priority for nurse to report in patient with concussion

Recognition and proper care of concussion is a priority to prevent injury and promote wellness in the pediatric population. Nurses are key players in the push to increase recognition and standardize treatment, making a significant impact on the prevention, recognition, and post-concussion care of youth athletes.

Full Answer

What can nurses do about concussions in schools?

School nurses can play a leadership role in concussion recognition, care, and referral, and in coordinating and monitoring proper cognitive rest and academic accommodations. Athletes and coaches also require concussion education.

What is included in patient monitoring for concussion?

Patient monitoring includes provider follow-up visits, school employee evaluations with assessment tests, and school nurse monitoring with checklists. Both physical and cognitive activity can worsen concussion symptoms and even delay recovery, so rest is the cornerstone of management.

What are the most recent Concussion guidelines?

The most recent guidelines are from the American Medical Society for Sports Medicine, the American Academy of Neurology Summary of Evidence-Based Guideline Update, and the Consensus Statement on Concussion in Sport. All were published in 2013, and they all concur on early assessment and treatment goals.

Should you RTP if you have a concussion?

Stating with certainty the number of days an individual must refrain from sports participatioion in Sport states that no one with a concussion should RTP on the same day the injury is sustained. And because of the possibility of delayed symptoms, sideline testing may not fully assess the injury’s extent.

What is the priority nursing management of the patient with a head injury?

The first priority in any emergency is always an adequate airway. The nurse is involved in clearing the mouth, inserting an oral airway, assisting with intubation, oxygen therapy and assessing continually the patient's respiratory system.

What assessment will a nurse do for a client with a concussion?

Using sideline assessment tools, coaches, trainers, nurses, and providers can perform preliminary evaluation for concussion. (See Signs and symptoms of concussion.) Assessment tools include symptom scales, balance and gait testing, and cognitive assessments.

What should you monitor for a concussion?

Headache or “pressure” in head.Nausea or vomiting.Balance problems or dizziness, or double or blurry vision.Bothered by light or noise.Feeling sluggish, hazy, foggy, or groggy.Confusion, or concentration or memory problems.Just not “feeling right,” or “feeling down”.

What are the priorities for initial management of a head injury?

Initial management priorities. The first priority is to stabilize vital signs. An important goal of stabilization is to avoid secondary injury to the traumatized brain from hypoxia, hypotension, hyperthermia or raised intracranial pressure.

Which of the following is the first priority in caring for a patient with severe head injury?

"The first priority for the head-injured patient is compete and rapid physiologic resuscitation. No specific treatment should be directed at intracranial hypertension in the absence of signs of transtentorial herniation or progressive neurological deterioration not attributable to extracranial explanations.

What is a concussion Assessment?

Concussion testing assesses your brain function before and after a head trauma. The tests are done by a doctor or other health care professional with expertise in evaluating and treating people with concussions.

What is the concussion protocol?

It's recommended that individuals with a concussion have a 1-2 day period of rest followed by progressive increases in activity. This return to activity should always be monitored by a trained healthcare provider. Most providers will try to see their patients 24-72 hours after the injury to assess their functioning.

What should you do for a concussion?

Rest (for 1–2 days after the concussion) You can try it again after a few minutes or longer, or you can try a less strenuous version of the activity. Avoid or cut down on screen time. Video games, texting, watching TV, and using social media are likely to cause symptoms or make them worse. Don't drive.

How do you care for someone with a concussion?

PainRest is the best treatment for post-concussion syndrome.Do not drive if you have taken a prescription pain medicine.Rest in a quiet, dark room until your headache is gone. ... Put a cold, moist cloth or cold pack on the painful area for 10 to 20 minutes at a time. ... Have someone gently massage your neck and shoulders.More items...

What are the five general guidelines for the priorities of care for trauma patients?

As always, start with the ABCs.Airway. The first part of the primary survey is always assessing the airway. ... Breathing. Assess your patient's breathing next. ... Circulation. Once you've assessed and supported your patient's breathing, attend to his circulatory status. ... Disability. ... Exposure.

When caring for a patient with a possible head injury?

The injured person should lie down with the head and shoulders slightly elevated. Don't move the person unless necessary, and avoid moving the person's neck. If the person is wearing a helmet, don't remove it. Stop any bleeding.

What are the initial assessment priorities for a patient with multiple trauma?

The trauma assessment begins prior to the patient's arrival with information gathering, the formation of the trauma team, and equipment preparation. On patient arrival, the team begins with the primary survey, which includes an assessment of the patient's airway, breathing, circulation, disability, and exposure.

What age group is most likely to have a concussion?

Concussions affect Americans of all ages. Children 0 to 4 years old, adolescents and young adults 15 to 19 years, and adults older than 75 years are the most likely age groups to visit the ED with traumatic brain injury. 9 Those older than 75 years have the highest rates of related hospitalizations and deaths. 9 The rate of concussions is highest in males. 1,10 The leading cause of nonfatal TBI is falls (35%), followed by motor vehicle crashes (17%) and objects striking the head (17%). 9

Can surgery be delayed after a concussion?

• Recommendations for Future Study. Although researchers have observed that anesthesia for surgery and other procedures is quite common after concussion, large knowledge gaps exist in the preoperative diagnosis of concussion as well as determining how long to delay procedures in light of possible postoperative symptoms. Future studies should seek to establish guidelines for delaying or proceeding with elective surgical cases. For urgent or emergent cases in which delay is not possible, specific evidence-based guidelines should establish safety parameters and interventions that notably improve the chances for positive patient outcomes.

What are the signs and symptoms of a concussion?

Signs and symptoms of concussion are grouped into four categories: physical,cognitive, emotional, and sleep disturbance. Youth athletes with these signs andsymptoms should be referred for evaluation by a healthcare provider trained inconcussion management.

Is there an evidence based protocol for concussion?

Although assessment and manage-ment of sports-related concussion in children and adolescents hasevolved, no definitive, evidence-based protocols exist. Several as-sessment algorithms and treatmentprotocols have been developed, butmost recent studies have concludedthat more research is needed.

Can a concussion cause brain damage?

For centuries, most healthcare professionals believed that concussion didn’tcause brain damage. Even today, some concussions are described as mild be-cause of the absence of structura l brain damage on radiographic examination.However, current understanding of pathophysiology suggests a cascade of eventsthat occurs in the brain during a concussion that may result in poorly understoodprimary and secondary mechanisms, including impaired neurotransmission, lossof ion regulation, deregulation of energy use and cellular metabolism, and re-ducedcerebral blood flow.

Nursing Care for the Post-Concussion Pediatric Patient

37 patients saw improvement after discontinuing analgesics, 7 reported no change or worsening headaches, and 10 did not discontinue analgesics or were lost to non-reporting.

Article

Title: "Does Analgesic Overuse Contribute to Chronic Post-traumatic Headaches in Adolescent Concussion Patients?"

Treatment

Children are usually discharged after being monitored in the emergency room.

What are the skills of a nurse to help patients with confusion?

Offer reassurance to the patient and use therapeutic communication at frequent intervals. Patient reassurance and communication are nursing skills that promote trust and orientation and reduce anxiety. Identify, evaluate, and treat pain immediately.

What is acute confusion in nursing?

Confusion is a term nurses use often to represent a pattern of cognitive impairments. It is a behavior that indicates a disruption in cerebral metabolism. Acute confusion ( delirium) can befall in any age group, which can evolve over a period of hours to days.

What are the factors that increase the risk of confusional states?

Factors that increase the risk for delirium and confusional states can be categorized into those that increase baseline vulnerability including underlying brain disease such as dementia, stroke, or Parkinson’s disease and those that precipitate the disturbance like infection, sedatives, and immobility.

How does continuity of care help patients?

Continuity of care helps decrease the disorienting effects of hospitalization. Maintain patient’s sleep-wake cycle as normal as possible (e.g., avoid letting the patient take daytime naps, avoid waking patients at night, give sedatives but not diuretics at bedtime, provide pain relief and backrubs).

What is the role of patient in a patient's behavior?

Patient regains normal reality orientation and level of consciousness. Patient verbalizes understanding of causative factors when known. Patient initiates lifestyle/behavior changes to prevent or minimize recurrence of the problem. Patient demonstrates appropriate motor behavior.

How to perform a mental status test?

Conduct an accurate mental status exam that includes the following: 1 Overall appearance, manner, and attitude 2 Behavior observations and level of psychomotor behavior 3 Mood and affect (presence of suicidal or homicidal ideation as observed by others and reported by patient) 4 Insight and judgment 5 Cognition as evidenced by level of consciousness, orientation (to time, place, and person), thought process and content (perceptual disturbances such as illusions and hallucinations, paranoia, delusions, abstract thinking) 6 Attention

What should a nurse do when treating a patient?

Nurses should provide a calm, comforting environment and approach the patient with care and concern. A complete head-to-toe examination should take place, looking for physical signs of abuse. A chaperone or witness should be present if possible as well.

What is the mandate of a nurse?

As mandated, they are trained to identify signs and symptoms of abuse or neglect and are required by law to report their findings. Failure to do so may result in discipline by the board of nursing, discipline by their employer, and possible legal action taken against them. If a nurse suspects abuse or neglect, they should first report it ...

Do nurses have a responsibility to care for victims of abuse?

Employers are typically clear with outlining requirements for their workers, but nurses have a responsibility to know what to do in case they care for a victim of abuse.

Should a nurse report abuse?

The nurse should notify law enforcement as soon as possible, while the victim is still in the care area. However, this depends on the victim and type of abuse. Adults who are alert and oriented and capable of their decision-making can choose not to report on their own and opt to leave. Depending on the state, nurses may be required ...

Do nurses have to be able to connect victims of abuse?

While not required by law, nurses should also offer to connect victims of abuse to counseling services. Many times, victims fall into a cycle of abuse which is difficult to escape.

Early Recognition Is The First Step to Proper Care.

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Evolving Guidelines

Pre-Participation Counseling

Assessment, Diagnosis, and Management

Management

Nurses’ Role

Selected References