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Trauma and Injury Prevention Section Newsletter - Summer 2016

Sports Medicine Edition

Chair's Corner

Ali RajaAfter the success of our last two themed issues on geriatric trauma and the work our members are doing to combat the opioid epidemic, we’ve decided not to mess with success and continue with theme-specific newsletters. This edition shines a spotlight on sports medicine and is once again organized by our outstanding resident Newsletter Editor, Dr. Elizabeth Johnson. We have great articles focusing on concussion prevention and sports injury epidemiology (just in time for summer backyard football) as well as exertional heat stroke (be careful when running on the beach!). We also focus on the ACEP/CDC guidelines, for those of us who haven’t seen them in a while.

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Concussion Prevention and the Future of American Football

Jefrrey Feden 2016

The concussion epidemic has captured significant attention in the mainstream media and the sports medicine community over the past several years. On the heels of a landmark NFL settlement and growing concerns over chronic traumatic encephalopathy, the safety of American football has come under scrutiny. It should be no surprise, then, that the future of the sport is at a crossroads.

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Mild Traumatic Brain Injury (MTBI) in the Emergency Department

Imoigele P. AisikuIn the United States, an estimated 2.5 million people annually present to the emergency department with TBI with 87% of the patients treated and discharged from the ED[1]. Patients with traumatic brain injury of varying severity are managed by multiple services (neurology, trauma, neurosurgery, and emergency medicine) in most institutions. MTBI patients are often managed in the ED and present with a variety of symptoms including headache, dizziness, fatigue, anxiety, depression, irritability, and personality changes. As many as 62% of patients post MTBI continue to have one or more of these symptoms at 3 months post injury [2, 3]. The increasing attention in the media, athletic, and military communities have highlighted the cognitive dysfunction and psychosocial impairment that is less well managed once the physical trauma has been managed.

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Epidemiology of ED Sports Injuries

Johnson2015

With the arrival of summer, more adults and children are playing sports, which inevitably means that emergency departments across the country will see an increase in visits due to sport-related injuries. In fact, sports related injuries are becoming more common. Between 2001 and 2013, it is estimated that there were 16,000,000 sports related injuries among patients aged 5 to 18. On average, a sports injury related ED visit will cost $1,200 and 1.6% of all sports related injuries required a hospital admission. Each year, the numbers have been increasing as more children are enrolled in sports and more adults are joining sports leagues.

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Exertional Heat Stroke

Raukar

I am writing this while at a conference at the NCAA in Indianapolis. Doug Casa, Ph.D., the foremost authority on exertional heat stroke and director of the Korey Stringer Institute, presented athlete after athlete who either died or ended up in a unit and/or on a transplant list as a result of heat stroke. When these cases were dissected, the failed intervention became clearer. In some instances, rapid cooling was never initiated on the sideline. In some, it was initiated but then stopped when EMS arrived and transported the patient, instead of allowing the patient to cool before transport; a mantra of the National Athletic Trainers Association (NATA).

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Make a Difference: Write that Council Resolution -- Deadline July 18, 2016

Many College members introduce new ideas and current issues to ACEP through Council resolutions. This may sound daunting to our newer members, but the good news is that only takes two ACEP members to submit a resolution for Council consideration. In just a few months the ACEP Council will meet and consider numerous resolutions.

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