Tag Archives: fluids

concussion

True or False: A Person With a Serious Head Injury or Concussion Should Be Kept Awake

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All head injuries should be treated seriously. While most won’t cause lasting effects, if improperly treated, they can lead to long-term disabilities or even death.

The most common type of head injury is a concussion. It is a jarring trauma to the brain that can cause a person to lose consciousness or have amnesia.

What do you do if you are around someone who experiences a serious head injury or concussion? You may have heard that you should not let the person go to sleep, but is this true? Most health professionals don’t think so. It is generally considered safe for people with head injuries or concussions to go to sleep. In some cases, a doctor may recommend waking the person regularly to make sure his or her condition has not worsened.

Evidence for the Health Claim
Many people will go to great lengths to keep a person who has had a head injury from falling asleep. They argue that keeping the person awake will decrease the risk that he or she slips into a coma.

This misunderstanding probably stems from hearing about a rare occurrence known as a lucid interval that has been associated with certain types of severe head injuries. A lucid interval occurs when the initial bleeding in the brain does not cause loss of consciousness. The bleeding eventually worsens and brain structures become compressed. The person’s condition can rapidly deteriorate, requiring emergency brain surgery.

Evidence Against the Health Claim

Most medical professionals say it is fine—sometimes even advised—to let people sleep after incurring a head injury.

The American Academy of Family Physicians states it is not necessary to keep a person awake after a head injury. If a person needs to be watched that closely, a doctor will most likely admit him or her to the hospital. The Dartmouth College of Sports Medicine advises that it is fine to go to sleep after a concussion so long as someone wakes you up every two hours. They are to check to make sure you can be easily awakened and aren’t displaying symptoms of a worsening condition.

In a study in the September-October 2005 issue of the Journal of Head Trauma Rehabilitation, researchers reported greater levels of fatigue in people who have had head injuries, compared with those who have not. The researchers concluded that regular rest breaks and increasing intervals of restful sleep should be a part of the rehabilitation from head injury.

neon concussion

Conclusion
If you are around someone who has a head injury or possible concussion, monitor the symptoms closely. It is important to call a doctor or go to a hospital immediately if the person has worrisome symptoms such as:
• Open wound in the scalp or misshapen deformity of the skull
• Severe or progressive worsening headache
• Changes in behavior (eg, confusion, restlessness, irritability, lethargy)
• Dilated pupils or pupils of different sizes
• Convulsions or seizures
• Difficulty waking from sleep
• Trouble walking or speaking
• Bleeding or drainage of fluids from nose or ears
• Unusual sleepiness or decreasing alertness
• Severe or persistent nausea, or vomiting more than twice
• Weakness or numbness in the arms or legs

When a head injury is serious enough to require medical care, a doctor will give you instructions on how to monitor and treat the injury once the person is released from the hospital or clinic. These instructions will generally not include keeping the person awake and alert.

by Krisha McCoy, MS

More PTandMe articles about concussions can be found here:

concussion physical therapy   concussion treatment

   

REFERENCES:
Head injuries. KidsHealth.org website. Available at: http://www.kidshealth.org/parent/firstaid_safe/emergencies/head_injury.html. Accessed November 5, 2008.

Head injuries: what to watch for afterward. Familydoctor.org website. Available at: http://familydoctor.org/084.xml. November 5, 2008.

Head injury: concussion. Dartmouth College of Sports Medicine website. Available at: http://www.dartmouth.edu/~sportmed/concussion.html. November 5, 2008.

Radiology for traumatic brain injury. Trauma.org website. Available at:http://www.trauma.org/neuro/neuroradiology.html. Accessed July 23, 2006.

Subjective reports of fatigue during early recovery from traumatic brain injury. Journal of Head Trauma Rehabilitation. 2005;20:416-425.

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dehydration

Hydration: What, When and How Much

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FLUID INTAKE IS ESSENTIAL TO GOOD HEALTH.

Water is needed to regulate your temperature, maintain joint health and to deliver essential vitamins and minerals. Dehydration leads to impaired nerve and muscle function due to the imbalance of sodium and potassium within the body. Brain and muscle function become impaired causing decreased muscle coordination and impaired athletic performance.

Early signs and symptoms of dehydration include headaches, dry mouth, chills, dry skin, excessive thirst, and fatigue. The color of ones urine is a good indicator of proper hydration. Improper hydration will cause your urine to become a dark yellow. Signs of worsening dehydration are increased body temperature, heart rate and body temperature. If you become confused, have vision disturbances and difficulty breathing seek immediate medical attention.

Your risk of dehydration increases when you sweat excessively, increase your exercise intensity and duration, when the temperature is high and at high altitudes.

The American Council on Fitness suggests these guidelines for moderate to high intensity exercise:
• Drink 17-20 ounces of water two to three hours before the start of exercise.
• Drink 8 ounces of fluid 20 to 30 minutes prior to exercise or during warm-up.
• Drink 7-10 ounces of fluid every 10 to 20 minutes during exercise.
• Drink an additional 8 ounces of fluid within 30 minutes after exercising.
• Drink 16-24 ounces of fluid for every pound of body weight lost after exercise.

WOW THAT IS A LOT!

But it shows us how much fluid we can lose during higher levels of exercise and why it is so important to stay hydrated. It is very important to drink water before, during and after practices and games especially in the warmer months.

Many sports teams will weigh the athletes before and after practice to determine the amount of fluid lost. The recommended weight loss limit due to fluid loss is 2% of your own body weight per day. It is recommended that you drink 16-24 ounces of water for every pound lost.

water bottle

ARE SPORTS DRINKS BETTER THAN WATER?

Definitely in taste but nothing hydrates the body better than water. Sports drinks do provide more potassium, minerals and other electrolytes which will help you sustain your performance during exercise and may help you recover quicker especially in workouts over one hour in duration. The biggest problem with sports drinks is the sugar content. Many of them have multiple servings per bottle. Glucose is essential but you do not need as much as you will find in most sports drinks. I recommend a combination of water and a low sugar sports drink. Research also indicates that chocolate milk may help the athlete recover more quickly when consumed after exercise due to its carbohydrate and protein content.

You should consult your pediatrician or family physician if you feel that you or your child has problems with dehydration.

This information was written by Sport and Spine Physical Therapy and Rehab, an outpatient physical therapy group located in Saginaw Valley, Michigan. At Sport and Spine Physical Therapy and Rehab, their physical therapy clinics use progressive techniques and technologies to stay on the forefront in their field. Their licensed physical and occupational therapists are committed to providing patients with advanced healing techniques. For more information click here.