Ontario researchers have released what’s believed to be the first comprehensive guide to diagnosing and treating concussions in children and youth.
The recommendations, which are available for free online, were put together by emergency medicine researchers at the Children’s Hospital of Eastern Ontario and the Ontario Neurotrauma Foundation.
They are designed to standardize the diagnosis and management of concussions in children between the ages of 5 and 18, from the initial assessment through to recovery.
Project leader and CHEO scientist Dr. Roger Zemek said there have been recommendations and policies on concussions available in the past, but they tended to focus on sports-related injuries in general.
“We’ve developed a reliable resource that is valuable for everyone affected by pediatric concussion: from children and their families, to health care providers, and to schools and recreational organizations,” Zemek said in a statement announcing the guidelines. “This is so important because children get more concussions than adults do, with increased risk because their brains are still developing.”
Among the tools in the resource:
- A pocket tool to help a coach or parent on the sidelines recognize a concussion and advise them on when to remove a child from play or seek emergency medical attention.
- Algorithms for emergency room doctors to help them decide whether or not to seek CT scans.
- Examples of discharge handouts for families of patients are also provided, as well as recommendations for ongoing symptom management.
- Recommendations for ongoing symptom management for family physicians and nurse practitioners.
- Decision tools on ‘return-to-learn’ and ‘return-to-play.”
- example of policy statement for school boards regarding pediatric concussions.
The researchers say the guidelines, which were developed by a panel of more than 30 experts, also fill a gap, by addressing a child’s reintegration into school and social activities, “both of which are crucial to children and adolescents during their formative years.”
Zemek said the evidence-based recommendations are also adapted to a technology-based society.
“It was fascinating to see how recommendations have changed over time,” he said. “Years ago, children were told to ‘rest’ after a concussion, which means something entirely different today with the onset of technology -- now, rest also includes a break from screen time.”
Rebekah Mannix, assistant professor of Pediatrics at Boston Children’s Hospital said in the statement that the guidelines are “exceedingly clear and comprehensive.”
“I think this will be an indispensable resource for caregivers in a wide range of care settings, and also be accessible for the general public,” Mannix said.
