In this episode, Dr. Marshall reviews the CDC Concussion Guidelines, and offers insights about how to apply them to concussion management and patient care.
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CDC Concussion Guidelines
The Journal of the American Medical Association (JAMA) published the Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children in September.
The recommendations are based on a systematic review of concussion literature from 2012 to 2015, and includes 19 sets of recommendations for the diagnosis, prognosis and management of paediatric concussions – or mild traumatic brain injury (mTBI).
The purpose of the document is to help improve the clinical guidance for licensed healthcare professionals, and ultimately, provide better concussion care.
Key highlights include:
- Healthcare professionals should not obtain x-ray, MRI or CT scans for diagnosing concussions. These are not required to diagnose a concussion; however, may sometimes be used if a healthcare professional suspects a skull fracture or brain bleed.
- Blood and saliva tests have not been proven to work for diagnosing concussions. These should not be used outside of a research or scientific setting.
- Most concussion symptoms in children resolve within one to three months; however, recovery time may vary for a number of reasons such as a history of concussion injuries.
- Children and teenagers with learning difficulties or mental illness (such as anxiety or depression) may require more time to fully recover.
- Healthcare professionals should use a variety of concussion tools and assessments that are based on age and have validated symptom rating scales.
- Rest is no longer considered the best approach to concussion care. Following a short period of rest (up to three days – according to the CDC concussion guidelines), gradual, guided and active treatment and rehabilitation should start under the guidance of a healthcare professional. It’s important to ensure that activity and rehabilitation stays below symptom threshold – or to the point until symptoms do not flare-up.
For more information about the CDC concussion guidelines, check out the full JAMA publication, or listen or watch Dr. Marshall’s summary below. Enjoy!
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 Angela Lumba-Brown, MD; Keith Owen Yeates, PhD; Kelly Sarmiento, MPH; et al. Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children. JAMA Pediatr. Published online September 4, 2018. doi:10.1001/jamapediatrics.2018.2853