Faced with more and more kids coming to emergency rooms for treatment of concussions, the U.S. Centers for Disease Control and Prevention has issued its first-ever guidance on how to deal with the condition in young patients.
Investigative reporting on the long-term danger of head injury in sports, especially football and hockey, has spurred change within sports as well as the medical world. Georgia in 2013 passed a law pushed by the National Football League and the Atlanta Falcons that requires any student with a concussion to be removed from the field until a doctor says it's safe.
Scientists are a long way from knowing exactly what head hits may be related down the road to chronic traumatic encephalopathy, the dangerous degenerative brain disease. Some are even concerned that the focus on concussion will divert attention from the smaller hits that may add up to triggering CTE.
But the CDC’s report was a place to start and one caregivers wanted to see.
“We have heard from health care providers that they want and need consistent, current and evidence-based guidance for diagnosing and managing mTBI (concussion),” said Dr. Deb Houry, the director of the CDC’s National Center for Injury Prevention and Control. “More than 800,000 children seek care for (traumatic brain injury) in U.S. emergency departments each year, and until today, there was no evidence-based guideline in the United States on pediatric mTBI — inclusive of all causes,” she said.
The documentation the CDC put together is also meant to be helpful for coaches and schools, the authors said. Some of the agency's advice:
- Do not routinely image pediatric patients to diagnose mTBI.
- There may be such a thing as too much rest. "Counsel patients and their parents/caregivers to return gradually to nonsports activities after no more than a 2-3 days of rest," the CDC says.
- Provide patients and their parents/caregivers with instructions on returning to activity customized to their symptoms.
- Adult diagnostic symptom scales may not work well for kids. Use validated, age-appropriate ones.
- Assess for risk factors for prolonged recovery, including history of mTBI or other brain injury, severe symptom presentation immediately after the injury, and personal characteristics and family history (such as learning difficulties and family and social stressors).
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