Fick D S
Department of Family Practice and Orthopaedic Surgery, University of Iowa College of Medicine, Iowa City 52242.
Postgrad Med. 1995 Feb;97(2):53-6, 59-60.
During high-risk sports events, it is important for team physicians to be alert to the possibility of concussion in athletes who may not realize they have been injured or may want to conceal their injury. If concussion is suspected and the player is conscious, history taking should include inquiries about loss of consciousness, loss of memory of events before and after the impact, headache, visual abnormalities, motor and sensory changes, and back, neck, and extremity pain. In an unconscious player, the airway, breathing, circulation, and cervical spine should be checked. The cervical spine must be stabilized before the player is moved if injury to it is suspected. Athletes with such an injury and those who have lost consciousness require hospital evaluation. If there is no cervical spine injury, a complete neurologic evaluation should be carried out on the sidelines and the player checked for signs of skull fracture. The Colorado Medical Society guidelines for grading concussions and deciding when athletes may return to competition are an excellent aid to clinical judgment.
在高风险体育赛事期间，团队医生必须警惕运动员发生脑震荡的可能性，这些运动员可能没有意识到自己受伤，或者可能想要隐瞒自己的伤势。如果怀疑发生脑震荡且运动员意识清醒，病史采集应包括询问意识丧失情况、撞击前后事件的记忆丧失情况、头痛、视觉异常、运动和感觉变化以及背部、颈部和四肢疼痛。对于昏迷的运动员，应检查气道、呼吸、循环和颈椎。如果怀疑颈椎受伤，在移动运动员之前必须稳定颈椎。有此类损伤的运动员和失去意识的运动员需要住院评估。如果没有颈椎损伤，应在赛场边进行全面的神经学评估，并检查运动员是否有颅骨骨折的迹象。科罗拉多医学协会关于脑震荡分级以及决定运动员何时可以重返比赛的指南对临床判断有很大帮助。
