Catastrophic injuries can occur during sport participation. Catestrophic injuries include death, coma, severe brain injury and paralysis. They can be classified into various categories based on causation.


Categories of catastrophic injury:

(1) direct (traumatic)

(2) indirect (nontraumatic)


The risk for direct injury is greatest in the contact sports but can occur in other sports where there is a risk of fall and/or contact with an object (cheerleading, gymnastics, pole vaulting, bicycling).


Direct contact can lead to catastrophic injury with:

(1) head injury

(2) cervical or thoracic spine injury

(3) commotio cordis

(4) splenic rupture or other inta-abdominal injury


Causes of indirect catastrophic injury include:

(1) hypertrophic cardiomyopathy

(2) coronary artery disease

(3) other cardiovascular condition

(4) heat illness

(5) exertional hyponatremia (with sweat replaced by water)

(6) dehydration

(7) thromboembolism

(8) asthma

(9) lightning

(10) sickling hemoglobinopathy


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