Page 120 - Athletic Health Handbook
P. 120
is a disease of airflow obstruction, cian. Exercise is a common trigger in therapy for their degree of asthma.
not oxygenation, and typically the atopic asthma and EIB. Non-pharma- The sports medicine physician
asthmatic is not hypoxic. Acute cological treatment options include should have a low threshold to refer
attacks should be treated with the avoidance of triggers and brief warm- an athlete who continues to need a
rescue medications, either in inhaler up periods. The pharmacological rescue inhaler during a practice or
or nebulized form, and any offending therapies are divided into chronic game, has typical asthmatic symptoms
triggers should be removed. This medications used to control asthma and is not on therapy, fatigues early, or
should involve moving the athlete and rescue medications used to treat whose performance starts to decline
from the hot humid playing field to attacks and symptoms. The average over time to a pulmonary specialist.
the cooler clubhouse or locker room. sports medicine physician will The athlete can then begin the proper
Status asthmaticus, which presents as encounter many athletes with asthma medication and develop a care plan
a prolonged and severe asthma attack, classified as intermittent or mild, to manage their asthma. With proper
may break over time with intense but will occasionally meet moderate therapy, the athlete can return to
therapy, but will not quickly resolve to severe asthmatic athletes. Many their sport and remain competitive,
with a rescue inhaler. Patients who fail patients are still not on appropriate and lead a normal life.
to immediately respond to their rescue
medications, or who have a second
attack once they proceed exercising
again should immediately stop exer-
cising and be evaluated by emergency
services. Epinephrine injection, a
non-specific therapy, will help with
bronchospasm and potentially bridge
the severe patient until they can be
transferred to an emergency depart-
ment. Typically, the athlete comes
prepared to a game or practice with
his or her own rescue medication,
but the team physician or trainer
should have a beta-agonist (such
as albuterol) available.

Education is the key to treating
asthma. The coaches, athletic trainers,
and team doctors must have clear
discussions with their players. Today’s
athlete continues to push himself or
herself harder, working to the edge of
exhaustion. Many asthmatic athletes
want to prove they can do the same
as others, and may ignore early
symptoms so as not to appear weak
or unfit. This environment should
be conducive to an athlete taking a
time-out for needed asthma therapy.
Athletes who remove themselves
temporarily from a practice for
therapy should be encouraged and
supported, and never penalized.

Unfortunately, an asthmatic’s
symptoms are not always clear to the
athlete or the sports medicine physi-

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