1. ATHLETES WITH SICKLE CELL Sports Injury Management

2. What does it look like? 1:12 African-Americans have the sickle cell trait.

3. SIGNS / SYMPTOMS Sluggish, cramping, disorientation Heat issues at the beginning or end of practice Fatiguing pain, normal muscle appearance, exhaustion to point of motionlessness

4. HOW CAN I TELL THE DIFFERENCE? CARDIAC ISSUES sudden collapse, no prodromal issues SICKLE CELL sluggish, cramping, disorientation EXERTIONAL HEAT COLLAPSE prolonged exercise in hot/humid environment SICKLE CELL happens with intense exercise at the beginning or end of practice

5. HOW CAN I TELL THE DIFFERENCE – con’t. CRAMPING obvious spasm, severe pain, intense reaction, locking up, difficult to return to practice/play SICKLE CELL normal muscle appearance, fatiguing pain, exhaustion to the point of being motionless, collapse, can return with rest after episode

6. PRECAUTIONS BE AWARE OF YOUR ATHLETES!!! Know who has the sickle cell trait! Build intensity slowly; allow athlete to “sit out” of Day One performance tests such as mile runs and serial sprints (these activities increase the levels of lactic acid → require longer recovery periods) Stop activity with associated S/Sx; heat, dehydration, and asthma are predisposing factors Year-round conditioning is encouraged

7. TREATMENT Activate your Emergency Action Plan – make participants aware of potential problem Check / monitor vital signs Administer O₂ at 15 l/min (ONLY IF WITHIN YOUR SCOPE OF PRACTICE) Cool the athlete (avoid using ice to avoid vasoconstriction, use “cool” instead If vitals drop, call 911; call hospital to inform ER of on-the-field evaluation

8. PARTING THOUGHTS Sickle cell athletes usually do well if they are allowed to “set their own pace.” Medical testing to screen for Sickle Cell is quite inexpensive ~ $5 for the initial screening, $30 to confirm a positive response = the average cost of a pair of NIKE receiver gloves READ MEDICAL HISTORY OF ALL ATHLETES!