Post on 05-Apr-2018
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Medical considerations
Dr Paul J Trafford
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Dr Paul J Trafford
Medical Director BTCC
Medical Advisor FIA Institute
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Officials, Doctors, Paramedics, Rescue,Marshalls, Organiser, Circuit Owners, Media, TV,
Journalists, Competitors etc.
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Concussion
Alteration in:
Concentration
Memory
Judgement
Balance
Coordination
Emotion
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Concussion
Associated with:
Headache
Nausea
Vomiting
Visual Disturbance
Amnesia
Sleep Disturbance
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Concussion
Important Features
Transient signs of confusion and disorientation
Presence or absence of Amnesia
Presence or absence of loss of consciousness ofany duration
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Concussion
Return to Competition aimed at reducing risk of:
further episodes of concussion more prone to in early post-concussion phase
second impact syndrome rare and controversial
catastrophic consequences
cumulative neurological damage multiple episodes of concussion
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Concussion
Concerns:
POST CONCUSSION SYNDROME
SECOND IMPACT SYNDROME
REPETITIVE BRAIN INJURY SYNDROME
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Concussion
Recommendations:
Accept what has happened
Expect to recover
Be honest about any symptoms
Talk to a doctor
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Concussion
Concussion Rates Higher in Adult Womenin multiple studies (reporting greater inwomen)
Recovery takes longer
Increased incidence of Post ConcussionSyndrome
Possible prolonged reduction inperformance testing
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Heat Stress
Larger surface area : mass ratio
Increased sweat gland density in women
Delayed onset and decreased sweating rates inwomen
No change with Oral Contraceptive Pill
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Heat Stress
Acclimatisation is more important than sexdifferences
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Motion Sickness
No difference between the sexes
Women report more motion sickness onquestioning than men
Early Cycle more associated with motionsickness than late
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Acceleration tolerance
NASA
Women and Men have equal tolerance to G
force
Women benefit by being shorter
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Burns
Some evidence to show survival in women ispoorer than survival in men in severe burns
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Strength
30y old
75% of male equivalent
50y old
50% of male equivalent
Non dominant hand shows greatest disparity
95th percentile female equating to 5th percentile male
Training can reduce the sex differences
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Size
50th percentile female = 5th percentile male
90th percentile female = 50th percentile male
Reduced hand and feet size for height
Decreased arm / reach / height
Reduced face width
Lower centre of gravity for height
Increased chest and hip size for height and weight
Reduced size can be an advantage in racing
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Oral Contraceptive Pill
Menstruation and normal cycle does not affect
exercise capacity and competitive success
Oral Contraceptive Pill may minimally reduce
aerobic capacity to exercise
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Fractures
Incidence
Up until 44y old men have a higher incidence of
fractures
Over 44y old, rate of fractures begin to increase
in women
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Osteoporosis
Lumbar vertebra
Age 37
Lumbar Vertebra
Age 84
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Change in bone density with age andoestrogen production
Hadji P, et al. Frauenarzt. 2005;47:1000-1005.
Age, years
Normal
Menopause
Peak bone mass
Puberty
SD
1.2
1.1
1.0
0.9
0.8
00 10 20 30 40 50 60 70
I I I I I I I
-
-
-
-
-
LS-BMD,g/m
2
Fracture risk
Decrease
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Osteoporosis
Vitamin D
Vitamin D is needed for bone formation
Sunlight is needed for Vitamin D production
North of Birmingham in UK sunlight too weak in
Winter to produce sufficient Vitamin D
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Osteoporosis
Vertebral crush fractures more common
Older women more prone to these
Especially if live in Northern Hemisphere
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Other
Hair
Long hair in men or women can cause problemswith helmets
Jewellery In men and women jewellery can result in injury
in accidents and transfer heat in burns
Bra
Metal stiffeners in bras can cause injury andtransfer heat in burns
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All jobs should be open to everyone unlessthey actually require a penis or a vagina
Florynce Kennedy
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Winning is based on more than individualperformance indicators
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