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Second-Impact Syndrome Case Study

The article title “Second-Impact Syndrome” written by Sarah Cobb, and Barbara Battin in The Journal of School Nursing, dated October 2004, speaks about the dangers of the head injury that occurs in schools or universities. The article starts by noting that head injuries are very common in high school/university sports, and that one has to properly face the potential problems associated with head injuries. Failure to properly treat or prevent injuries (especially second-impact injuries) might cause great damage to the central nervous system of people and cause somatic, emotional and cognitive problems later in their lives.

The article called concussion a “form of head injury that occurs immediately after a blunt force strikes the head causing the brain to move within the confines of the skull”(Cobb et al, p.262). Contrary to the common belief concussion does not always lead to Loss of consciousness (LOC) and thus is oftentimes left unnoticed. Later individuals experience headaches, amnesia, confusion and other sensual disturbance that interfere with normal functioning.

Concussion has three different grades as shown below (Cobb et al, p.263):

  1. Mental abnormalities lasting less than 15 minutes, no loss of consciousness.
  2. mental abnormalities lasting over 15 minutes, no loss of consciousness.
  3. Loss of consciousness

Second impact syndrome, on the other hand is a repeated single or multiple injury to the head before the brain had recovered from the prior period concussion. The article noted the synergist effect of the second impact which provides additional harm to the health. One learns that second impact creates hematomas and brain swelling and that in turn usually entails long term negative effects on the student health.

The article noted that the school athletes are in greatest danger because of the three determinant factors:

  1. Age. It was noted that younger athletes recover slower than adult/college athletes, thus students who experienced concussion need a longer recovery period.
  2. Type of Sport. Some sports are more traumatic than the others (e.g. wrestling, boxing, football, and hockey).
  3. Prior history of concussion. After a concussion one needs at least one week to recover (again depending on the grade of concussion). Second impact concussion requires months to recover.

The article noted that at present many athletes do not report concussion since they are afraid that the coach would keep them on the sidelines and thus halt their athletic career. The role of a nurse then, is to educate the athletes about concussion and the dangers it usually has if left unreported and untreated. The article depicted the return-to-play guidelines that need to be applied to athletes who experienced concussion and noted that one has to follow them strictly if further damage to health is to be avoided.

The last thing that one reads in the article is the necessity to prevent the second-impact syndrome from occurring. This is when the athletes after a concussion are given enough time to rest and recover from the first injury. The article gives then a list of various resources on the prevention and management of head injuries and second impact syndrome and concludes with the statement that it is necessary to prevent the second-impact syndrome from occurring in athletes despite the fact that one might have to wait on the sidelines and not play.

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