CHAPTER 6

Environmental
Considerations
 Topic Outcome
In this chapter, students will be able to:
•Differentiate the two major injuries of
environmental conditions.
•Use the knowledge of emergency management
techniques in providing treatment to environmental
considerations.
ENVIRONMENTAL CONSIDERATIONS
•Environmental stress can adversely impact
performance and pose serious health threats.
•Areas of concern are hyperthermia and
hypothermia.
HYPERTHERMIA
• A condition in which body temperature is elevated.

• Athletes must take extreme caution when exercising in hot, humid environment.
• Prolonged exposure to extreme heat can result in heat illness.
• The physiological processes in the body will continue to function only as long as
body temperature is maintained within a normal range.
• Depends on the body's ability to dissipate heat.
• An individual training or competing in cold environment may also be susceptible to
heat stress if the athlete becomes dehydrated or if protective equipment does not
allow heat dissipation through the sweating mechanism.
HYPERTHERMIA
Psychrometer

• Heat stress prevention:

• Hydration
• Gradual acclimatization
• Identifying susceptible individuals
• Selecting appropriate uniforms
• Maintaining weight records
• Measure temperature and humidity
• Provide rest periods to dissipate accumulated body
heat
HYPERTHERMIA
• Hydration:
• Body requires 2.5L of water daily when engaged in minimal activity.
• Adult will typically lose an average of 1.5L per hour of exercise.
• 1-2% drop in body weight (due to dehydration) results in thirst (mild
dehydration).
• Should begin activity well hydrated (urine should be a light yellow in color).
• Dark urine is an indication of dehydration. refractometer
• Recommended to drink 500-600ml of water or sports drink 2-3 hours prior to
activity and an additional 200-300ml 10-20 minutes before exercise.
• Dehydrated person cannot generate enough energy and they fell weak
(negative effect on performance).
• Signs and symptoms of dehydration are thirst, dizziness, dry mouth, irritability,
excessive fatigue, and possible cramps.
HYPERTHERMIA
• Important notes regarding hydration:
• Research has shown that replacing lost fluids with formulated sport
drink is more effective than using water alone.
• Sports drinks replace both the fluid and electrolyte that are lost in
sweat, and they provide energy in the form of carbohydrates to the
working muscles.
• Water is a good thirst quencher, but it is not a good rehydrater because
it actually "turns off" thirst before the body is completely rehydrated.
• Water also "turns on" the kidneys prematurely, so an individual loses
fluid in the form of urine more quickly than when the athlete is
drinking a sports drink. The small amount of sodium in sports drink
allows the body to hold on to the fluid consumed rather than losing it
through urine.
HYPERTHERMIA
• Important notes regarding hydration:
• Not all sports drinks are the same. The optimal level
of carbohydrate is 14gram per 250ml of water (6% of
carbohydrate) for the quickest fluid absorption.
• Sports drinks with greater than 6 percent
carbohydrate as well as sports drinks with too little
carbohydrate are absorbed more slowly.
• Research has shown that sports drinks are effective
for improving performance during both short-term
and endurance activities.
HYPERTHERMIA
• Gradual Acclimatization:
• Involves becoming accustomed to heat and exercising in
heat.
• Early pre-season training and graded intensity changes are
recommended with progressive exposure over 7-10 day
period.
• 80% of acclimatization can be achieved during first 5-6
days with 2 hour morning and 2 hour afternoon practice
sessions.
• Each practice period should be broken down into twenty
minutes of work alternated with twenty minutes of rest in
shade.
HYPERTHERMIA
• Identifying Susceptible Individuals:
• Athletes with a large muscle mass
• Overweight person
• Men
• Poor fitness level/inadequate physical conditioning
• Previous history of heat illness
• Anyone with febrile condition
• The young
• The elderly
HYPERTHERMIA
•Selecting Appropriate Uniforms:
• Should be selected based on temperature and
humidity.
• Use lightweight clothing that is loose fitting at the
neck, waist and sleeves.
• Avoid dark-coloured clothing and rubberized
suits.
• Avoid excessive clothing, padding and taping.
HYPERTHERMIA
• Maintaining Weight Records:
• Weights should be measured both before and after
practice for at least the first two weeks of practice.
• If sudden increase in temperature and humidity
occurs during the season, weights should again be
recorded for a period of time.
• A loss greater than 2% loss of body weight indicates
that the athlete is severely dehydrated and should be
removed from practice until normal weight has
returned.
HYPERTHERMIA
•Measure temperature and humidity:
• Make measurements before and during training
sessions.
• Adjust activity level according to environmental
conditions.
HYPERTHERMIA
•Provide rest periods to dissipate accumulated body
heat:
• Rest athletes in cool, shaded area with some air
movement.
• Avoid hot brick walls and hot benches.
• Provide fluid during rest period.
• Remove helmets or other headgear.
• Instruct athletes to loosen or remove jerseys or
other garments.
HYPERTHERMIA
•Type of heat stress/illness:
• Heat rash
• Heat syncope
• Heat cramp
• Heat exhaustion
• Heat stroke
HYPERTHERMIA
• Heat rash (prickly heat)
• Benign condition associated with
red, raised rash, with sensations of
prickling and tingling during
sweating.
• Occurs when the skin is
continuously wet with
unevaporated sweat.
• Continually toweling the body can
help prevent the rash from
developing.
• Generally localized to areas
covered with clothing.
HYPERTHERMIA
• Heat Syncope (heat collapse)
• Associated with rapid fatigue during overexposure to
heat, standing in heat for long periods of time, or by
not being accustomed to exercising in the heat.
• Caused by peripheral vasodilation, or pooling of
blood in extremities resulting in dizziness and
fainting.
• Treat by lying the athlete down/flat in cool
environment (with both legs elevated) and replacing
fluids.
HYPERTHERMIA
•Heat Cramps
• Painful muscle contraction (calf, abdominal) due
to excessive water loss and electrolyte imbalance.
• The immediate treatment for heat cramps is
rehydration (preferably sports drinks), mild
prolonged stretching with ice massage of the
muscle in spasm.
• Prevent by consuming extra fluids and
maintaining electrolyte balance.
HYPERTHERMIA
HYPERTHERMIA
• Heat Exhaustion
• Moderate form of heat illness with core temperature less than 40o C and no evidence of
altered mental status.
• Result of inadequate fluid replacement.
• Signs and symptoms include profuse sweating, pale skin, mildly elevated temperature (less
than 40o C), dizziness, nausea, vomiting or diarrhea, hyperventilation, persistent muscle
cramps, and loss of coordination.
• If not properly managed, can progress to heatstroke.
• Treatment:
• Have rest in a cool, shaded area.
• Remove excess clothing and equipment.
• Lie down with his/her legs elevated.
• Rehydration.
• Continually monitor vital signs.
• If rapid improvement is not observed, must be transported to the hospital.
HYPERTHERMIA
• Heatstroke
• Is a life-threatening emergency (severe form of heat illness)
• Signs and symptoms includes sudden collapse, altered mental status
(seizure, confusion, altered consciousness, irrational behaviour), flushed hot
skin, minimal/no sweating, rapid shallow breathing, strong rapid pulse,
nausea, vomiting, dizziness, weakness, and core temperature more than
40oC.
• The key to managing this condition is aggressive and immediate whole-body
cooling. Arrange transport to hospital immediately. However, it is
recommended that the athlete be cooled down first and then transported if
onsite rapid cooling are available.
• Athlete should avoid exercise for a minimum of one week and gradually
return to full practice after being completely asymptomatic and cleared by a
doctor.
HYPERTHERMIA
• Heatstroke
• Treatment:
• Checking the patients vitals (airway, breathing, circulation)
• Activating the EMS
• Have rest in a cool, shaded area.
• Remove excess clothing and equipment.
• Cool the individual down as quickly as possible by immersing him/her in a
cold water tub.
• Continuously monitor his/her vital sign until rescue squad arrives.
• The individual core temperature should be around 38o C before he/she is
removed from the cold tub.
• If cold tub is not available, sponge the athlete with cool water/cold pack
and fan with a towel. Try to lower core temperature to 38o C.
HYPERTHERMIA
HYPERTHERMIA
HYPERTHERMIA
HYPOTHERMIA AND COLD INJURIES
•Low temperature in conjunction with wind chill and
dampness or wetness can increase chances of
hypothermia
•Problems arise when heat lost exceeds heat
production generated by metabolism
•Drop in core temperature stimulates shivering but
stops after temperature drops below 30oC to 32oC.
•Death is imminent when core temperature falls
below 25oC to 29oC.
HYPOTHERMIA AND COLD INJURIES
HYPOTHERMIA AND COLD INJURIES
HYPOTHERMIA AND COLD INJURIES
• Prevention:
• Hydration
• Stay as dry as possible (avoid wetness/dampness)
• Wearing hat
• Appropriate attire
• Monitor temperature/wind chill temperature index
• Avoid alcohol
• Warm-up
• Acclimatization
• Weight record
• Stay out wind/rain
• Eating carbohydrate-rich foods
• Identifies individuals that most susceptible to hypothermia
HYPOTHERMIA AND COLD INJURIES
• First aid care for hypothermia:
• Move the victim to a warm, sheltered place.
• Insulate the head and body, especially the core.
• Remove wet clothing, then cover with layer of dry clothing.
• Check the victim’s vital signs.
• Keep the victim in a supine position to prevent shock and
increase blood flow to the brain.
• Give warm fluids.
• Never rub or manipulate the arms or legs.
HYPOTHERMIA AND COLD INJURIES
•Common cold injuries:
• Foot trench/cold immersion foot
• Frostnip
• Frostbite
HYPOTHERMIA AND COLD INJURIES
• Trench foot (non-freezing cold injury)
• Condition that results from your feet
being wet and cold for too long.
• Signs and symptoms:
• blisters
• blotchy skin
• redness
• skin tissue that dies and falls off
• coldness
• numbness
• prickly or heavy feeling
• tingling and itching
• may become gangrenous
HYPOTHERMIA AND COLD INJURIES
HYPOTHERMIA AND COLD INJURIES
• Frostnip
• Freezing of the skin surface.
• Involves ears, cheeks, nose, chin, fingers, and toes.
• Occurs with high wind, severe cold or both.
• Skin appears very firm with cold, painless areas that
may peel and blister in 24-72 hours.
• Treat with firm pressure, blowing warm air or hands
in armpits (if fingers involved).
• Do not rub.
HYPOTHERMIA AND COLD INJURIES
• Frostbite
• Damage to the tissues resulting from prolonged exposure to extreme cold.
• Formation of ice crystals between cells, destroys cells, disrupts blood flow, clotting may occur.
• Signs and symptoms:
• Painful, prickly, itching sensation
• Red, white, pale, grayish skin
• Hard or waxy-looking skin
• Cold skin, burning feeling
• Swelling
• Clumsiness due to joint and muscle stiffness
• Blistering after rewarming, in severe cases
• May become gangrenous
• When re-warming the area will feel numb, then sting and burn.
• Do not rub
HYPOTHERMIA AND COLD INJURIES
HYPOTHERMIA AND COLD INJURIES
THANK YOU