A football player is brought to the emergency department after a helmet-to-helmet collision without loss of consciousness or signs of external trauma. Which clinical finding warrants immediate intervention?

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11ecbb05_ca91_4047_b433_1d693f401bfc_MD0009_00 Blunt-force trauma to the head is associated with potentially severe complications (eg, brain damage and herniation, retinal detachment, seizures). Prompt recognition of potential complications is essential to prevent irreversible changes to the client's neurological status and level of function. Retinal detachment is a separation of the retina from the posterior wall of the eye that may occur following head trauma. This is an ocular emergency as permanent blindness may result without intervention. Signs of retinal detachment include perception of lightning flashes or floaters and a curtain-like or gnats/hairnet/cobweb effect throughout the visual field (Option A). (Option B) Loss of memory about the accident, or retrograde amnesia, is commonly reported after mild head injuries. The client should be monitored for decreased level of consciousness or alterations in mental status, which may indicate intracranial bleeding. (Option C) Headache is expected after mild head injury, and is not innately concerning except if the pain acutely worsens or is not relieved by over-the-counter analgesics (eg, acetaminophen, ibuprofen). (Option D) A bleeding tongue laceration may occur when the force of the trauma causes the client to accidentally bite the tongue. Oozing blood, although disturbing to the client, does not pose an immediate threat. Educational objective: Retinal detachment is a separation of the retina from the posterior wall of the eye, and may result from blunt-force trauma. If not promptly recognized and treated, permanent blindness may occur. Signs of detachment include lightning flashes or floaters and a curtain-like or gnats/hairnet/cobweb effect throughout the field of vision.

A Football Player Is Brought to the Emergency Department After