In a study looking at concussion discharge instructions in the ED:
Physician documented discussion of concussion discharge instructions occurred in 41%
Printed discharge instructions were given 71% of the time
This was more likely to occur with
Kids > adults
Sport > non-sport related concussions
Appropriate discharge instructions 75%
Cognitive rest recommendations 12%
Referrals to sports concussion specialist 43%
Note referral should generally occur with ongoing symptoms lasting one month or greater.
A 2020 study looked at patients aged 6-18 years diagnosed with concussion on either first or subsequent ED visit.
Those patients with delayed diagnosis required more medical visits during recovery, had a significantly longer time to symptom resolution (21 vs. 11 days), and had a higher likelihood of having persistent concussion symptoms.
Take home: Consider printed concussion discharge instructions in the appropriate ED patients as this has downstream benefits for health and recovery.
References
Lane et al., 2017. Retrospective Chart Analysis of Concussion Discharge Instructions in the Emergency Department.
Upchurch et al., 2015. Discharge instructions for youth sports-related concussions in the emergency department, 2004 to 2012.
Corwin DJ et al. Characteristics and Outcomes for Delayed Diagnosis of Concussion in Pediatric Patients Presenting to the Emergency Department. 2020.
