Aug 2, 2017 4 min read

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As an emergency medicine doctor, Dr. Tony Aprea of Washington Health System has seen his fare share of sports-related injuries as students prepare to go back to school – and back on the playing field. We spoke to the Washington resident about how to stay out of the ER, and what you should look for once you leave it in some situations.

What types of injuries/illnesses do you see more of as August and September come, particularly with school-aged children and teens? By the same token, do you tend to see more school-aged children and teens in general during this time?

At this time of year, we do see different illnesses than in the fall/winter. In July and August, there is always an influx of heat related illness, as well as injuries from outdoor activities. We will start to see an increase in school-aged visits towards the end of August as fall practices start, and September is typically our busiest month for school-aged patients.

What are the signs and symptoms of dehydration and heat exhaustion/heat stroke? How important is quick treatment in these cases?

Dehydration is something we see year-round, with a spike in the summer. Typical symptoms are: nausea/vomiting/diarrhea, dry mucous membranes, tachycardia (a heart rhythm disorder in which the heart beats faster than normal while at rest), dizziness and low blood pressure. Heat exhaustion patients have all of these symptoms, they continue to sweat and usually have normal mental status. Patients with heat stroke at times will have a high core body temperature (over 104), stop sweating and become very confused, even to the point of being unresponsive in severe cases.

It is extremely important to treat these patients as quickly as possible. These patients need to be removed from the environment causing their problem, and be immediately cooled. We do this by using ice packs to their armpits/groin, IV fluids and at times spraying the patients with cool mist and running fans over them. They can also be cooled by cool-water baths. Usually, you can stop cooling when their temperature comes down below 102.

Heat cramps are seen frequently during football season. Athletes will get spontaneous cramping of muscles during activity, which can be very painful. Stretching along with rehydration with electrolyte containing fluids are the mainstays of treatment.

What is the protocol for treating a concussion, and what should parents look for after leaving the hospital?

Concussion treatment has changed quite a bit in the past few years and the typical grading scale we used for head injuries in the past has fallen by the wayside. Anytime an athlete or patient strikes their head and has a headache, it is technically a concussion. Athletes should not return to play unless they are completely symptom free. Things to look for after discharge from the hospital are somnolence (sleepiness or drowsiness), change in mental status, difficulty awakening the person, nausea, vomiting, blurred vision or any change or discrepancy in size of eye pupils. Most high school students are getting IMPACT testing prior to the start of sports seasons. IMPACT testing gives the a baseline look at their cognition so if they sustain an injury, they can repeat the test to monitor how well they are recovering.

What are some things that student athletes should keep in mind when they start training and practicing for fall sports?

Stretch – I can’t stress enough how important stretching can be to avoid injury. Also, light conditioning prior to beginning a season makes it much easier to handle the stress of practices in the summer heat. Athletes need to continually hydrate when in hot/humid temperatures and make sure they are getting adequate meals/lunch in between sessions.