It is a functional rather than structural injury that results from shear stress to brain tissue caused by rotational or angular forces—direct impact to the head is not required. Initial evaluation involves eliminating cervical spine injury and serious traumatic brain injury. Headache is the most common symptom of concussion, although a variety of clinical domains (e. Signs and symptoms are nonspecific; therefore, a temporal relationship between an appropriate mechanism of injury and symptoms must be determined. There are numerous assessment tools to aid diagnosis, including symptom checklists, neuropsychological tests, postural stability tests, and sideline assessment tools. These tools are also used to monitor recovery. Cognitive and physical rest are the cornerstones of initial management. There are no specific treatments for concussion; therefore, focus is on managing symptoms and return to play. Because concussion recovery is variable, rigid classification systems have mostly been abandoned in favor of an individualized approach. A graded return- to- play protocol can be implemented once a patient has recovered in all affected domains. Children, adolescents, and those with a history of concussions may require a longer recovery period. There is limited research on the management of concussions in children and adolescents, but concern for potential consequences of injury to the developing brain suggests that a more conservative approach to management is appropriate in these patients. SCORZA, MD, MBA, Fort Belvoir Community Hospital, Fort Belvoir, Virginia About NGC Guideline Summaries. NGC's guidelines summaries contain information systematically derived from original guidelines. Choa.org/concussion glasgow coma scale the glasgow coma scale, or gcs, is a score of a patient's state of consciousness or coma. Pediatric Transport Cheat Sheet.pdf. This PDF book incorporate pediatric dosing cheat sheet. Current Concepts in Concussion. SAC, BESS, and Glasgow Coma Scale);. Brain Injury in Children and Youth. TBIs in the United States occur in the pediatric population (ages. Neurologic and Neurosurgical Emergencies in the ICUEmergencies in the ICU. Adult and Pediatric Glasgow coma scale. O'CONNOR, MD, MPH, Uniformed Services University of the Health Sciences, Bethesda, Maryland The Pediatric Glasgow Coma Scale (GCS) and the Pediatric Trauma Scale (PTS) meet these criteria. Glasgow Coma Scale <14. Statewide Trauma Field Triage Criteria and Point of Entry Plan for Adult and Pediatric Patients Early notification of the receiving. EMRA Critical Medications Reference Cards Joshua Glick, MD;. EMRA Pediatric Qwic Card. Cognitive and physical rest are the cornerstones of initial management. There are no specific treatments for concussion; therefore, focus is on managing symptoms and return to play. Because concussion recovery is variable, rigid classification systems have mostly been abandoned in favor of an individualized approach. A graded return- to- play protocol can be implemented once a patient has recovered in all affected domains. Children, adolescents, and those with a history of concussions may require a longer recovery period. There is limited research on the management of concussions in children and adolescents, but concern for potential consequences of injury to the developing brain suggests that a more conservative approach to management is appropriate in these patients. Consequently, management of concussions has changed significantly. Concussion can be difficult to recognize, complicated by the lack of a universal definition. Additionally, there are no direct objective measures for diagnosis or recovery, no treatments with well- documented effectiveness,
Factors predictive of recovery are poorly defined. Traditional markers (i. Studies have demonstrated that brief loss of consciousness is not associated with prolonged recovery,
Written tests are labor- intensive and require trained administrators, whereas computer- based tests allow for rapid administration to multiple patients simultaneously.
With concussion, neurologic findings are normal other than mental status and balance deficits; however, subtle changes from a concussion are not identifiable through standard orientation questions or traditional balance testing.
Athletes should not return to play until they are completely recovered from the concussion and free of medications that may mask the symptoms of the concussion.
Evidence regarding pharmacologic therapy is limited. Treatment focuses on symptom management, including the same medications appropriate in patients without a concussion.
Little is known about concussions in children; therefore, conservative management is appropriate (e. Educational and clinical management tools are available at
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