Mild EH No IV fluids Consider oral fluid restriction Pt may drink salty oral fluids like V8, Coke, or chicken broth (4 bouillon cubes in 4oz water).
Mild EH Defined by Na+ less than 135mmol/L with headache, paresthesias, nausea, bloated/swollen sensation Severe EH Defined by Na+ less than 135mmol/L with decreased mental status, confusion, disorientation, agitation, delirium, seizures, respiratory distress Risk factors Finishing time over 4 hours Marathon running inexperience Small stature Female gender NSAID use Unusually hot conditions London Marathon Br J Sports Med Jan 45(1):14-9. If the patient is too nauseated to tolerate oral fluids antiemetic medications are available.ĭilutional decrease in serum sodium concentration during physical activity caused by: Over hydration Salt losses in sweat Fluid retention enhanced by increased ADH secretion during running Incidence 12.5% of marathon runners.
Oral rehydration is safer and less expensive. You should give her a liter of IV normal saline.ħ False It would be appropriate to check her core temperature (rectal thermometer) and serum electrolytes. Runners with EAC will be exhausted, lightheaded, unsteady on their feet or unable to standĮvaluate in supine position with legs elevated Oral rehydration Cooling Rest Most patients will recover in 30 min Monitor for MENTAL STATUS CHANGES or failure to progress – which might suggest Exertional Hyponatremia Hyperthermia Cardiac Arrest Hypothermia HypoglycemiaĦ True or False? A patient with suspected exercise associated collapse is not improving despite 30 minutes of rest with her legs elevated, gentle cooling and oral fluids. This is the most common medical problem encountered after marathons 59-85% of all post-marathon medical visits Br J Sports Med Nov 45(14): EAC is caused by a postural drop in systolic blood pressure Inactivation of the calf muscle pump upon cessation of prolonged exercise Results in lower extremity venous blood pooling, reduced atrial filling pressure, and subsequent syncopeĤ Exercise Associated Collapse Presentation These issues include: Exercise Associated Collapse Heat-Related Illness Exertional Hyponatremia Cardiac Arrest Stress Fracture
This course is designed to introduce you to the most common and most important conditions you’ll be treating in the medical tent. 1 Marathon Medicine Medical Volunteer Training Courseīen Nelson MD Essentia Health Sports Medicine Grandma’s MarathonĢ Introduction Thank you very much for volunteering to provide medical coverage at Grandma’s Marathon.
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