Over 630,000 children visit the ED every year with a diagnosis of concussion
Predictors of persistent post-concussive symptoms (PPCS):
female sex
age over 13 years
previous concussive symptoms lasting over 1 week
headache
sensistivity to noise
fatigue
slow response to questions.
Appromixately 1/3 of pediatric patients will have PPCS lasting over 2 weeks
Likelihood of PPCS increases to >50% in those with risk factors identified in the ED
Every state has a youth concussion law. The basic tenants are a) immediate removal from play b) written clearance from health professional to return to play c) education for athlete, parents, coaches.
References
Babcock, L, Kurowski, BG. Identifying childeren and adolescents at risk for persistent postconcussion symptoms. JAMA. 2016. 315(10): 987-988.
Kruse AJ, Nugent, AS, Peterson AR. Using sideline concussion tests in the emergency department. Open Access EM. 2018(10): 113-121.
Tarimala, A, Singichetti, B. Initial emergency department visit and follow-up care for concussions among children with Medicaid. J. of Pediatrics. 2018(206): 178-183.
