It’s well known and universally accepted that allowing your children to participate in youth and high school sports is a fantastic way for them to explore their interests and develop lifelong skills. Youth sports not only play an important role in exercise, but they also promote positive mental and psychological development.
So, what about youth participation should be cause for concern? Athletic medical professionals see all kinds of injuries during sports or related activities that range from mild to catastrophic. Is everything being done on your child’s behalf to ensure safe participation in sport? Sudden death in high school athletes happens. It is important to understand that a large majority of these tragic deaths are caused by one of four factors: head, heart, heat, or hemoglobin.
Head
The most common type of head injury is a concussion, in which biomechanical forces sustained to the head lead to dysfunctional processing in the brain. The most dangerous type of concussion is known as second-impact syndrome. This occurs when an athlete returns to play too soon after having a concussion and sustains another traumatic head injury.
Research shows there are 1.1-1.9 million sports and recreational related concussions in children 18 years or younger every year. Recognition and detection are key to managing these injuries. A concussion can manifest as balance issues, blurred vision or dizziness, confusion, and/or memory problems.
How we can help prevent and treat concussions:
- Ensure game equipment is properly fitted and maintained.
- Enforce game rules and prioritize safety precautions.
- Have on-site medical care and play/equipment/contact regulations.
- Immediately remove a suspected concussed athlete from play.
- Adhere to mandatory return-to-play criteria following head injuries.
Heart
More than 60% of all catastrophic injuries in sports are caused by sudden cardiac arrest. One in 70 schools will have one of their athletes experience a cardiac event annually: sports-related or otherwise. There are several cardiac conditions that may predispose athletes to sudden cardiac arrest. It is important to be aware of the following potentially dangerous conditions:
- Structural cardiac abnormalities.
- Conditions associated with cardiac arrhythmias.
- Direct trauma to the chest affecting the heart (e.g., commotio cordis).
Symptoms of cardiac disorders can include but are not limited to:
- Chest pain
- Passing out or almost passing out
- Irregular heartbeat
- Shortness of breath
How can we help prevent and treat sudden cardiac arrest (SCA)?
- Access to external defibrillators (AED) for those who have undetected heart conditions or may not have been screened. This is a critical element in saving a person’s life who experiences SCA. There is an 85% survival rate when a defibrillator (AED) is applied within three minutes of a collapse.
- Heart screenings such as an echocardiogram that may detect a heart condition.
- Emergency action plans must be in place at every site and practiced regularly.
Heat
There are several forms of heat illness. Exertional heat stroke is the most severe form. This happens when a body's internal temperature exceeds 104 degrees Fahrenheit. It is vital for all sports constituents to be aware of the signs that an athlete may be experiencing heat stroke. Symptoms include:
- Hot/dry skin, profuse sweating.
- Confusion, slurred speech, altered mental status.
- Seizure symptoms.
- Loss of consciousness.
How we can help prevent and treat heat stroke:
- Acclimate an athlete to the environment gradually to improve exercise capacity in the heat.
- Practice early or late in the day when temperatures, UV levels and humidity are low.
- Provide frequent and adequate hydration breaks throughout practice.
- Utilize cooling mechanisms such as cold-water immersion tubs on sidelines during warm weather practices.
There is a crucial window of time in which an overheated athlete's temperature must be lowered. The core temperature must be lowered to about 103 degrees as quickly as possible, usually within 10 minutes. Athletes should be cooled before they are transported by EMS. Think: cool first, transport second.
Hemoglobin
Exertional sickling deaths occur in athletes carrying the Sickle Cell trait. Exertional sickling can happen when red blood cells change shape or "sickle," which causes a buildup of red blood cells in small blood vessels. A drop in blood flow can lead to a breakdown of muscle tissue, also known as rhabdomyolysis, which can be fatal.
How we can prevent and treat exertional sickling:
- Screen athletes for the Sickle Cell trait.
- Acclimate athletes with gradual increase of intensity when conditioning or lifting.
- Limit activity if an athlete with Sickle Cell is sick.
- Educate athletes, parents and coaches on the signs, symptoms, and treatment of exertional sickling.
- If someone sickles, the gold standard is to give them high-flow oxygen and nearly immediate IV fluids. Call 911 with an exertional sickling emergency.
Fortunately, catastrophic injuries in sports are not common, but do occur. To prevent these events from becoming tragedies, it is vital that athletes, coaches, and parents identify and act immediately when these situations arise.
The Top 10 Health Benefits of Youth Sports (healthfitnessrevolution.com)
Leading causes of death in high school athletes (courier-journal.com)
National Center for Catastrophic Sport Injury Research (unc.edu)
