Whiteside John W
Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona 85259, USA.
Am Fam Physician. 2006 Oct 15;74(8):1357-62.
Injuries to the head and neck are common in sports. Sideline physicians must be attentive and prepared with an organized approach to detect and manage these injuries. Because head and neck injuries often occur simultaneously, the sideline physician can combine the head and neck evaluations. When assessing a conscious athlete, the physician initially evaluates the neck for spinal cord injury and determines whether the athlete can be moved safely to the sideline for further evaluation. This decision is made using an on-field assessment of the athlete's peripheral sensation and strength, as well as neck tenderness and range of motion. If these evaluations are normal, axial loading and Spurling testing can be performed. Once the neck has been determined to be normal, the athlete can be assisted to the sideline for assessment of concussion symptoms and severity. This assessment should include evaluations of the athlete's reported symptoms, recently acquired memory, and postural stability. Injured athletes should be monitored with serial examinations, and those with severe, prolonged, or progressive findings require transport to an emergency department for further evaluation.
头部和颈部损伤在体育运动中很常见。场边医生必须保持警惕，并准备好采用有条理的方法来检测和处理这些损伤。由于头部和颈部损伤常常同时发生，场边医生可以将头部和颈部评估结合起来。在评估意识清醒的运动员时，医生首先评估颈部是否有脊髓损伤，并确定运动员是否能够安全地转移到场边进行进一步评估。这一决定是通过对运动员的外周感觉和力量、颈部压痛及活动范围进行现场评估来做出的。如果这些评估结果正常，可以进行轴向负荷试验和斯珀林试验。一旦确定颈部正常，就可以协助运动员到场边评估脑震荡的症状和严重程度。这种评估应包括对运动员报告的症状、近期记忆和姿势稳定性的评估。受伤的运动员应通过系列检查进行监测，那些有严重、持续或进展性症状的运动员需要送往急诊科进行进一步评估。
