Emergency Assessment and Management of the Athlete
On-field approach
Use a systematic primary survey (airway, breathing, circulation, disability, exposure) and assume cervical spine injury in any athlete with head/neck mechanism, neck pain, or altered mental status. Do not remove helmets/pads unless trained and necessary. Recognize sudden cardiac arrest: unresponsive, not breathing normally-start CPR and use an AED immediately; early defibrillation is the strongest survival determinant.
Environmental illness
Heat stroke is a medical emergency: core temperature >40°C with CNS dysfunction-cool immediately (ice immersion) and do not delay for measurement perfection. Exertional hyponatremia presents with confusion, seizures, or vomiting in endurance athletes who overhydrate; treat with hypertonic saline, not free water. Hypothermia and lightning safety are also high-yield.
Traps and rule of thumb
Trap: attributing collapse to dehydration or heat when it is cardiac arrest-if unresponsive and not breathing normally, start CPR. Rule of thumb: in heat stroke, "cool first, transport second"; in suspected hyponatremia with neurologic symptoms, do not give free water.