Concussion management by paediatricians: A national survey of Canadian paediatricians. (March 2014)

• Record Type: Journal Article
• Authors: Gordon, Kevin E.; Do, Minh T.; Thompson, Wendy; McFaull, Steven
• Is Part Of: Brain injury. Volume 28:Number 3(2014)
• Page Start: 311
• Page End: 317
• Publication Date: 2014-03
• Subjects: Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.3109/02699052.2013.862740
• Languages: English
• ISSNs: 0269-9052

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective</italic>: To assess the use of concussion/mild traumatic brain injury (mTBI) guidelines, criteria used in the initiation of return-to-play (RTP) and management of RTP for brain injured children and youth by Canadian paediatricians.</p> <p> <italic>Methods</italic>: A cross-sectional survey was mailed through the Canadian Paediatric Surveillance Program to ∼2600 paediatric specialists and sub-specialists.</p> <p> <italic>Results</italic>: Of 809 respondents (31%), 503 encountered newly diagnosed paediatric concussion/mTBI within the past 12 months, reporting ∼6900 cases. Of the respondents, 96.7% (95% CI = 94.7–98.6%) reported using one or more of the presented concussion/mTBI guidelines in the management of their patients. The most frequently reported criteria (>50%) used to determine asymptomatic status were: free from all concussion symptoms, by patient report (92%), by proxy report (76%), normal physical examination (65%), in school full-time, with usual school performance (53%). Most respondents (84.9%) did not initiate RTP immediately after their patients became asymptomatic. The median time waiting before initiating RTP was 7 days. The median duration of the RTP sequence was 7 days, with considerable variation reported.</p> <p> <italic>Conclusions</italic>: Canadian paediatricians frequently encounter patients with concussion/mTBI. Their concussion/mTBI care appears to be consistent with current guidelines, but also shows practice variation, particularly when current guidelines become less proscriptive.</p> </abstract>