Sports have been passed down from generation to generation, since the start of the first pitch or first pass. Following the tradition of sports being passed down to the younger generation are also concussions. Concussions have been following sports since the dawn of time, and it has always been a worrisome topic. When you bring pediatrics into the mix it gets more difficult. Since the start of healthcare providers, we have always had to make the best decision for a patient who has sustained a concussion, or Traumatic Brain Injury (TBI). We have also had to recognize and judge if the patient has sustained a TBI, and the Signs & Symptoms (S&S) following the TBI.
In the journal article “Rough Play” the topic was brought up about concussions involving children, and who is most likely to get a concussion from anything. 70% of the patients were boys between the ages of 10-19 years old. The younger boys or girls were likely to be injured playing on a playground. The older the boys got, the more likely they would get hurt playing some type of sport like football. The older the girls got, the more likely they would be injured playing soccer, biking, or basketball. In 2001, there were 153,000 cases reported of children going to the Emergency Department for concussions, and in 2009 there was a jump in reported cases to 250,00. The jump in reported concussion cases was because there was an increase in public awareness of concussions in any age group and the fact that concussions may have long-lasting effects. A couple of weeks after the concussion you may have lingering physical effects, like your reaction time may be a little slower than normal, or you may still have a headache from the concussion.
Recognition of a TBI is very important. You as a healthcare professional don’t want to be at a football game and get called over to a patient who has just collapsed because he was hit extremely hard and he has a concussion, which you don’t recognize. The patient gets hurt and is not able to play for the rest of the summer and loses his scholarship or even worse, the patient is paralyzed because you cleared him to continue playing football. Recognition of a concussion can be very difficult, and it would get more challenging if the patient’s normal level of consciousness (LOC) is different, to begin with. When you recognize a patient may have a TBI you need to make sure that the patient does not return to an activity that may worsen the TBI and cause the patient to become paralyzed.
The patient does not always need to be hit in the head to have a TBI. The patient can get hit in the back, neck, or head and receive a TBI. Let’s say a patient jumps up to catch a ball and is tackled in midair, and he falls over and gets up a few seconds later. He complains of back pain, and he is having trouble walking. Would your first thought be a TBI or a spinal injury that needs to be immobilized? It could be either because the Mechanism of Injury (MOI) is consistent with either the TBI or a spinal cord injury. So you would want to check the patient out for a concussion, plus you would want to make sure the patient does not try and move because that could cause further injury to his spinal cord.
Along with noticing the MOI, it might suggest the patient has received a TBI, you can also look for S&S of a concussion. S&S include headache, nausea, fatigue, sensitivity to light, stunned, and balance problems. The patient may have a bunch of different S&S, such as answering questions slowly, repeating questions a lot, and forgetting recent information.
Since the start of sports and concussions, there has been a need for patients and healthcare professionals to look out for a person who may have a concussion, and treat him/ her accordingly to make sure that the patient does not cause any further damage to themselves or others. While you are treating this type of patient always remember that they are unstable, and could forget at any moment who you are, and what happened. You will need to be careful and always treat any patient with respect, and honesty the way you would want to be treated if you were in their shoes. As discussed in the journal article “Rough Play”, when there is a severe enough MOI involved in the incident, there could be a possible TBI. Concussions have been around forever, but now we are more aware and conscious of them.
References
Meredith, MD, Mark. “Rough Play.” JEMS, Journal of Emergency Medical Services Apr. 2012: 52-57. Print.
