice Springs Masters Games (an event held biennially since 1982), their pre existing medical and orthopaedic conditions, and their in-competition risk of injury. The implication of these findings allow guidelines to be offered to government and event organizers for safe masters’ competitions

It’s Not A Torch! : Medical care on the Australian sector of The Queen’s Baton relay – a unique experienceS. Mejak1,2,3,4*1Melbourne 20062Alphington Sports Medicine Clinic3Victorian Institute Of Sport4Northern Knights AFL

This abstract was not available at the time of printing.

Lessons learnt from a heatstroke deathS. Rudzki1*1Australian Army

Introduction : Following the death of a young soldier from Heatstroke in October 2005 , the Australian Army embarked on a thorough review of it’s policies, training and clinical management of Heat Injury. A number of deficiencies were identified and corrective action instituted. Methodology: A thorough review of the literature on heat injury was conducted and comprehensive policy was produced that was evidence based. This policy was peer reviewed by a panel of international experts in November 2006. In addition an educational DVD was produced and made a part of mandatory annual training. Lessons Learnt: Prevention of heat injury was considered to be the most important lesson and this must be based on risk management principles. Commanders were educated on the important interaction between external heat stress (WBGT) and exercise intensity. Comprehensive work-rest tables were introduced and mandatory levels of medical support required when risk levels were high or extreme. It became apparent that there was no appreciation of the difference between self-limiting heat illnesses such as heat exhaustion and life threatening heat injuries such as heatstroke. Strong cultural resistance led to rectal temperatures not being taken as a routine. There was an overwhelming belief that adequate fluid replacement would prevent heat injury, and all preventative efforts were focused on encouraging maximum water intake, rather than effective cooling. The importance of salt replacement was neither understood nor applied. The effectiveness of different cooling methods were not understood. The use of ice packs applied to the groin, axilla and neck were utilised as standard practice despite the literature showing that this produces the slowest rate of core temperature reduction of all methods reported. Conclusion: The confusion identified within Army members is likely to be replicated in the broader community. A clear understanding of appropriate preventative measures, accurate diagnostic approaches and effective treatment methods is essential to prevent further deaths from heatstroke in the exercising community.

Musculoskeletal and medical issues in world class sprinters: a twelve month prospective cohort studyB. Hamilton1,2*, P. McCourt1,2 & N. Black1

1UK Athletics2English Institute of Sport

World class sprinting places demands on both the athletes’ bodies and medical staff. There are limited epidemiological studies into either the injury profile of such athletes or the medical demands placed upon practitioners to keep them injury and illness free. It is our observation that British track athletes have expectations of high levels of therapeutic input. As part of a wider prospective clinical audit, UK Athletics monitored both the injury and illness profile, and any therapeutic interventions in six world class (Olympic and World Championship medallists and finalists) 100/200 metre sprinters, for a twelve-month period. On a weekly basis athletes were contacted directly or by phone and the week assessed using a variety of directed questions. Training weeks were divided into fourteen sessions, with the quality of each session assessed, injuries or impediments to training noted and all medical or therapeutic interventions recorded. In addition, all investigations undertaken for the period were documented. One athlete retired from the sport and was not included in the data analysis. The results revealed a high rate and broad range of musculoskeletal injuries, with a variable impact on training quality and quantity. There was a high level of therapeutic input noted, with marked individual variability. We conclude that elite British sprinters train with a large number of musculoskeletal concerns and require a high level of therapeutic input. This data will be of interest to those involved in the provision of medical services to elite athletes.

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