Case Study- Joe is a 14 yo Hispanic male currently participating in competitive skateboarding. He wears the regulation helmet while competing, but often chooses a half helmet while practicing because...

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Case Study- Joe is a 14 yo Hispanic male currently participating in competitive skateboarding. He wears the regulation helmet while competing, but often chooses a half helmet while practicing because it's lighter. 3 days ago he hit his head when he fell from the top of the half pipe while practicing a new trick. He states that at the time he felt fine but now is nauseated and dizzy. He reports that he often falls when practicing so he didn't think this was such a big deal. He weighs 112 lbs and is 5 foot 4 inches tall. His mother brings him to your clinic for treatment.

1. What are the symptoms of an acute concussion?


2. Name 2 reasons why the often go unnoticed in a teen athlete.


3. What are the possible long term complications of repeated concussions.


4. Which teen athletes are are greatest risk for concussions?


5. Should female athletes be worried?


6. Should those playing non contact sports (like baseball) be worried?


7. Find a professional journal article describing the treatment of concussions in teens and describe the appropriate diagnostic criteria and treatment plan for Joe. Attach a copy of the article and give the citation in APA format.




JNN20208 286..290 Copyright @ 201 American Association of Neuroscience Nurses. Unauthorized reproduction of this article is prohibited.1 Concussion and the Adolescent Athlete Donald E. Kimbler, Marguerite Murphy, Krishnan M. Dhandapani ABSTRACT Traumatic brain injury (TBI) is a complex and debilitating neurological injury that places a significant financial and emotional burden on both families and medical providers. Accumulating evidence suggests that mild TBI or concussion remains grossly underdiagnosed, as compared with more severe TBI, due to a poor understanding of the clinical signs and symptoms involved with a head injury. Notably, pediatric head injury may be associated with the subsequent development of serious, long-term neurological consequences, emphasizing the need for improved diagnosis and acute medical intervention. The purpose of this minireview is to summarize the association between participation in youth athletics and the occurrence of concussions, a primary source of mild TBI in the adolescent population, with the goal of increasing awareness within the nursing profession for this clinically important yet underdiagnosed form of brain injury. T raumatic brain injury (TBI) is a leading causeof death and disability across all populationdemographics. Over 57 million people world- wide live with the neurological consequences of a TBI, including 10 million people who require hos- pitalization (Zitnay et al., 2008). Within the United States, over 1.7 million Americans experience TBI annually, resulting in 275,000 hospitalizations and 52,000 deaths (Bramlett & Dietrich, 2004; Langlois, Rutland-Brown, & Thomas, 2004; Nortje & Menon, 2004). The incidence of TBI has increased more than 5% within the past decade, producing an annual eco- nomic impact of È$60 billion due to medical ex- penses and the cost of lost productivity (Faul, Wald, & Coronado, 2010; Thurman, 2001; Zitnay et al., 2008). TBI represents a heterogeneous group of injuries that exhibit a variable, complex pathophysiology and produce a range of long-term sequelae that include emotional disturbances, cognitive difficulties, lan- guage disturbances, and other neurobehavioral issues (Faul et al., 2010; Zitnay et al., 2008). The Centers for Disease Control and Prevention broadly defines TBI as ‘‘a bump, blow or jolt to the head or a pene- trating head injury that disrupts the normal function of the brain’’ (Binder, Corrigan, & Langlois, 2005; Faul et al., 2010); however, patient outcomes vary widely depending on the severity of the initial trauma. Moderate to severe TBIs, which are frequently caused by motor vehicle accidents or falls, may induce loss of consciousness and confusion, whereas mild TBI (mTBI) is often associated with more mild deficits and/or the lack of overt clinical symptoms. The clin- ical criteria for defining mTBI remain poorly defined; thus, many victims fail to seek and/or receive imme- diate medical attention and may experience long-term deleterious consequences as a result. Given the public health importance, improved awareness and under- standing of the signs and symptoms of mTBI are needed to improve patient outcomes. The Problem In contrast to other common neurological diseases, such as stroke and Alzheimer disease, TBI is most prevalent in younger populations, with the 0Y4-year and 15Y19-year age groups experiencing the highest rates of incidence (Mitka, 2010). Overall, TBI is more prevalent than breast cancer, AIDS, multiple sclero- sis, and spinal cord injury combined; however, these data reflect only the number of neurotrauma patients seeking emergency medical treatment and overlook an increasing number of mTBI victims (e.g., concus- sions) who fail to obtain medical evaluation. As a result, TBI is now commonly regarded as a ‘‘silent epidemic.’’ Journal of Neuroscience Nursing286 Questions or comments about this article may be directed to Donald E. Kimbler, MSN CRNA, at [email protected]. He is a graduate student in the Department of Neurosurgery, Georgia Health Sciences University, Augusta, GA. Marguerite Murphy, DNP, is an associate professor in the School of Nursing, Georgia Health Sciences University, Augusta, GA. Krishnan M. Dhandapani, PhD MS, is an associate professor in the Department of Neurosurgery, Georgia Health Sciences University, Augusta, GA. This project is sponsored, in part, by grants from the National Institutes of Health (R01NS065172) and from the TriService Nurs- ing Research Program, Uniformed Services University of the Health Sciences. The information, content, and conclusions do not nec- essarily represent the official position or policy of, nor should any official endorsement be inferred by the TriService Nursing Re- search Program, the Uniformed Services University of the Health Sciences, the Department of Defense, or the U.S. Government. The authors declare no conflict of interest. Copyright B 2011American Association of Neuroscience Nurses DOI: 10.1097/JNN.0b013e31823858a6 Copyright @ 201 American Association of Neuroscience Nurses. Unauthorized reproduction of this article is prohibited.1 Despite the prevalence within society, a relatively modest percentage of research effort has been de- voted to the mechanistic understanding and treat- ment of TBI; however, approximately 22%Y29% of all wounded soldiers from the Operation Iraqi Freedom and Operation Enduring Freedom experi- enced at least one reported TBI, making this the ‘‘signature wound’’ in current military personnel (Bradshaw, 2008; Okie, 2005). These recent findings in the Armed Services have resulted in a renewed interest in understanding the clinical pathophysiol- ogy of TBI and have raised awareness to this type of injury. On the basis of the prevalence of mTBI in soldiers, in 2009, the Department of Veterans’ Affairs put forth clearly defined clinical guidelines for TBI that included a defined characterization of TBI, as summarized below: A traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force that is indicated by new onset or worsening of at least one of the following clinical signs, immediately following the event: 1. any period of loss of or a decreased level of consciousness (LOC), 2. any loss of memory for events immediately before or after the injury (post-traumatic amnesia (PTA), 3. any alteration in mental state at the time of the injury (confusion, disorientation, slowed thinking, etc), 4. neurological deficits (weakness, loss of balance, change in vision, praxis, paresis/plegia, sensory loss, aphasia, etc) that may or may not be transient, 5. intracranial lesion. (Management of Concussion/mTBI Working Group, 2009) Although important for ensuring adequate care to veterans, these studies have served another impor- tant purpose in that public awareness for TBI within civilian populations has been significantly height- ened. To maintain focus and limit the scope of this mini-review, the following sections will present cur- rent data on sports-related TBI in the adolescent ath- lete because this topic is of clinical import to many nurses, trainers, and other emergency room medical personnel. ConcussionVA Form of mTBI Historically, TBI represented an all-encompassing term covering the complete spectrum of neuro- trauma, ranging from mild to severe head trauma (Faul et al., 2010); however, this broad definition does not adequately differentiate between mTBI and severe head injury. Throughout the literature, the terms mTBI and concussion are used interchangeably (Tanielian, 2008); however, mild simply refers to the severity of the initial insult rather than providing a predictor of the long-term sequelae (Grady, 2010). In contrast, the term concussion is more often used when communicating with mTBI patients or with families of patients because È33% of Americans are unfamiliar with the term TBI or equate this with the more severe forms of injury (Langlois, Marr, Mitchko, & Johnson, 2005). To provide further clarity and consistency within the medical community, the Academy of Neurology defines concussion as ‘‘a trauma-induced alteration in mental status that may or may not involve loss of consciousness and whose hallmark is confusion’’ (‘‘Practice Parameter: The Man- agement of Concussion in Sports (Summary State- ment),’’ 2011). Furthermore, in a 2008 consensus statement from the International Symposium on Con- cussion in Sports, concussion was defined as ‘‘com- plex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.’’ This sports concussion may or may not involve a loss of consciousness and generally reflects functional dis- turbances rather than structural damage or injury. This results in the absence of abnormalities on stan- dard structural neuroimaging (McCrory et al., 2005). Sports Concussions and the Adolescent Athlete Concussions are an increasingly common sports- related injury. The Centers for Disease Control and Prevention estimates that È135,000 children between the ages of 5 and 18 are treated in the emergency room each year for concussion as a result of partic- ipation in sports-related activities (Faul et al., 2010); however, these numbers may represent significant underestimates because recent reports indicate that È300,000Y3,800,000 sports-related mTBIs occur an- nually, with children aged 14Y19 exhibiting three times more TBI in 2007 as compared with 1997 (Buzzini & Guskiewicz, 2006; Halstead & Walter, An ever-growing body of evidence suggests that concussion, or mild traumatic brain injury (mTBI), in young individuals is an often unrecognized or overlooked, underreported, and inadequately treated problem in pediatric and adolescent neuroscience. Volume 43 & Number 6 & December 2011 287 Copyright @ 201 American Association of Neuroscience Nurses. Unauthorized reproduction of this article is prohibited.1 2010; Mitka, 2010). It remains unclear whether the increased presentation of concussed adolescents in the clinic represents a true increase in the number of injuries or whether this reflects an increased aware- ness of the signs and symptoms of concussion. Given the potentially dire long-term consequences of con- cussion, these data indicate an alarming number of adolescents experiencing head injuries during partic- ipation in sporting activities. Participation in youth sports and sports-related ac- tivities has risen dramatically over the past several de- cades, given the increased number of programs for both male and female youths. Furthermore, the rec- ognized benefits of physical fitness resulted in more adolescent involvement in competitive sports. Paral- leling this trend of increased sports participation, re- ports of mTBI as a result of involvement in a sporting event have also increased, particularly in contact sports such as football and ice hockey (Mitka, 2010). Despite improvements and more widespread use of protec- tive equipment (e.g., improved helmet design), which reduce the incidence of concussion, a large number of concussions occur each year, indicating a large pub- lic health need to better understand the risk factors and symptoms and signs of a concussion. A common problem with sports-related concus- sion is that the symptoms often appear mild, lead- ing to the refusal of appropriate medical treatment by the youth; however, it is equally likely that the athlete, coaches, and/or parents do not fully under- stand how a concussion manifests. As such, the in- jured athlete, who may experience an impaired sense of self-awareness due to the concussion or disregard the severity of the injury due to a competitive drive to continue, declines medical attention and seeks to return to action, where they are vulnerable to a sec- ond head injury (Buzzini & Guskiewicz, 2006; Grady,
Answered Same DayDec 25, 2021

Answer To: Case Study- Joe is a 14 yo Hispanic male currently participating in competitive skateboarding. He...

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CONCUSSION AND THE ADOLESCENT ATHLETE 1

Running head: CONCUSSION AND THE ADOLESCENT ATHLETE
Concussion and the Adolescent Athlete
CO
NCUSSION AND THE ADOLESCENT ATHLETE 2

Symptoms of an Acute Concussion
The main symptoms of an acute concussion can be seen as nausea and dizzy, as well as
often falling while practicing as a player. This is a serious symptom caused by head injury when
meeting with an accident. Apart from this, the symptom can also be recognized as disruption of
the normal function of the brain, and decreased level of consciousness. It can also be seen that
the patient of an acute concussion would show alteration in mental state, such as confusion,
slowed thinking, etc (Choe & Giza, 2015). Apart from this, loss of balance, changes in vision
and sensory loss are also known as the symptoms of an acute concussion.
Reasons that often Go Unnoticed in a Teen Athlete
TBI (Traumatic Brain Injury) is a serious issue that frequently occurs by motor vehicle
accidents or falls. Mostly, athletes are specifically linked to this problem because they always
face this type of accidents. However, in case of teen athlete, TBI or concussion often goes
unnoticed in most of the situations (Choe & Giza, 2015). The first reason can be considered as
poor understanding of the clinical signs and symptoms in case of head injury. The second reason
that often goes unnoticed in a teen athlete is the lack of public awareness within civilian
populations significantly.
Possible Long Term Complications of Repeated Concussions
There would be long term complications of repeated concussions when brain injury
occurs and victims fail to receive immediate medical attention. The possible long term
complications of repeated concussions can be seen as deleterious consequences as a result that is
very harmful towards leading death and disability (Choe & Giza, 2015). The concussion is also
known as silent epidemic that creates possible...
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