School nurses play an important role in the safety of students every day, but efforts in treating and preventing sports and recreational injuries such as concussions often go unnoticed. Concussions are a type of traumatic brain injury (TBI) that can affect the way the brain works. Even when mild and non-life-threatening, they may have serious effects.
Concussions can happen to any student as a result of a fall or coming into contact with another student during play or sports activities. Over an eight-year period, more than 2.5 million children aged 19 and younger were treated for sports-related injuries, and nearly 180,000 of them were TBIs. The majority of these TBIs resulted from activities such as football, soccer, and basketball, as well as unorganized playground activities.
Sometimes, students may suffer a concussion outside of school but come to campus displaying signs that need attention. Regardless of the cause of injury, the United States Centers for Disease Control and Prevention (CDC) recommends that nurses and other school professionals be aware of the ABCs of concussions:
- Assess the situation.
- Be alert for signs and symptoms.
- Contact a healthcare professional.
Assess the Situation
School nurses should ask anyone who was around the student what happened to determine whether there was any sort of blow to the head, or any change in behavior. If the student displays at least one concussion symptom during evaluation, they should receive a medical evaluation.
Be Alert for Signs and Symptoms
Concussions may present with one or more signs or symptoms. For the safety of the student, the school nurse should evaluate any suspected concussion for 30 minutes after the injury occurs to watch for changes in condition. Signs and symptoms include:
- Difficulty thinking
- Pressure/pain in the head
- Drowsiness/more or less sleepy than usual
- Numbness or tingling feeling
- Sensitivity to light
- Generally not feeling “right”
More serious concussions may present with:
- One pupil larger than the other
- Blurred vision
- Slurred speech
- Loss of consciousness/difficulty remaining conscious
Concussions cannot be seen, and many of them present without loss of consciousness. As a result, nurses must know what to look for, with the understanding that some symptoms may not be observed or reported until hours or even days after the injury.
Contact a Healthcare Professional
School nurses who believe a student has a concussion should contact parents and medical professionals right away to ensure the student receives proper and immediate medical care.
Post-Concussion Care
After a student suffers a concussion and has received proper medical treatment, parents, teachers, coaches, and other school employees or caregivers who come in contact with the student must be notified of the condition, to help watch for signs of trouble to ensure the recovery is going smoothly.
Students suffering from a recent concussion should not engage in any physical activity that could lead to another concussion for a few weeks, up to a few months, after the initial injury. A second concussion can not only slow recovery, it can cause serious swelling which can lead to more serious long-term effects, and sometimes death.
Concussion Education and Prevention
School nurses play a key role in concussion education and prevention, as their medical knowledge can help school administrators be aware of what to look for, and make changes to help keep students safe. If a district-wide concussion policy is not in place within the nurse’s local area, the nurse can advocate to implement one.
In addition to taking preventive actions such as helping to create safe sports environments and play areas, nurses can interact directly with students to make sure they are aware of the signs and symptoms, and know when to visit for help, or when to tell a teacher about another student who may be suffering.
School nurses can send home important information about concussions, including their: causes, symptoms, treatment, aftercare, and long-term effects. They can also host on-campus meetings for parents, helping to ensure students are safe both at school and at home.
Children and young adolescents are at risk for more dangerous long-term effects from concussions, as their brains are still developing. Through awareness, education, and prevention, school nurses help to ensure their students’ overall safety.
