Current sports medicine reports
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The increasing use of automated external defibrillators (AEDs), coupled with methods to improve cardiopulmonary resuscitation and implementation of early defibrillation, have significantly improved survival from sudden cardiac death (SCD) in the prehospital setting. This article reviews the evidence and principles of management of SCD in the sports setting. It is noted that ventricular fibrillation is the most common arrhythmia causing SCD in athletes. ⋯ New evidence on pharmacotherapy in SCD is also reviewed. Although drug administration in SCD is unlikely to be required in the sports setting, clinicians are updated on some of the newer considerations. Finally, selected articles from the recent literature on advanced cardiac life support are provided to guide the team physician in using the most current approach to the management of SCD.
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The threatened airway is, fortunately, an infrequent occurrence in sports medicine, but one that requires up-to-date knowledge and skill in order to be managed in an effective and timely manner. Sports medicine physicians are responsible for having the education and tools required to secure a compromised airway in any setting. ⋯ This article offers physicians some perspective on the newest innovations that exist in airway management in comparison with the standard equipment and techniques. It is up to sports medicine physicians to develop treatment algorithms they are comfortable with, should they encounter an airway emergency.
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This article reviews sideline assessment and treatment of commonly encountered joint dislocations. Although often deferred for formal management in an emergency room, many of these injuries can be safely and appropriately reduced by experienced hands on the field. ⋯ Emphasis is placed on awareness of possible complications of injury and from treatment, proper documentation of neurovascular status before and after intervention, and formal radiographic confirmation following joint reduction. When appropriate, the immediate sideline management of common joint dislocations may minimize morbidity encountered with later treatment in the hospital setting.
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Physicians are increasingly called upon to provide medical support for mass gatherings such as concerts, sporting events, political conventions, and other special events. Until recently, individuals planning such support have had little reliable information to assist them in determining what specific personnel and equipment are necessary to optimally support a mass gathering. Recently, the National Association of Emergency Medical Services Physicians established and published the most definitive and up-to-date document to assist a physician with planning medical care for a mass gathering: Mass Gathering Medical Care: The Medical Director's Checklist. As one of the most important developments in mass gathering medicine, this article highlights and discusses key areas of the document.
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Infectious mononucleosis is an extremely common problem in the athletic population. "Mono" occurs in 3% of college students. Diagnosing infectious mononucleosis requires an understanding of the clinical features such as fever, lymphadenopathy, pharyngitis, and splenomegaly, as well as laboratory findings. The time at which these clinical features and laboratory abnormalities develop is also important to understand. ⋯ This article provides an overview of infectious mononucleosis. The most common complications are reviewed and the management of these problems discussed. A practical approach to determining when an athlete may return to activity is presented.