Runners with Exercise Associated Collapse may not actually collapse. They may walk into the medical tent with various complaints. Symptoms may include exhaustion, fatigue, feeling hot/cold, nausea, stomach cramps, lightheaded, headache and leg cramps. Physical signs may include abnormal body temperature, unconsciousness, altered mental status, CNS changes, inability to walk unassisted, leg muscle spasms, tachycardia, vomiting, and diarrhea
- Elevate legs 12 inches above their core (Trendelenburg)
- Review history for previous cardiac issues and for risk factors.
- Consider obtaining a rectal temperature if questionable mental status
- Be ready with a red bag/bucket for vomiting
- Encourage oral fluid intake once nausea resolved
- Runner should have normal mental status and be able to sit-up then stand and then walk without symptoms prior to discharge
Anticipated treatment time in medical tent is 20 minutes. If the runner is non responding within 15 minutes or is getting worse then:
- Repeat vitals (HR, BP, rectal temperature)
- Obtain IV access
- Check an I-Stat sodium level
- If abnormal (<135) see Exercise Associated Hyponatremia page
- If normal (> 135) infuse one liter of 0.9% normal saline over 30 minutes
- Once IV fluids are administered, the patient must be able to urinate prior to discharge.
Consider alternative etiologies if the patient continues to be unresponsive to medical treatment.