Exertional Sickling in Athletes: Treatment and Prevention

presented by Susan Yeargin, PhD, ATC and Clint Haggard, MA, ATC, NREMT-B

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Disclosure Statement:

Financial: Clint Haggard receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Susan Yeargin receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Non-Financial: Clint Haggard has no competing non-financial interests or relationships with regard to the content presented in this course.

Non-Financial: Susan Yeargin serves on the Korey Stringer Institute Medical and Science Advisory Board, and is a faculty member at the University of South Carolina.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 59 Minutes, Learning Assessments: 24 Minutes

Sickle cell trait is a common hemoglobinopathy that can have mortality or morbidity consequences if not treated promptly and correctly. This course provides detailed information on the treatment of exertional sickling events across different clinical sites. Clinicians will become knowledgeable in how exertional sickling treatment can differ depending on when intervention occurs. Current consensus on return-to-activity guidelines after an exertional event are presented. Clinicians will be able to develop the foundation of a return-to-activity protocol for their institution to prepare for when exertional sickling episodes occur. Predisposing factors are divided into internal and external categories. Clinicians will be able to determine which predisposing factors are relevant at their clinical site and determine which prevention strategies need to be implemented. This course relates to athletic trainers who work in different clinical settings (e.g., all organized sports and military), sports board-certified physicians, strength and conditioning coaches, and sports board-certified physical therapists that work in any level of organized sport.

Meet Your Instructors

Susan Yeargin, PhD, ATC

Susan Yeargin is an associate professor of athletic training at the University of South Carolina. She serves on NATA's pronouncements and research committees. She was a task force member and author of the "Preseason Heat-Acclimatization Guidelines for Secondary School Athletics" and a coauthor of the recent NATA position statement update on exertional heat illnesses. She…

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Clint Haggard, MA, ATC, NREMT-B

Clint Haggard is in his 12th season at the University of South Carolina. He was named head football athletic trainer on July 22, 2009. Prior to his arrival in Columbia, South Carolina, Haggard served as the assistant athletics director for medical services/head athletic trainer at Rice University, a position he held from 2006 to 2009.…

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1. Treatment: Early Intervention

When an exertional sickling episode is recognized early, treatment can improve the likelihood of quick return to activity. This chapter will outline each step that clinicians should take when intervening early and providing treatment to an athlete with known SCT status.

2. Treatment: Moderate to Severe Cases

Similarities and differences in the treatment of more severe cases of exertional sickling are covered. Additionally, transport and hospital decisions are discussed to ensure that best possible care is provided when care transitions from the on-site responder. Information that should be conveyed to EMS and the receiving emergency department is provided.

3. Return to Activity

The basic elements needed for return to activity in mild to severe cases are provided as well as how additional considerations may be needed in more severe cases. General guidelines for developing an institutional-graded return-to-activity protocol are given. Examples of when medical disqualification may need to be considered are provided.

4. External Risk Factors and Prevention

Factors with external causes that increase the risk of exertional sickling are provided in addition to the physiological reasoning behind each factor. Physiological reasons include altitude, hyperthermia, acidosis, and pressure. After each factor is explained, one or more paired prevention strategies are recommended to reduce risk.

5. Internal Risk Factors and Prevention

Factors with internal causes that increase the risk of exertional sickling are provided in addition to the physiological reasoning behind each factor. Physiological reasons include respiratory conditions, illnesses, poor sleep, inadequate nutrition, and hypohydration. After each factor is explained, one or more paired prevention strategies are recommended to reduce risk.

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