Identifying Sudden Cardiac Arrest Risk in Adolescent Male Athletes.

The purpose of the study was to determine the prevalence of sudden cardiac arrest (SCA) risk factors in high school (HS) athletes. Thirty-three male soccer players from a public HS in the southeastern United States (ages 14-17) self-reported survey data. Participants reported demographic, lifestyle, heart health, COVID-19 history, and symptoms indicative of SCA risk. An electrocardiogram (ECG) assessed heart rate (HR), rhythm, and electrical activity. Resting HR and blood pressure (BP) were measured with a BP monitor. The association between COVID-19 history, HR, and BP were calculated. Participants were divided into ECG groups (normal or abnormal). Independent t-tests assessed comparisons between groups to identify SCA risk. Over 50% of participants (n=17) reported experiencing shortness of breath (SOB) and 30% (n=10) reported chest pain. A history of chest pain was associated with abnormal ECGs (p<0.04). Thirteen (39.4%) participants reported a COVID-19 history. Of these, 5 presented with persisting symptoms, 2 with elevated HR, and 3 with elevated BP. Eleven (33.3%) participants had an abnormal ECG and of these eleven, 8 (72.7%) reported a positive COVID-19 history (p<0.01). The current American Heart Association suggested screening method is limited. An ECG should be used in preparticipation screenings (PPS) and return to participation (RTP) decisions for athletes with a COVID-19 history. Family cardiac history, chest pain during exercise, and an abnormal QRS interval should be used to identify SCA risk.

Principles of Rehabilitation.

Developing and implementing a rehabilitation program is one of the most challenging patient care skills because it requires a firm grasp of the healing process and available treatment options, which must then be serially compared with the pathologic condition of the injury and the patient's progress. This cyclical problem-based approach to rehabilitation allows clinicians to most effectively individualize the rehabilitation plan to the patient's individual needs and progress. In each phase of the rehabilitation process, problems should be identified and goals developed taking into consideration the phase of healing.

National Athletic Trainers' Association Position Statement: Immediate Management of Appendicular Joint Dislocations.

OBJECTIVE: To provide certified athletic trainers (ATs) with recommendations and guidelines for the immediate management of patients with joint dislocations. BACKGROUND: One of the primary responsibilities of ATs is to provide immediate injury care for active individuals. Although ATs are confronted with managing patients who have many kinds of injuries, the onsite management of a joint dislocation presents challenges in evaluation and immediate treatment. The critical concern in managing a dislocation is deciding when a joint can be reduced onsite and when the patient should be splinted and transported for reduction to be performed in the hospital or medical setting. Factors that influence the decision-making process include the following: whether the AT possesses a documented protocol that is supported by his or her supervising physician(s), employer documents, and respective state regulations; the AT's qualifications and experience; the dislocated joint; whether the dislocation is first time or recurrent; the patient's age and general health; and whether associated injuries are present. RECOMMENDATIONS: These guidelines are intended to provide considerations for the initial care of specific joint dislocations. They are not intended to represent the standard of care and should not be interpreted as a standard of care for therapeutic or legal discussion.