Concussion management for the adolescent patient: an algorithm for primary-care providers

A sharp increase in the number of diagnosed concussions has been observed for the traditional adultathlete, as well as the young recreational athlete. An enhancing awareness and growing concern has been noted for the potentially larger number of concussions that go undiagnosed and the unknown capability for long-term complications associated with this injury. This increase in concussion awareness has appropriately led to an enhanced utilization of the health-care system for concussion evaluation and management. As is always the case in the practice of medicine, it is important for healthcare providers, from all points of entry in the healthcare system, to provide consistent management for the best outcomes for any disease process. Millions of sport-related concussions occur each year in the United States, placing a large demand on the healthcare system. Utilization of appropriate and congruent treatment plans during the medical discourse when transferring care of patients between providers is paramount. In the co-management model of care, subspecialists lend expertise to assist primary-care providers (PCPs) in gaining the core competencies necessary to provide appropriate levels of care for certain conditions. Increased use of co-management could make the health-care system more efficient and collaborative, leading to: increased access for patients, lower overall costs, and improved quality of care and health outcomes. Co-management allows patients and families to have access to the expert knowledge of subspecialist while receiving more of their care from their PCP, increasing their comfort and making treatment more convenient. The intent of this paper is to distribute an algorithm created by a multidisciplinary group of medical providers to provide a rational approach, congruent with the standard of care, for the primary-care provider to institute an individualized stepwise progression.