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Brian W. Potter

Column-editor : James M. Mensch

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Richard J. Boergers, Thomas G. Bowman, Nicole Sgherza, Marguerite Montjoy, Melanie Lu and Christopher W. O’Brien

Key Points ▸ Lack of personnel and training are barriers for prehospital equipment removal. ▸ Athletic trainers do not frequently practice equipment removal with emergency medical services (EMS). ▸ Athletic trainers do not have confidence in EMS equipment removal skills. One of the primary roles of

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Lindsey E. Eberman, Stephanie M. Mazerolle, Kelly D. Pagnotta, Kristin A. Applegate, Douglas J. Casa and Carl M. Maresh

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Carol Biddington, Mary Popovich, Noel Kupczyk and Joni Roh


Certified athletic trainers (ATCs) must be able to manage sport-related emergencies.


To report emergency medical services (EMS) directors’ perception of how ATCs manage emergencies and ATCs’ comfort level in managing them.


2 descriptive questionnaires.


EMS directors (n = 64) were asked about their perceptions of ATCs’ ability to handle emergencies. ATCs (n = 224) identified their comfort level with handling emergencies.


EMS directors who had preseason meetings with ATCs had a significantly better perception of the ATCs’ ability to handle emergencies than did those who did not have preseason meetings. ATCs with advanced certifications (emergency medical technician-basic, emergency medical technician-paramedic, and automated external defibrillator) were more comfortable handling emergencies than those without.


EMS directors and ATCs revealed that ATCs could manage most emergencies that might arise in athletic activities. ATCs had a higher perception of their own ability to manage emergency situations than did the EMS directors.

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Martin D. Hoffman and Thomas M. Myers

Symptomatic exercise-associated hyponatremia (EAH) is known to be a potential complication from overhydration during exercise, but there remains a general belief that sodium supplementation will prevent EAH. We present a case in which a runner with a prior history of EAH consulted a sports nutritionist who advised him to consume considerable supplemental sodium, which did not prevent him from developing symptomatic EAH during a subsequent long run. Emergency medical services were requested for this runner shortly after he finished a 17-hr, 72-km run and hike in Grand Canyon National Park during which he reported having consumed 9.2–10.6 L of water and >6,500 mg of sodium. First responders determined his serum sodium concentration with point-of-care testing was 122 mEq/L. His hyponatremia was documented to have improved from field treatment with an oral hypertonic solution of 800 mg of sodium in 200 ml of water, and it improved further after significant aquaresis despite in-hospital treatment with isotonic fluids (lactated Ringer’s). He was discharged about 5 hr after admission in good condition. This case demonstrates that while oral sodium supplementation does not necessarily prevent symptomatic EAH associated with overhydration, early recognition and field management with oral hypertonic saline in combination with fluid restriction can be effective treatment for mild EAH. There continues to be a lack of universal understanding of the underlying pathophysiology and appropriate hospital management of EAH.

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believed athletic trainers are the most qualified health care providers to perform athletic equipment removal. a. True b. False 13. In order to reach the adequate number of personnel, most athletic trainers will need to work with emergency medical services personnel to perform their desired emergency

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Zachary Y. Kerr, Susan W. Yeargin, Yuri Hosokawa, Rebecca M. Hirschhorn, Lauren A. Pierpoint and Douglas J. Casa

(fatigue, electrolyte losses, cardiovascular inefficiency, and hypohydration); in particular, the treatment of exertional heat stroke has focused on rapidly reducing core body temperature via cold-water immersion. Transportation for EHI by emergency medical services has also been used, with previous

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Riana R. Pryor, Douglas J. Casa, Susan W. Yeargin and Zachary Y. Kerr

backup 21.5 (175/814) 18.7 (62/331) 23.4 (113/483) .112 Abbreviations: AT = athletic trainer; EHI = exertional heat illness; EMS = emergency medical services. Note . p values are from χ 2 tests unless the expected cell sizes are <5, for which a Fisher exact test was performed. p  ≤ .05 indicates

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Kelley D. Henderson, Sarah A. Manspeaker and Zevon Stubblefield

for the arrival of emergency medical services. Upon admission to the ED (14:26), the patient’s vitals were recorded as a blood pressure of 119/69 mmHG and a pulse rate of 103 beats per minute. The patient was unable to produce urine for analysis at this time; however, blood tests performed at 14

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Gary Allen, Kristy Smith, Brady Tripp, Jason Zaremski and Seth Smith

state he was recovering from a gastrointestinal illness from 1 day ago. The patient became increasingly unresponsive, with acute mental status decline within 30–60 s, prompting the athletic trainer to activate emergency medical services (EMS). Given the patient’s symptoms and the 80° wet bulb globe