Nursing in sports ankle injury based on the fitness exercise / A enfermagem nas lesões de tornozelo com base no exercício de aptidão física / La enfermería en las lesiones del tobillo basada en el ejercicio de aptitud física

ABSTRACT Introduction Ankle injury is an acute soft tissue pathology where the ankle ligaments are distended, lacerated, or ruptured due to violence during sport. This joint is also one of the most vulnerable in sports. After an injury, immediate and adequate care is significant in reducing pain and complication. Objective Statistically analyze the sports injuries of the ankle cases, determining the principal reasons for injury and outlining preventive measures. Methods A statistical investigation on the sports injuries of 275 Qiqihar higher education students was performed with questionnaires and teaching practice methods. The research was focused on the injured structures and the injury causes analysis. In parallel, corresponding proposals aimed at preventing these sports injuries were raised. Results Joint injuries and ankle sprains followed by hematomas represented the most significant proportion of ankle injuries. The reasons are lack of physical fitness, lack of awareness of self-protection, inadequate preparation in the sporting environment facilities, and performing tasks outside what the superior specified was specified. Conclusion Medical work needs to increase dissemination so that people realize the causes of sports injuries. At the same time, it helps people master the care measures before and after the injury. This reduces the incidence of sports injuries and reduces the occurrence of complications. Evidence level II; Therapeutic Studies - Investigating the results.

RESUMO Introdução A lesão no tornozelo é uma patologia aguda dos tecidos moles na qual os ligamentos do tornozelo são distendidos, lacerados, ou rompidos devido a violência durante o esporte. Essa articulação é também uma das mais vulneráveis nos esportes. Depois de uma lesão, o cuidado imediato e correto é significativo para aliviar a dor e reduzir complicações. Objetivo Analisar estatisticamente os casos de lesões esportivas do tornozelo, levantando as principais razões de lesão e traçar condutas preventivas. Métodos Uma investigação estatística sobre as lesões esportivas de 275 estudantes do ensino superior de Qiqihar foi executada com questionário e métodos de prática de ensino. A pesquisa foi concentrada na análise das estruturas lesionadas e a causa da lesão. Paralelamente foram levantadas propostas correspondentes visando a prevenção dessas lesões esportivas. Resultados As lesões articulares e entorses do tornozelo seguidas por hematomas representaram a maior proporção de lesões no tornozelo. Dentre os motivos, destacaram-se a falta de preparo físico, falta de consciência de autoproteção, preparação inadequada nas instalações do ambiente esportivo e execuções de tarefas fora do especificado pelo superior. Conclusão O trabalho médico precisa aumentar a divulgação para que as pessoas percebam as causas das lesões esportivas. Ao mesmo tempo, ajuda as pessoas a dominar as medidas de cuidado antes e depois da lesão. Isso reduz a incidência de lesões esportivas e reduz a ocorrência de complicações. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.

RESUMEN Introducción La lesión de tobillo es una patología aguda de las partes blandas en la que los ligamentos del tobillo se distienden, desgarran o rompen debido a la violencia durante la práctica deportiva. Esta articulación es también una de las más vulnerables en el deporte. Después de una lesión, una atención rápida y correcta es importante para aliviar el dolor y reducir las complicaciones. Objetivo Analizar estadísticamente los casos de lesiones esporádicas del tobillo, levantando las principales causas de lesión y trazar conductas preventivas. Métodos Se realizó una investigación estadística sobre las lesiones deportivas de 275 estudiantes de educación superior en Qiqihar con métodos de cuestionario y práctica docente. La investigación se centró en el análisis de las estructuras lesionadas y la causa de la lesión. Paralelamente, se plantearon las correspondientes propuestas encaminadas a la prevención de estas lesiones deportivas. Resultados Las lesiones articulares y los esguinces de tobillo, seguidos de los hematomas, representaron la mayor proporción de lesiones de tobillo. Entre los motivos, destacaron la falta de preparación física, la falta de conciencia de autoprotección, la preparación inadecuada en las instalaciones del entorno deportivo y la ejecución de tareas fuera de lo especificado por el superior. Conclusión El trabajo médico debe aumentar la difusión para que la gente se dé cuenta de las causas de las lesiones deportivas. Al mismo tiempo, ayuda a las personas a dominar las medidas de cuidado antes y después de la lesión. Esto reduce la incidencia de las lesiones deportivas y disminuye la aparición de complicaciones. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Mild Traumatic Brain Injury in the Emergency Department: A Clinical Practice Gap.

This article, "Concussion Care in the Emergency Department: A Prospective Observational Brief Report," by seeks to examine current clinician practice patterns related to the evaluation and management of patients identified as at risk for a sustained mild traumatic brain injury (mTBI). The findings are discussed in the context of an evaluation and management gap surrounding mTBI care among emergency department (ED) providers at a Level I trauma and emergency care center. Although variabilities exist among mTBI care in the ED, provider education, standardization of guidelines, and implementation practices are strategies for increasing the uptake of care in the ED for patients presenting with mTBI.

Advances in Sports Medicine and Care of the Adolescent Athlete.

Over the past several decades there has been a dramatic change in the landscape of youth sports. This article provides an overview of sport-related injuries in the child and adolescent populations, looking at changes over the past 10 to 15 years. A closer look at frequently seen injuries, including assessment, diagnosis, and management in osteochondritis dissecans, sprains, fractures, anterior cruciate ligament, and meniscus tears, is provided. Current protocols and screening tools for this population are discussed, including preparticipation screening. The nursing implications in the clinical and community setting are identified, with ways to incorporate this information into practice.

Application of Components of the Massachusetts' Sports Concussion Regulations to All Students With Concussion: A Survey of School Nurses.

Appropriate management by schools of all students with a concussion, regardless of the cause, has not received the same attention as sports-related concussions. Focus groups conducted with Massachusetts School Nurses in 2015 found that some had applied protocols required in the state's sports concussion regulations to all students with concussion, not just student athletes. We surveyed high school nurses in Massachusetts to examine (1) the extent of this practice and (2) the extent to which protocols for all students with concussion are included in school policies. Of 168 (74%) responding, 94% applied the return-to-learn and play, and medical clearance requirements to all students with concussion, regardless of how or where the concussion occurred and 77% reported their school's policy required these protocols for all students with concussion. A significant association (odds ratio: 13.3, 95% confidence interval [2.4, 72.8], p <.01) existed between the two measures. These findings have important clinical and academic implications.

Sex Differences in Common Sports-Related Injuries.

Sex plays a role in mediating different susceptibilities and outcomes of disease and injury. Sports injuries are included in this phenomenon, as recent research demonstrates that males and females show differences in incidences of varying injuries, presentations of injury, and treatment outcomes. Incidence of certain sports injuries like anterior cruciate ligament injury or patellofemoral pain syndrome may vary widely between male and female athletes, with female athletes being more susceptible to anterior cruciate ligament injury and patellofemoral pain syndrome. Treatment outcomes for males and females may also vary widely. For example, males have a higher risk of recurrent shoulder instability compared with females. These variances among incidence and outcome following certain injuries highlight the necessity of understanding these differences to provide quality care. It is especially important for the school nurse to be aware of these sex differences as they are well positioned to make youth athletes and their families aware of the varying injury susceptibilities among them.

School Nurses on the Front Lines of Medicine: Emergencies Associated With Sport and Physical Activities: Part 1.

Illness and injury associated with sport and physical activities may occur in the school setting. Although most sport-related illness and injury in students are considered minor emergencies, life- and limb-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus, catastrophic brain or cervical spine injuries, hypoglycemia, blunt chest/abdominal injuries, or extremity fractures requiring surgery. It is important for the school nurse to recognize potential life- and limb-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life- and limb-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary healthcare provider's office, or directly to the closest emergency department via emergency medical services). This article describes the initial assessment and management of three common emergencies associated with sport and physical activities.

Sever's Disease (Calcaneal Apophysitis).

Sever's disease, or calcaneal apophysitis, is the primary cause of heel pain in pediatric patients between the ages of 8 and 15 years. Primary risk factors in pediatric athletes are obesity and high levels of physical activity. Sever's injury primarily results from high-impact sports such as soccer, track, cross-country, gymnastics, tennis, and ballet. This injury mainly occurs during puberty with an open growth plate in the immature calcaneus. Clinical diagnosis can be confirmed by performing a "squeeze test" of the heel on physical examination. Diagnostic imaging findings include increased sclerosis and fragmentation of the calcaneal apophysis on plain radiograph x-rays. Ice, activity restriction, stretching, nonsteroidal anti-inflammatory drugs, immobilization, and heel cups are all methods that can be utilized in treating the pain caused by Sever's. No long-term effects have been associated with Sever's disease.

School Nurses' Management and Collaborative Practices for Student-Athletes Following Sport-Related Concussion.

The purpose of this study was to examine school nurses' management and collaboration with health-care providers (HCPs) for student-athletes following a concussion. Secondary school nurses accessed an online survey titled the Beliefs, Attitudes, and Knowledge of Pediatric Athletes with Concussions (access rate = 15.6%; n = 1,246/8,000). Approximately 40% of schools where nurses were employed administered baseline and postinjury concussion assessments. No significant differences were found between employment model (single vs. multiple sites) in regard to conducting baseline (p = .908) administration at their site; however, those employed at a single school more frequently offered postinjury assessments at their site than those at multiple sites (p = .019). School nurses most frequently reported relationships with an athletic trainer (38.8%, n = 483/1,246) compared to other HCPs. A concussion management team, including school nurses, and other recommended members should develop comprehensive concussion management plans. Plans should comprise of multiple concussion assessments to aid in the return-to-learn/play processes.

Concussion Symptom Prevalence, Severity and Trajectory: Implications for Nursing Practice.

PURPOSE: The purpose of this study was to describe the symptom severity and trajectory in concussed children who were followed during a one year period at a concussion clinic. DESIGN AND METHODS: A retrospective chart review was completed to describe the symptom trajectory up to three months during the recovery. RESULTS: One hundred and thirty-six patients were included (74 female, 62 male) with a median age of 15.4years (range 13-17). The most common mechanisms of injury included: falls (19.9%), hockey injuries (15.4%), soccer (14.0%) and football injuries (6.6%). Most concussion symptoms decreased in severity or improved over time. Four symptoms including fatigue/low energy, drowsiness, concentration difficulties and irritability had the highest symptoms scores at both 28 and 84days post-injury in patients with persistent symptoms. Emotionality and nervousness/anxiousness and nausea/vomiting scores were seen to increase over time in patients with persistent symptoms. IMPLICATIONS: Clinical use of standardized assessment tools can help caregivers track and monitor concussion symptoms over time. Appropriate management strategies need to be devised for symptoms that are prevalent or increasing over time.

Concussion in sport: the importance of accurate and reliable discharge advice.

Concussion in sport is a common presentation in urgent and emergency care settings, so it is essential that nurses have a full understanding of the condition. Most patients who attend an emergency department with concussion are discharged and discharge advice must be well-informed and evidence based. This article outlines the normal anatomy of the brain and the pathophysiology of concussion, and discusses the guidelines on returning to sport following this injury.

Factors Related to Injury Prevention Programming by Missouri School Nurses.

Schools often offer injury prevention (IP) programs, but little is known about the types of programs provided or how school nurses decide which to choose. Nurses in the Missouri School Health Services Staffing Survey Database were sent a survey in spring, 2011, to describe school-based IP efforts being offered. A multivariate linear regression was conducted to delineate factors associated with offering IP programs. In total, 522 school nurses participated (33% response rate). The highest priority for selecting an IP program was perceived program effectiveness (92.3% agreement, n = 482). Determinants of offering IP programs included being asked to identify a speaker, being a high school, receiving funding in the last year, prioritizing evidence-based programs, perceiving that administrators support professional development, and knowing how to address patterns of injuries. School nurses should be competent in planning, implementing, and evaluating IP programs, and additional training may be required to accomplish this.

The Female Athlete: Key Differences Between Girls and Boys.

Studies have shown female athletes to be subject to different risks than male athletes, even for the same sports and particularly after puberty. The purpose of this article is to identify some of those differences, discuss how treatment for female athletes differs both for healing and prevention, and emphasize key school nurse roles in identifying and responding to female athlete injuries.

Sideline Management of Joint Dislocations.

Athletes can sustain a large variety of injuries from simple soft tissue sprains to complex fractures and joint dislocations. This article reviews and provides the most recent information for sports medicine professionals on the management of simple and complex joint dislocations, i.e., irreducible and/or associated with a fracture, from the sidelines without the benefit of imaging. For each joint, the relevant anatomy, common mechanisms, sideline assessment, reduction techniques, initial treatment, and potential complications will be discussed, which allow for the safe and prompt return of athletes to the field of play.

Arrhythmias in the epilepsy monitoring unit: watching for sudden unexpected death in epilepsy.

Nurses who work with patients at risk for seizures should be informed that both adult and pediatric patients are at risk for sudden unexpected death in epilepsy (SUDEP). Although the exact pathophysiology of SUDEP is not determined, patients with mesial temporal lobe epilepsy represent an at-risk population because of autonomic dysregulation. With prompt treatment, patients with near-SUDEP can continue to lead normal productive lives. This case series presents three patients with near-SUDEP diagnosed with temporal lobe epilepsy.

Managing concussion in the school setting.

Concussion is a significant injury that can occur in physical education, during recreational activities, and during sports. School nurses should be included as an integral member of the concussion management team and assist with education, evaluation, and management of a concussed student. Recent and updated sport-related concussion management recommendations from the National Athletic Trainers' Association Research and Education Foundation as published in the March 2014 Journal of Athletic Training are reviewed to provide an understanding of best practices for concussion management in the school setting.

Sports-related head injuries in students: parents' knowledge, attitudes, and perceptions.

The short- and long-term neurologic impairment of children sustaining sports-related head injuries has recently entered the forefront of medical literature, resulting in new guidelines on concussion management being provided to clinicians, coaches, and trainers. Yet, most parents have not been formally educated on head injuries. The purpose of this article is to share the findings of a study conducted with 235 parents that identified their knowledge, attitudes, and perceptions of sports-related head injuries in school-age students. The study found that 51% of respondents were unaware that head trauma was more serious in children, 80% were uninformed as to whether the school district had a policy on sports-related head injuries, 44% did not know if there were medical guidelines for return to play, and 35% did not know that repeated head trauma could cause dementia. Results of this research implore school nurses to improve patient and parental education when they care for and monitor students with head injuries.

Recognizing and managing concussion in school sport.

Every country around the world enjoys some sort of sport. The Olympics sees countries from all over the globe participate in elite sport, in both winter and summer competitions. Australia is widely known for cricket and rugby; America is known for baseball and gridiron football (among others). These sports are played at an elite level as well as beginners from early ages as young as 4 years in the backyard. Yet, it is also these sports that can deliver a ball at the speed of 100 km/h (football), 105 km/h (baseball), 112 km/h (rugby), 150 km/h (cricket), and 211 km/h (soccer). This is the same force that a car collision can produce. That force eventually finds a target, and in some cases, unfortunately, it is a head. Damage to the brain is not only from the impact of the ball hitting its target but rather also the shearing forces of acceleration-deceleration injury that can cause extensive injuries. There has been much discussion of late regarding concussion in sport and the accumulative effects of head blows resulting in varying degrees of memory loss and dementia later in life. The media have been saturated with heightened awareness of chronic traumatic encephalopathy. This, however, is still being researched. It is true that each concussion compounds the one before, but rather than focus on the injury, managers/coaches and sporting codes should be focusing on the identification and proper management of a suspected concussion and the return-to-play protocols. This is especially important in our schools where growing brains need nurturing. Neuroscience nurses are at the forefront of educating school children, teachers, and coaches through partnering with local schools. This article will focus on concussion recognition and management in school sport.