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Dr Derek Martin Medical Officer For the GB Paralympic Swimming Team.

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Presentation on theme: "Dr Derek Martin Medical Officer For the GB Paralympic Swimming Team."— Presentation transcript:

1 Dr Derek Martin Medical Officer For the GB Paralympic Swimming Team

2 Recent Past Athens Gold 20 Silver 16 Bronze Total 52

3 Durban World Championships Gold 14 Silver 16 Bronze Total 52

4 World Champions

5 Amputees Stump injuries/infection Prosthesis shorter for the swing through -hip, pelvic and back pain. Injuries to artificial limbs! Falls

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8 Visually Impaired Classification Total Up to 2/60 /or a field of less than 5 degrees. 2/60 – 6/60 or field loss of 5-20 degrees Falls/cuts/collisions Missed tapping Poolside checks

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13 Cerebral Palsy Complex condition Spastic – motor cortex Choreo-athetoid – Basal Ganglia or Cerebellum Mono-Quadriplegia Epilepsy Intellectual impairment Visual defects Speech impairment

14 Spinal Lesions/Injuries Sensory/motor loss Urinary retention Fractures due to osteopenia Bowel impaction Pressure sores Increase in shoulder injuries. Hand, median/ulnar nerve injuries Access Punctures

15 High Spinal Injuries Thermoregulation Autonomic dysreflexia Boosting Impaired cardiac response above T2-4 Loss of intercostal muscle function

16 Thermoregulation Loss of autonomic function Loss of sensory afferent impulses below level of lesion may limit hypothalamic response. Loss of sweating/vasodilatation. Loss of shivering Strategies needed for extreme conditions

17 Autonomic Dysreflexia Medical emergency Lesions above the splancnic sympathetic outflow (C2-T6) Irritant stimuli below this level

18 Causes Bladder distension Irritation of the urinary tract Skin ulcers Fractures Abdominal emergencies Uterine contractions

19 Mechanism Impulses ascend the spinal chord to the sympathetic cell bodies resulting in massive sympathetic discharge.

20 Symptoms Intense headache Profuse sweating Nasal stuffiness

21 Signs Goosebumps Facial erythema Pallor distal to lesion Blood pressure > 200 mm Hg

22 Sequelae Seizures Pulmonary oedema Increased force and rate of cardiac contractions Dysrythmia Cerebral haemorrhage Death

23 Treatment Treat the underlying cause Sit patient up Sublingual nifedipine

24 Boosting Increased output 7-10% Banned in 1994 Call up room checks if BP > 180 mm Hg systolic athlete withdrawn Previous records can be requested Policing difficult

25 Multiple Disability Athens opening ceremony Paraplegia Epilepsy Laryngomalacia Ulcerative colitis Ileostomy

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27 Thank You!


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