Trauma Week Day 3 Dr. Rippey
On day three of Trauma Week Dr Rippey, MD, was the guest speaker of the day. He continued the topic of our patient, a fellow student, and was able to diagnose our patient with a concussion. After the diagnosis he continued on about how a concussion affects a person and other information about the common head injury. When diagnosing a concussion it is important to know that the diagnosis should be clinical, vestibular sx occur in approximately 66% of patients, and ocular sx occur in 45-50% or concussed patients. Our patient was a 17 y/o male that sustained an open Tib/Fib fracture during tackle on the football field. He reported no neck pain, stiffness, or paresthesia on the field or in the ER. He underwent ORIF, open reduction and internal fixation, the following day. The day following the injury he reported light sensitivity, sound sensitivity, sleep problems, and said he felt "foggy". What is a sport related concussion? A sport related concussion is a traumatically induced transient disturbance of brain function. It is also a subset of mild TBI (GCS 13-15), and usually the symptoms are not explained by other injuries, comorbidities or influence of other substances. There is a 2-15% risk of concussion during the athletic season. The CDC estimates 1.6-3.8 million concussions annually in sports/recreational activities. Another fact is that sports concussions account for roughly 30% of concussions reported. Alan Carson, a neuropsychiatrist at the University of Edinburgh, once said "If football were to be viewed as a drug, it saved 296 lives but at the cost of 17 deaths". What's the big deal about concussions? They can worsen pre-existing conditions like ADD, depression, anxiety, and migraines, forcing you to lose time from school, sports, and other activities. Those with concussions have a lower GPA than those without it, a risk of developing mood disorders, double impact syndrome, and neurodegenerative conditions later in life. Regular concussion treatments include initial rest for 24-48 hours, sub-symptom threshold exercise, taking Tylenol/NSAIDs, staying home from school or altering schedule, and a possible PT referral. Once returning to school there are no firm guidelines, they are individualized for the athlete, try to avoid tests during the time of the concussion, may need a brief time out of school or a reduced schedule, and clear communication is of paramount importance.
