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Scenario
A 17-year-old boy is in clear need of physical examination that can conclude on his aptitude to participate in sports activities, namely, football. Football is a rather active game that involves coordination, sharp eyesight, and hearing. These functions are affected by brain injuries, and a temporary pause in sports activity might be required until full recovery (Kirkendall, Jordan, & Garrett, 2001). Head traumas typically incur concussions, and, depending on the severity of one, an individual should abstain from active sports for different periods of time. According to Kirkendall et al. (2001), the concussion has three degrees of severity such as mild, moderate, and severe. Mild involves no loss of consciousness; moderate is defined through loss of consciousness with retrograde amnesia. Severe can be diagnosed if a patient has been unconscious for longer than five minutes. All of them require temporary withdrawal from football.
Therefore, an examination is required to state the presence of concussion or the absence of thereof. Health data include a self-reported headache, dizziness, nausea, or vomiting directly after the event of the trauma. Other concussion symptoms may include the presence of vacant stare, disorientation, incoherent speech, loss of coordination, memory deficits, and loss of focus. Sports Concussion Assessment Tool (SCAT) could be used by medical professionals to diagnose the presence and severity of concussion in patients (“Sports Concussion Assessment,” 2013). It is important to note that it is a supplementary tool and may require further examination.
Provided even mild concussion signs are observed, an individual in question should advise against participating in sports activities for 7-10 days with a follow-up in the clinic (Kirkendall et al., 2001). A return to play needs to be preceded by a period of non-contact physical exercise as required in football training. A 24-hour period with no symptoms’ return may indicate a transition to full-scale sports activity (Kirkendall et al., 2001).
Evidence-Based Response
In accordance with the procedure for head injury inspection, a nurse should check for symptoms, such as a headache, nausea, vomiting, physical signs, brain function, and behavior to diagnose the presence or absence of a concussion (Ball, Dains, Flynn, Solomon, & Stewart, 2015). The individual needs to be questioned as per the mechanisms of his injury to be able to determine the scale of the damage. Neck examination should also be performed to rule out any possible spinal comorbidity (Nilsson, Hägglund, Ekstrand, & Waldén, 2013). Standardized Assessment of Concussion needs to be implemented to test the orientation, immediate memory, and concentration (Ball et al., 2015).
A nurse should also examine balance and coordination by evaluating the quality of one and both leg stance and arm precision functioning. A delayed recall test could also be helpful. It is paramount to note that information given by the person may be biased as he wants to return to play in three days. Should any symptoms, physical or mental signs indicate a concussion, the individual should be advised against playing the next football match as football is a high-contact sport, and further injuries may lead to condition deterioration (Ball et al., 2015).
Recommendation
Ethical considerations are tightly related to the conflict of interest. The patient himself, his parents, team, and coach all have different goals. To ensure the best outcomes for the health of the patient, a care provider needs to use several reasoning sources, such as technical, narrative, and ethical (Greenfield & West, 2012). Relations with patients and parents need to have clear rules in order to establish authority and rule out possible incidents of non-compliance.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby
Greenfield, B. H., & West, C. R. (2012). Ethical issues in sports medicine. Sports Health, 4(6), 475–479.
Kirkendall, D. T., Jordan, S. E., & Garrett, W. E. (2001). Heading and head Injuries in soccer. Sports Medicine, 31(5), 369–386.
Nilsson, M., Hägglund, M., Ekstrand, J., & Waldén, M. (2013). Head and neck injuries in professional soccer. Clinical Journal of Sport Medicine, 23(4), 255-260.
Sport Concussion Assessment Tool.(2013). Web.
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